# Certificate of Casualty Facultative Reinsurance

**Issued by:**
Cologne Reinsurance Company of America
Stamford, Connecticut 06902
*an affiliate of the world's oldest reinsurance company*

**Certificate No.:** A 0000179
**Renews/Replaces:**

**Intermediary and Address:**
National Facultative Services, Inc.
5 Marineview Plaza
Hoboken, New Jersey 07030
Attention: Mr. Leon F. Gonzalez
International Business Machine Corp.

**Name of Insured:**
Armonk, N.Y.

**Ceding Company and Address:**
National Union/American Home
New York, N.Y.

**Ceding Company Policy No.:** 991-03-10 U.S.
**Ceding Company Policy Period:** From May 21, 1980 To May 21, 1981

**Reinsurers Certificate Period:** From May 21, 1980 To May 21, 1981

**Item 1: Type of Insurance**
Excess Umbrella Liability

**Item 2: Policy Limits and Application**
- $15,000,000 CSL ea.occ
- $15,000,000 agg. w.a. part of
- $40,000,000 CSL ea. occ.
- $40,000,000 agg. w.a. in excess of
- $40,000,000 CSL ea.occ
- $40,000,000 agg. w.a. in excess of underlying insurance

**Item 3: Company Retention**
70% of the limits as stated in Item 2

**Item 4: Reinsurance Accepted**
5% of the limits as stated in Item 2

**Item 5: Basis of Acceptance**
- Contributing Excess (X)

**The Reinsurers Premium for this Certificate shall be payable as follows:**
- $1,161.00 US
- $39.00 Canadian
- Flat (X)
- Adjustable as follows:

**Total:** $1,200.00

**Countersigned at:** Stamford, Ct.
**This 9th Day of October 1980**

**Cologne Reinsurance Company of America**
By: [Authorized Signature]

**Please give special notice of this facultative reinsurance to your claim department**

CRA FI 11/79