**American Guarantee & Liability Insurance Company**

**POLICY NO:** 186-68-700  
**AGENCY AGENCY NO:** 50-915

**AUDIT ADJUSTMENT OF PREMIUM**

**AGENCY NAME:** Johnson & Higgins  
**AUDIT NO.:** 2465  
**PERIOD OF AUDIT:** 1-1-72 to 1-1-73  
**DATE (IF CANCELLED):** 8-28-73  

**NAME AND ADDRESS OF INSURED:** International Business Machines Corp., Armonk, N.Y.

| STATE | CLASSIFICATION OF OPERATION | CLASS 'N. NO. | PAYROLL, SALES OR OTHER | RATE | PREMIUM |
|-------|------------------------------|---------------|-------------------------|------|---------|
| Var   | Composite Rate              |               | 1,972,760,753.          | .1562 | 308,145 |
|       | Non-owned autos end. #13    |               | F/C                     |      | 65,000  |

**TOTAL:** 373,145  
**LESS DEPOSIT OR OTHER CREDIT:** 369,109  
**ADDITIONAL PREMIUM:** 4,036  

**Gassman**

**IBM 062395**