# Endorsement No. 2

## Canadian Declarations

**Named Insured:** INTERNATIONAL BUSINESS MACHINES COMPANY LIMITED (CANADA)

**Producer:** JOHNSON & HIGGINS WILLIS FABER LTD.
PLACE VICTORIA, MONTREAL, CANADA

**Premium:** $152.10

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On account of the foregoing, the additional premium is $ , the return premium is $.

This endorsement shall not be binding upon the company unless countersigned by a duly authorized representative of the company. This endorsement forms a part of the designated policy and applies, unless otherwise stated herein, as of the effective time and date of such policy.

Policy No.: LX-633-C2-23 issued to INTERNATIONAL BUSINESS MACHINES CORP. by THE FIDELITY & CASUALTY CO. OF NEW YORK (Insuring Company).

Effective: MAY 21, 1967 at 12:00 A.M.

Countersigned by: [Signature]

Branch Office: [Address]
General Agent: [Address]
Agent or Broker: [Address]

President: [Signature]