**INA Insurance Company of North America**

**CANADIAN DECLARATIONS**

**Canadian Agent:** Johnson & Higgins (Canada) Ltd.
**Address:** 360 St. James Street West, Montreal, Canada
**No.:** XCP 3665

**1. NAMED INSURED:** INTERNATIONAL BUSINESS MACHINES CORP., ETAL
**Address:** Armonk, New York

**Business of the Named Insured:** Mfg. of Business Machines

**2. Policy Period:** From May 21, 1970 to May 21, 1973
**3. PREMIUM COMPUTATION:** Description of Property, Coverage, including Limits of Liability
**MAJOR PERIL OR LINE:** 
**PREMIUMS:** $373.50

**Certificate of Excess Insurance:**
- **$10,000,000 excess of $112,500,000 and Primary Insurance**

**J.K. Risley**
**Secretary**