# General Change Endorsement

This endorsement forms a part of and is for attachment to the following designated policy:

- **Affiliated FM Insurance Company**
  - **Policy No.:** XL 98107
  - **Issued To:** International Business Machines Corp.

- **Appalachian Insurance Company**

- **Completes Binder No.:** 6
- **No Binder**

All Terms and Conditions remain unchanged except:
- Additional premium due now $ (pro rata of $)
- Return premium due now $ (pro rata of $)

It is agreed that the premium breakdown is as follows:
- U.S. Funds: $12,000
- Canadian Funds: $500

## Canadian Schedule

- **Named Insured:** I.B.M. Canada Ltd., 1150 Eglinton Avenue East, Don Mills, Ontario
- **Producer:** Johnson & Higgins Willis Faber Ltd., Place Victoria, Suite 2300, Montreal, Quebec H4Z1E2
- **Producer Code:** P 921

7/19/78