**INA REINSURANCE COMPANY**

1600 ARCH STREET, PHILADELPHIA, PENNSYLVANIA 19101

**DECLARATIONS**

In consideration of the payment of the premium and subject to the terms hereon and the general conditions set forth on the reverse side hereof, does hereby reinsure,

Coding Company Name and Address (herein called The Company):

National Union Fire Insurance Co. of Pittsburgh, Pa.
c/o National Facultative Services, Inc.
5 Marineview Plaza
Hoboken, New Jersey 07030

ATTENTION: Mr. Leon Gonzalez

International Business Machine Corporation, et al.

Armonk, New York 10504
991 03 10 May 21, 1980 May 21, 1981 May 21, 1980 May 21, 1981

**PLEASE MAIL ALL CORRESPONDENCE TO N.Y. BRANCH OFFICE**

**CASUALTY FACULTATIVE REINSURANCE**

**Excess Umbrella Liability**

$5,000,000 CSL each occ.-agg. where applicable part of $21,000,000 CSL each occ.-agg., excess of $19,000,000 CSL each occ.-agg. which is excess of underlying insurance or SIR.

$3,500,000 CSL each occ.-agg. part of $5,000,000 CSL each occ.-agg., subject to other reinsurance.

$1,500,000 CSL each occ.-agg. part of $5,000,000 CSL each occ.-agg.

**DUE DATE** | **AMOUNT** | **COMM. RATE** | **FREQUENCY** | **PREMIUM BASIS** | **EST. EXPOSURE** | **RATE** | **PER** | **MINIMUM PREMIUM OR REINSURANCE PERIOD**
--- | --- | --- | --- | --- | --- | --- | --- | ---
5/21/80 | $3338.10 | 25% | PREMIUM BASIS | EST. EXPOSURE | RATE | PER | $3338.10

THE PREMIUM AND LOSS SHALL BE PAYABLE IN CURRENCY INDICATED X USA CAN OTHER

COUNTERSIGNED AT New York Branch THE 19th DAY OF September 1980
MYC/dr 127 John Street New York, NY 10038
By Authorized Representative

PLEASE GIVE SPECIAL NOTICE OF THIS FACULTATIVE REINSURANCE TO YOUR CLAIM DEPARTMENT