**REINSURANCE LAYOFF SHEET**

- **ASSURED:** J.B.M.
- **TYPE OF COVERAGE:** X/3 Umb.
- **POLICY NUMBER:** 9910319
- **EFF. DATE OF REINSURANCE:** 5/21/80
- **POLICY LIMIT:** $18,000,000
- **UNDERLYING LAYER:** am *p.*
- **POLICY PREMIUM:** $198,832.50
- **POLICY PERIOD:** FROM: 5/21/80 TO: 5/21/81

**I. PARTICIPATING/QUOTA SHARE**
- **LIMITS:** 8m + 2m *x U.L.*
- **PREMIUM:** $69,484.50

| REINSURER | REINSURANCE BROKER/DIRECT | PERCENT OF PARTICIP. | % OF CHANGE | TOTAL COMM. TO COMPANY | CLOSING CERT NUMBER | Ceded Premium Annual | Ceded Premium Pro-Rata |
|-----------|--------------------------|----------------------|-------------|------------------------|---------------------|-----------------------|-------------------------|
| Nat'l Union | -                        | -                    | -          | -                      | 4/122                | -                     | -                       |
| Sterling Global | Math Fac. Law. | .125 | 25% | 25% | 26,560 | 26,560 | 26,560 |
| CNA | -                        | -                    | -          | -                      | 20,564               | 20,564                | 20,564                  |
| Nat'l Fac. | -                        | -                    | -          | -                      | 15,420               | 15,420                | 15,420                  |
| Amer Cent | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| Money | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| Reck | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| Mission | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| Freemont | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| Mead | -                        | -                    | -          | -                      | 5,140                | 5,140                 | 5,140                   |
| Unity Fire | -                        | -                    | -          | -                      | 10,380               | 10,380                | 10,380                  |
| **+** | -                        | -                    | -          | -                      | 123,362              | 123,362               | 123,362                 |

**II. EXCESS OF LOSS OR SECTION II CASUALTY**
- **LIMITS:** 5m P/10 21m + 195
- **PREMIUM:** $14,127

| REINSURER | REINSURANCE BROKER/DIRECT | PERCENT OF PARTICIP. | % OF CHANGE | TOTAL COMM. TO COMPANY | CLOSING CERT NUMBER | Ceded Premium Annual | Ceded Premium Pro-Rata |
|-----------|--------------------------|----------------------|-------------|------------------------|---------------------|-----------------------|-------------------------|
| Nat'l Union | Math Fac. Law. | .50% | 25% | 25% | 5,564 | 5,564 | 5,564 |
| CNA | Math Fac. Law. | .30% | 25% | 25% | 3,338 | 3,338 | 3,338 |
| Mission | -                        | -                    | -          | -                      | 2,225               | 2,225                 | 2,225                   |

**III. LIMITS:**

**AUTOMATIC EXCESS TREATY REINSURANCE**

**REMARKS:** N.Y.-01
**BRANCH:** N.Y.
**UNDERWRITER:** J.S. Bagnasco
**DATE:** 12/1/80

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