# Premium Discount Endorsement - North Carolina

**POLICY NO:** 8506175  
**AFFECTIVE DATE:** DEC. 31, 1965  

**Named Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION, ETAL

This endorsement is issued by the 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.

It is agreed that the premium pertaining to North Carolina for Liability, Medical Payments and Elevator Collision insurance is subject to discount in accordance with the following procedure:

1. **North Carolina Standard Premium:** Such premium pertaining to North Carolina computed in accordance with the provisions of the policies designated in paragraph 3 hereof, other than this endorsement and exclusive of the application of any retrospective rating plan, and exclusive of any premium under an Automobile Liability Policy applicable to any vehicle required to be insured classified as "Livery", "Buses", or "Long Haul Truckmen", shall be known as the North Carolina Standard Premium.
2. **Total Standard Premium for All States:** The Liability, Medical Payments and Elevator Collision premium computed in accordance with the provisions of the policies designated in paragraph 3 hereof, other than this endorsement and exclusive of the application of any retrospective rating plan, any Automatic Premium Adjustment Endorsement, and Premium Return Plan Endorsement, or other Premium Discount Endorsement, shall be known as the Total Standard Premium.
3. **Policy Numbers:** Estimated Annual Standard Premium  
   8506175 | 220,092.39

**Total:** 220,092.39

### 4. Premium Discount - North Carolina

(a) The initial premium discount percentages applicable to North Carolina Standard Premium is as follows:
- General Liability: 10.2%
- Automobile Liability (excluding Livery, Buses and Long Haul Truckmen): 10.2%
- Other Automobile Liability: 10.2%

The final premium discount percentage applicable to North Carolina Standard Premium shall be subject to paragraphs (b), (c) and (d) following.

(b) For policy periods of one year or less – The North Carolina Standard Premium, exclusive of any premium subject to any retrospective rating plan, shall be subject to the applicable discount percentage for the Total Standard Premium obtained from the Table of "North Carolina Premium Discounts".

(c) For policy periods of more than one year – The North Carolina Standard Premium, exclusive of any premium subject to any retrospective rating plan, shall be subject to the applicable discount percentage stated in said Table of "North Carolina Premium Discounts" opposite the average annual total standard premium for the policies which shall be determined by dividing the Total Standard Premium for the policy period by the term of said policies in years and fractions thereof.

(d) If retrospective rating is applicable to a part of the premium pertaining to North Carolina, the amount of premium discount applicable to the North Carolina Standard Premium, exclusive of any premium subject to retrospective rating, shall be the difference between (1) the discount determined by applying to the North Carolina Standard Premium the applicable percentages stated in said Table opposite the Total Standard Premium and (2) the discount determined by applying to that portion of the North Carolina Standard Premium which is subject to retrospective rating the applicable percentages stated in said Table opposite so much of the Total Standard Premium as is subject to retrospective rating.

(Continued on reverse side)

**ZURICH INSURANCE COMPANY**  
**AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY**

**Countersigned:**  
**Fully authorized agent:**  
**Form 4026-1-E (N.C.)**  
**RS:BW**

**JOHNSON & HIGGINS**
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This document outlines the premium discount structure for a policy covering liability, medical payments, and elevator collision insurance in North Carolina, specifying the calculation methods and discount percentages applicable to the North Carolina Standard Premium.