# Excess Liability Policy Renewal Certificate

**Johnson & Higgins**
519548-4566 63 WALL ST, NEW YORK, NY

**Excess Liability Policy Renewal Certificate**

**Item 1: Insurer's Name and Address**
- **Name:** Fireman's Fund American Insurance Company
- **Address:** 2000 California Street, San Francisco, California

**Item 2: Policy Details**
- **Policy Number:** XL-75249
- **Inception Date:** 5/21/70
- **Expiration Date:** 5/21/73

**International Business Machines Corp. (As per original policy)**
Armonk, New York

**Renewal Premium for this policy shall be $5,625, subject to the following: PER END'T. ATTACHED**

**(a) The following percentages of the earned premiums paid under the policy of the primary insurer shall be used in computation of the final earned premium hereunder:**
- **Bodily Injury Liability:** Automobile FLAT %; Other than Automobile FLAT %
- **Property Damage Liability:** Automobile CHARGE %; Other than Automobile CHARGE %

**(b) This policy is subject to an ANNUAL MINIMUM PREMIUM OF $2,5M Part of 7.5M X 45M ?**

**Schedule of Primary Insurance**
- **Name of Primary Insurer(s):** AS ON FILE WITH COMPANY
- **Policy Number(s):** 

**In Witness Whereof, the company has caused this certificate to be executed and attested, but this certificate shall not be valid unless countersigned by a duly authorized representative of the company.**

**Date of Issue:** 6/4/70
**Counter-signed by Authorized Agent:**

**Important: Please attach this certificate to your policy**