**POLICY NO:** 0506175  
**EFFECTIVE DATE:** DEC. 31, 1965  
**AGENCY NO.:** 50-515  
**ADD'L. PREMIUM:** $  
**RETURN PREMIUM:** $  

**Named Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION

This endorsement is issued by that company named below which is the insurer under the policy designated above issued to the Named Insured and forms a part of said policy as of the effective date hereof at the hour stated in the policy Declarations.

**PREMIUM COMPUTATION ENDORSEMENT**

THE PREMIUM FOR SUCH INSURANCE AS IS AFFORDED BY THE POLICY SHALL BE COMPUTED BY APPLYING TO EACH $1,000 OF WORKMEN'S COMPENSATION PAYROLL, THE COMPOSITE RATE ESTABLISHED FOR THE POLICY.

| EST. ANN. PAYROLL | COMPOSITE RATES | EST. PREMIUM |
|------------------|----------------|--------------|
| 1,070,000,000    | .17018         | $182,093.00  |

JOHNSON & HIGGINS  
NLS:BW

ZURICH INSURANCE COMPANY  
AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY

Countersigned:

Form 116-G

United States Manager (Zurich)  
President (American Guarantees)

Secretary (American Guarantees)

Z 006943