IT IS AGREED THAT THE COMPANY POLICY NUMBER IS AMENDED TO READ: 991 03 10

This endorsement forms a part of and is for attachment to the following described certificate of reinsurance issued by the company designated therein, takes effect on the effective date of said certificate of reinsurance unless another effective date is shown below, at the hour stated in said certificate of reinsurance and expires concurrently with the said certificate of reinsurance.

| Must Be Completed | Complete Only When This Endorsement Is Not Prepared With The Certificate Of Reinsurance Or Is Not To Be Effective With The Certificate Of Reinsurance |
| --- | --- |
| ENDT. NO. | ISSUED TO: R/I NATIONAL UNION FIRE INSURANCE CO. AND AMERICAN HOME ASSURANCE COMPANY |
| CERTIFICATE NO. | EFFECTIVE DATE OF THIS ENDORSEMENT: 5/21/80 |
| 1 | A/C INTERNATIONAL BUSINESS MACHINES |

INSURANCE FROM CNA

SAK 10/9/80
Blank Endorsement
C-17093-A

Countersigned by E. T. KELLEY Authorized Representative