# Non-Premium Endorsement

**Issued by:**
- The Home Insurance Company (X)
- City Insurance Company ( )
- The Home Indemnity Company ( )
- The Home Insurance Company of Indiana ( )

**Policy Number:** HXL 1 64 01 95
**Certificate Number:** 
**Named Insured:** International Business Machines Corp., Etal.
**Producer:** Johnson & Higgins
**Producer No.:** OPC 50138-081
**Policy Period:** Inception (Month-Day-Year): 5-21-85 | Expiration (Month-Day-Year): 5-21-86
**Effective Date and Time of Endorsement:** 5-21-85

It is agreed that this policy is hereby amended as indicated. All other terms and conditions of this policy remain unchanged.

**Item 2. Policy Premium:**
- United States (96.5%) $52,110.
- Canada (3.5%) $1,890.
**Total Premium:** $54,000.

**Signature of Authorized Representative:**

**Insured Copy**
The Home Insurance Companies