# Zurich Insurance Company Endorsement

**Policy No:** 0026230  
**Eff. Date of Pol.:** 1-1-76  
**Eff. Date of End:** 1-1-76  
**Agency No.:**  
**Add'l Premium:** $8  
**Return Premium:** $5  

## Named Insured

This endorsement is issued by the company named below, which is the insurer under the policy designated above, to the Named Insured and forms a part of said policy as of the effective date hereof, at the hour stated in the policy Declarations.

## Coverage

IT IS AGREED THAT THE PREMISES MEDICAL PAYMENTS INSURANCE COVERAGE PART APPLIES ONLY AT LOCATIONS COVERED UNDER THIS POLICY AT ENDICOTT, POUGHKEEPSIE, SAUSALITO, HASTON ABD ARMONK, NEW YORK AS RESPECTS COUNTRY CLUBS, HOMESTEAD OPERATIONS AND RECREATIONAL FACILITIES ON OR OFF THE PREMISES OR ANY COUNTRY CLUB OR HOMESTEAD WHICH MAY BE ACTIVATED IN THE FUTURE.

IT IS FURTHER AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THIS ENDORSEMENT SHALL APPLY TO ORGANIZED SOCIAL ACTIVITIES OF THE OTHER I.B.M. PLANT CLUBS OR OFF-PREMISES AS RESPECTS FIELD DAYS AND CHRISTMAS PARTIES.

## Signature

Replaces Endorsement #4

## Zurich Insurance Company

American Guarantee and Liability Insurance Company

**Authorized Agent:**