**THE UNITY FIRE AND GENERAL INSURANCE COMPANY**
- ☐ THE GENERAL SECURITY ASSURANCE CORPORATION OF NEW YORK

127 JOHN STREET
NEW YORK, N.Y. 10038

**National Facultative Services**
5 Marineview Plaza
Hoboken, NJ 07030
ATTENTION: Mr. Lee Gonzalez

**DESCRIPTION/CHANGE**
A-1025
1
5/21/80   5/21/81
991 03 10

**REINSURER**
National Union Fire Insurance Co.
**Ceding Company**
National Facultative Services
**ADDRESS OF INSURED**
International Business Machines Corp., etal
Armonk, NY

**DESCRIPTION/CHANGE**
It is agreed that:
1) The following Company Policy Number is added: CE-364 0492 (Canadian Policy)
2) The following Ceding Company is added: American Home Assurance Co. (Canadian Policy)

**ADDITIONAL PREMIUM** ☐
**(RETURN PREMIUM)** ☐

**AT INCEPTION**
S | S | % | S
S | S | % | S
S | S | % | S
TOTALS | S | S | S

**ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED**

IN WITNESS WHEREOF THE REINSURER DESIGNATED ABOVE HAS CAUSED THIS ENDORSEMENT TO BE SIGNED BY ITS PRESIDENT AND SECRETARY AND IT SHALL BECOME VALID AND BINDING WHEN SIGNED BY A DULY AUTHORIZED REPRESENTATIVE OR CHIEF AGENT.

**James T. Dunne**
SECRETARY
RAK
11/6/80
DATE

**Robert A. Nathan**
PRESIDENT?
AUTHORIZED REPRESENTATIVE
OR CHIEF AGENT
CFD 1001