**POLICY NO:** 8448300  
**EFFECTIVE DATE:** DEC. 31, 1963  
**AGENCY NO:** 50-515  
**ADD'L PREMIUM:** $  
**RETURN PREMIUM:** $  

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

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. PREM. |
|-------------------|-----------------|------------|
| 610,000,000       | B. I. .21422    | 130,670.45 |
|                   | P. D. .04565    | 27,847.16  |
|                   |                 | .25987     | 158,517.61 |
| INCL. PREM.DISC.  |                 |            | 134,200.00 |

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

**Countersigned:**  
**Vital Nigro**  
**Duly Authorized Agent**  
**BY:**  
**ATTORNEY-IN-FACT**

**Form 116-G**  
**100 W 10-62**  
**100 DM**  

**JOHNSON & HIGGINS**  
**MC:LO**

**United States Manager (Zurich)**  
**President (American Guarantee)**

**Secretary (American Guarantee)**

**Z 006865**