**The Continental Insurance Company**

**IT IS AGREED THAT FORM Y503 IS AMENDED IN PART AS FOLLOWS:**

**ITEM 4 UNDERLYING INSURANCE**

CONTINENTAL CASUALTY COMPANY ROJ 0433466
AMERICAN HOME ASSURANCE CO. CE 250011

**ITEM 6 UNDERLYING LIMITS $145,000,000 IN EXCESS OF PRIMARY INSURANCE AS DESCRIBED IN CONTINENTAL CASUALTY COMPANY'S POLICY NO. ROJ 0433466 AND AMERICAN HOME ASSURANCE COMPANY'S POLICY NO. CE350011.**

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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. 14533466, issued to INTERNATIONAL BUSINESS MACHINES CORP.
BY THE CONTINENTAL CASUALTY COMPANY
(Date) 19.27. at 10:27 A.M.
(Insert Name of Company)
Effective
COUNTERSIGNED BY R. Lock
AUTHORIZED REPRESENTATIVE
BRANCH OFFICE 1000 7/10/15
AGENT OR JOHNSON & WILLIAMS
GENERAL BROKER
BROKER (ADDRESS)

| SOURCE/TRANS | CO CODE | ACCT LINE | REINS CO | PAY CODE | PREMIUM | RATE OF CANCELLATION | RETURN PREMIUM | ORIGINAL PREMIUM | RETURN PREMIUM | TAX AND SD OR REINS CO |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| TERM | STATE | CITY | LIMITS | LINE | KING | AGE | STR | CLASS | OUT % | EXPOSURE | CURRENT | DEFERRED | CANCELLED | EXPOSURE | CURRENT | CANCELLED | EXPOSED | CURRENT | CANCELLED | DEFERRED | IP |
| 31 | 35 | 29-40 | 41-43 | 41 | 45-60 | 41-48 | 49-50 | 51-53 | 54 | 55-56 | 59 | 80-85 | 96-98 | 55-58 | 59 | 96-95 | 89-74 | 75-78 | 79 | 80 |

ACCOUNTING PREMIUMS BY COMMISSION RATE

LIAB. 5131C