# Zurich-American Insurance Group Audit Adjustment of Premium

## Policy Information
- **Policy Number:** CGL 32-78-678-02
- **Policy Period:** From 5/21/86 to 5/21/87
- **Insured/Mailing Address:** International Business Machines Corp., E.T.A.L., Armonk, New York 10504
- **Insurance Company:** Zurich Insurance Company
- **Producer:** Johnson & Higgins (50-315-910)
- **SR54 Page:** 3

## Premium Details
| ST | STD. PREMIUM | COMM.% | COMM. |
|----|--------------|--------|-------|
| VRS | $5,025.485 AP | 4.5 | $226.147 |
|     | $266.932 AP | 0 | 0 |
|     | $4,794.677 RP | 0 | 0 |
|     | $629.338 RP | 39.4 | $247.959 |
|     | $288.100 RP | 0 | 0 |

## Total Earned Premium
- **Total Earned Premium:** $2,917.48
- **Deposit Premium:** Not specified
- **Additional Due Company:** Not specified
- **Refund Due Insured:** Not specified

## Agent Copy
- **Agent:** Not specified
- **Date:** Not specified
- **Reference:** JPJ/NZ/KLS/7-23-87
- **MM:** 009806