**Policy Number:** KA 0000484  
**Effective Date:** 5-21-95  

**Named Insured and Address:** INTERNATIONAL BUSINESS MACHINES CORP.  
OLD ORCHARD ROAD  
ARMONK, NEW YORK 10504  

**Endt. No.:** 14  

**THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY**

This endorsement modifies insurance provided under the following:
Excess Liability

**Return Premium:** $9,450  

In consideration of a Return Premium shown above, it is agreed that Item 3 as respect Deposit Premium shall be amended to read as follows:

**Deposit Premium:** $44,550  

**NOTICE:**
THESE POLICY FORMS AND THE ATTACHED RATES ARE EXEMPT FROM THE FIELD REGULATIONS OF THE NEW YORK STATE INSURANCE DEPARTMENT. HOWEVER, SUCH FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.

**First State Management Group**
**Authorized**

This endorsement does not change the policy except as shown.
4-24-96/FS

Form L-5040-0 (Ed. 4-86) Printed In U.S.A. (NS)