**REINSURANCE LAYOFF SHEET**

- **ASSURED:** J.B.M.
- **POLICY NUMBER:** 9910310
- **EFF. DATE OF REINSURANCE:** 5/21/80
- **POLICY LIMIT:** 18,000,000
- **UNDERLYING LAYER:** 2M
- **POLICY PREMIUM:** $199,832.50
- **POLICY PERIOD:** FROM: 5/21/80 TO: 5/24/81

**I PARTICIPATING/QUOTA SHARE**

| LIMITS: | 15m | 140 | 40m | 40m |
| --- | --- | --- | --- | --- |
| REINSURER | NET | 64,966 | 7,742 | 3,433 | 1,547 | 1,547 | 1,161 | 773 |
| TREATY NO. | Met. Re. | Int'l Ins. | .3334 | 35% | 7,742 | 3,433 | 1,547 | 1,547 | 1,161 | 773 |

**II EXCESS OF LOSS OR SECTION II CASUALTY**

| LIMITS: | PREMIUM |
| --- | --- |
| REINSURER | REINSURANCE BROKER/DIRECT | PERCENT OF PARTICIP. | % OF CHANGE + | TOTAL COMM. TO COMPANY | CLOSING CERT. NUMBER | CEDED PREMIUM ANNUAL | PRO-RATA |
| --- | --- | --- | --- | --- | --- | --- | --- |

**III EXCESS OF LOSS OR SECTION II CASUALTY**

| LIMITS: | PREMIUM |
| --- | --- |
| REINSURER | REINSURANCE BROKER/DIRECT | PERCENT OF PARTICIP. | % OF CHANGE + | TOTAL COMM. TO COMPANY | CLOSING CERT. NUMBER | CEDED PREMIUM ANNUAL | PRO-RATA |
| --- | --- | --- | --- | --- | --- | --- | --- |

**AUTOMATIC**

- **EXCESS TREATY REINSURANCE:**

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