# Audit Adjustment of Premium

**Agency No.:** 50-515-810  
**Agency Name:** Johnson & Higgins  
**Policy No.:** CGL 32-78-678-01  
**Period of Audit:** 5-21-85 to 5-21-86  
**Expiration Date:** 5-21-89  
**Date (If Cancelled):** N/A  

## Classification of Operation
- **State:** WRS  
- **Classification of Operation:** Composite Rated Payroll  
- **Class/Ins. No.:** N/A  
- **Payroll, Sales or Other:** 9,643,537,911  
- **Rate:** 0.3387  
- **Premium:** 3,266,266  

**Billed as:**
- (3,353,565) @ 0.0563 = 189,473  
- 3,266,266 @ 0.058 = 189,473  
- Total AP 327  

**Chet AP 189,473**  
**Total AP 327**  
**AP 327**  
**AP 327**  

**Name and Address of Insured:**  
International Business Machines Corp., etal  
Armonk, New York 10504  

## Total
- **Total:** 3,266,266  

## Less Deposit or Other Credit
- **Less Deposit or Other Credit:** 3,353,565  

## Additional Premium
- **Additional Premium:** -  

## Return Premium
- **Return Premium:** 87,299  

## Summary
- **Premium:** 3,266,266  
- **AP:** 389,929  
- **RP:** 2,963,636  
- **RP:** 87,299  

**Commission:**
- **Comm. %:** 5.8%  
- **Comm. %:** 48.5%  
- **Comm. %:** 0%  
- **Comm. %:** 0%  
- **Comm. %:** 0%  
- **Comm. %:** 0%  

**D/NZ/tam/8-14-86**  

**Agent's Copy**

**MM 009767**