# Document Details

**Policy No.:** 86-68-700  
**RFP Date of Pol:** Dec. 31, 1970  
**Eff. Date of End:** Jan. 1, 1972  
**Agency No.:** 50-515-000  
**Add'l. Premium:** $369,109.  
**Return Premium:** $  

**Named Insured:** International Business Machines Corporation  

**Premium Computation Endorsement**

For the period January 1, 1972 to January 1, 1973, the premium for such insurance as is afforded by the Policy shall be computed by applying to each $1,000. of Workmen's Compensation Payroll, the composite rate established for the Policy.

| Est. Ann. Payroll | Composite Rates | Est. Premium |
|------------------|-----------------|--------------|
| $ 1,946,921,000. | .156200         | $ 304,109.   |
| End. No. 13      |                 | $ 65,000.    |
|                  |                 | $ 369,109.   |

**ZURICH INSURANCE COMPANY**  
**AMERICAN GUARANTEE AND LIABILITY INSURANCE COMPANY**

**Countersigned:**
- **N. W. N.**  
- **W. J. E.**  

**Form 110-G 50M 1049**  
**ATTORNEY IN FACT**  

**IBM 062390**