# Casualty Reinsurance Layoff

## Assured:
- Policy Dates: FROM: / TO:

## Type of Coverage:
- Underlying Limits:

## Policy Limits:
- Policy Number: 5512881
- Effective Date of Reinsurance:
- Reinsurance Premium:

## Description of Operations:

## Reinsurer | Broker | Limit | Premium | Pct. of Premium | Total Comm. to LX | Treaty Usage | Closing Certificate Number
- 7856 | 08803 | 250,000 | 1320 | 33 | QS | QS
- 7857 |  | 250,000 | 181 | 46 | XS |
- NORTH Am | 0891 | 1,000,000 | 3000 | 50 | QS | 981265

## H.O. Referral
- Approved By
- Underwriter
- Date