**Canadian Declarations**

**Canadian Agent and Location:**
- **Johnson & Higgins, Willis Faber Ltd.**
- **Place Victoria, Suite 2300**
- **505 Montreal, Canada**

**No.: XCF 3929**

**1. Named Insured:**
- **International Business Machines Corp., et al.**
- **Address:** Armonk, New York 10504

**Business of the Named Insured:**
- **Manufacture of business machines**

**2. Policy Period:**
- **From:** 5/21/73
- **To:** 5/21/76

**3. Premium Computation: Description of Property, Coverages, Including Limits of Liability**

| MAJOR PERIL OR LINE | PREMIUMS |
|---------------------|----------|
| Certificate of excess insurance | $259.00 prepaid for 3 years |
| $5,000,000 Quota share part of $20,000,000 excess of primary and $80,000,000 intervening excess |

**Signatures:**
- **Secretary:** [Signature]
- **Charles K. Co.**: [Signature]

**C-18734 PTD. IN U.S.A. (SM 3/70)**