# Certificate of Casualty Facultative Reinsurance

**Issued by Security Insurance Company of Hartford**

**Security Reinsurance Underwriters, Inc.**

**Sru, Inc. In New York**
127 John Street
New York, New York 10038

**Declarations**

**National Union Fire Insurance Company**
c/o National Facultative Services, Inc.
5 Marineview Plaza
Hoboken, New Jersey 07030

Attn: Leon F. Gonzalez

**Name of Insured:** International Business Machine Corp.
**City and State:** Armonk, New York

**Co. Policy No.:** 991 0310
**Co. Policy Period:** 5/21/80 - 5/21/81
**Reinsurance Certif. Period:** 5/21/80 - 5/21/81
**Prior Certificate No.:** New

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

**Item 2: Policy Limits and Application**  
$15,000,000 CSL ea. occ./$15,000,000 agg. part of $40,000,000 CSL ea. occ./$40,000,000 agg. in excess of $40,000,000 CSL ea. occ./$40,000,000 agg. in excess of primary

**Item 3: Company Retention**  
93.3%

**Item 4: Reinsurance Accepted**  
6.6%

**Item 5: Basis of Acceptance**  
- Excess of Loss (unchecked)
- Contributing Excess (checked)

**Reinsurers Premium for this Certificate Shall Be:** $1,600.00
- Net Premium (unchecked)
- Gross Premium Less 25% Commission (checked)
- Fixed Charge (unchecked)
- Deposit Premium (unchecked)

**This Premium Shall Be Adjusted Annually At:**

- Rate
- Base
- Estimated Exposure
- Reinsurer's Est. Annual Prem.
- Minimum Prem. For Reins. Period

**A. Per $1000 of Receipts**
**B. Other**

**Date:** October 17, 1980
**By:** [Signature]

**Authorized Representative**

**Please Give Special Notice of This Facultative Reinsurance to Your Claim Department**

**Original**