**Document Title:**

The document appears to be an insurance policy form, specifically for General Liability coverage.

**Header Information:**

- **Invoice Number:** 23055
- **Insured:** R. Michel
- **Address Override:** Same
- **Renewal of Number:** CGL 3278678-05

**Bill To:**

- **Name:** Intl' Business Machines Corp.
- **Attention:** Mr. J.M. Costello, Ins. Dept.
- **Address:** 208 Harbor Plaza, P.O. Box 10501, Stamford, CT 06904

**Policy Details:**

- **Policy Number:** CGL 3278678-04
- **Insurance Description:** General Liability
- **Effective Date:** 5/21/88
- **Expiration Date:** 5/21/89
- **Underwriter:** Zurich Ins. Co.
- **Payee Name and Address:** Same
- **Location of Coverage:** Various
- **Gross Premium:** $730,176.4
- **Premium Discount & Net Premium (Workers Compensation Only):** Not specified
- **Commission:** 39.5%
- **Foreign Currency Transactions:**
  - Premium to be received in: Not specified
  - Premium to be paid to insurer in: Not specified
- **Installments:**
  - Total # of Payments: 11
  - Amount Due on 1st Payment: $60,897
  - Deposit: $60,897
- **Tax Payments:**
  - Domestic Tax Dollars: Not specified
  - Tax Payee: Not specified

**Additional Fields:**

- **Policy Type:** Not specified
- **Product Line:** Not specified
- **Policy Version:** Not specified
- **Term:** Not specified
- **Attachment:** Not specified

**Footer Information:**

- **MM:** 009865
- **Prepared By:** Not specified

**Comments:**

- **Retro Claims Date:** Not specified
- **Future Claims Date:** Not specified
- **Policy is Claims Made Form:** Not specified
- **Policy is Auditable:** Not specified

**Other Notes:**

- The document includes various checkboxes and fields that are not filled out or are marked as "Same" or "Not Applicable."
- The form is likely used for billing and administrative purposes related to the insurance policy.