**1/20/LT/BH**
JOHNSON & HIGGINS
25-2719

**A/P $100.00 ENDT #5**
THE HARTFORD

**Named Insured and Address**
INTERNATIONAL BUSINESS MACHINES CORP.
ARMONK, NY

**Policy Number**
10 XS 100917

This endorsement forms a part of the policy as numbered above, issued by THE HARTFORD INSURANCE GROUP company designated therein, and takes effect as of the effective date of said policy unless another is herein.

Effective hour is the same as stated in the Declarations of the policy.

**IT IS AGREED AS RESPECTS #3 PREMIUM BE AMENDED TO READ:**

$3,250.00 A/P OF $100.00

Nothing herein contained shall be held to vary, waive, alter, or extend any of the terms, conditions, agreements or declarations of the policy, other than as herein stated.

This endorsement shall not be binding unless countersigned by a duly authorized agent of the company; provided that if this endorsement takes effect as of the effective date of the policy and, at issue of said policy, forms a part thereof, countersignature on the declarations page of said policy by a duly authorized agent of the company shall constitute valid countersignature of this endorsement. The company located these documents in its system and does not certify that these documents constitute a complete and accurate copy of the policy.

Form Q-2240-3 B Printed in U.S.A.

Countersigned by: ___________________________ Authorized Agent