# ENDORSEMENT

**Additional Premium:** _______

**Return Premium:** _______

**Effective on and after:** 11-5-70

**12:01 AM Standard Time**

**this endorsement forms part of policy No:** DCL 441 14 43

**Expiration Date:** 11-5-73

**Issued to:** INTERNATIONAL BUSINESS MACHINESCORP

**By:** UNITED STATES FIRE INSURANCE COMPANY

**PREMIUM ALLOCATION ENDORSEMENT**

**UNITED STATES OF AMERICA:** $5,143.69

**CANADA:** 1,556.35

**$50,000.00**

**All other terms and conditions of this policy remain unchanged.**

**Authorized Representative:** [Signature]