Exhibit 2.6

                                    CROP HAIL


                   INSURANCE SERVICES AND INDEMNITY AGREEMENT


This Insurance Services and Indemnity Agreement, (hereinafter referred to as the
"Agreement")  is made and  entered  into by and between  IGF  Insurance  Company
(hereinafter  referred to as "IGF"), an Indiana domiciled  property and casualty
insurer with principal offices located at 6000 Grand, Des Moines, Iowa 50312 and
Continental  Casualty Company,  (hereinafter  referred to as "CCC"), an Illinois
domiciled  property and casualty  insurer with principal  offices located at CNA
Plaza, Chicago,  Illinois,  effective January 1, 1998 for the benefit of IGF and
CCC.

WHEREAS, CCC and IGF, IGF Holdings, Inc. and Symons International Group, Inc.
have entered into a Strategic Alliance Agreement (hereinafter referred to as the
"SAA"), and pursuant to Article 6 thereof have agreed to execute certain
Ancillary Agreements;

WHEREAS,  among the Ancillary Agreements CCC and IGF have entered into is a Crop
Hail  Quota  Share  Contract   (hereinafter  referred  to  as  the  "Reinsurance
Contract")  effective  January  1,1998 for  certain  policies  issued by CCC and
reinsured 100% by IGF (as defined in the Reinsurance  Contract,  and hereinafter
referred to as the "Policy (ies) "),  pursuant to the terms of such  Reinsurance
Contract;

WHEREAS, in connection therewith CCC and IGF wish to enter into an agreement for
the provision of insurance services and indemnity;

WHEREAS,  IGF possesses  the staff and expertise to administer  the Policies and
agrees  to  assume  certain  duties  and  responsibilities  to  administer  such
Policies; and

WHEREAS, CCC'S offer to write such business is based on IGF'S acceptance of such
duties and responsibilities as described herein;

NOW,  THEREFORE,  the  parties,  in  consideration  of  the  mutual  agreements,
covenants, and provisions herein contained, agree as follows:

                                     I. TERM



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This Agreement  shall take effect with the  Reinsurance  Contract and shall have
the same term and  cancellation  provisions in their entirety as provided in the
Reinsurance Contract,  except as specified in Sections 4.5 and 4.7 of Article IV
and  Sections  12.1  through  12. 6 of Article  XII of this  Agreement.  If this
Agreement is  terminated  or expires for any reason,  the  Reinsurance  Contract
shall simultaneously terminate or expire.

                                II. APPOINTMENTS

Section 2.1: IGF shall serve as CCC'S  marketing,  production,  and underwriting
agent for the Policies and shall adjust any claims made under the Policies.

Section 2.2: IGF warrants that it has and shall maintain  throughout the term of
this Agreement any and all licenses required to perform and provide the services
specified  in this  Agreement in CCC's state of domicile and in all other states
or  provinces  in which IGF is  performing  services on behalf of CCC.  IGF also
warrants  that it shall  abide by all  rules  and  regulations  as  required  by
insurance  department,  bureau of  insurance,  or other  appropriate  regulatory
agency of the states or provinces in which  Policies are written,  including any
rate,  form,  or other filings as required by each state  insurance  department,
bureau of insurance, or other appropriate regulatory agency.

Section 2.3:  Payment of all commissions  due on Policies  produced by producers
shall be made directly by IGF to the producers.

Section  2.4:  In  consideration  for these  appointments,  IGF and CCC agree to
exercise all authority and perform all duties required by this Agreement.

                 III. UNDERWRITING AUTHORITY AND RELATED DUTIES

Section  3.1:  IGF is  authorized,  and  agrees on behalf of CCC,  to accept and
decline insurance risks, underwrite,  price, bind, issue, and cancel or nonrenew
the Policies, make customary endorsements,  changes, assignments,  transfers and
modifications of existing Policies,  subject to limitations provided herein. IGF
warrants that it shall accept and decline  insurance risks,  underwrite,  price,
issue,  and  cancel or  nonrenew  the  Policies,  make  customary  endorsements,
changes,  assignments,  transfers and  modifications  of existing  Policies in a
timely and professional  manner through qualified  persons,  fully familiar with
generally  accepted  standards in the United States and Canada,  as appropriate,
and for the 1998 Crop Year according to CCC's formal  written  guidelines as may
be provided from time to time to IGF, and for the 1999 Crop Year and  subsequent
Crop Years according to formal written guidelines of the Underwriting  Committee
(as defined in the SAA) as may be provided from time to time to IGF.


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Section 3.2:  Nothing stated anywhere in this Agreement shall impair IGF'S right
to cancel or nonrenew any Policy,  providing  such action is in full  compliance
with applicable law and CCC receives advance notice of IGF'S intent. CCC has the
right to cancel or  nonrenew  any Policy  upon the prior  approval of IGF unless
this Agreement  expires or is terminated,  whereupon CCC may do so without prior
approval but shall provide ten (10) days prior written notice to IGF.

Section 3.3: CCC agrees that it shall,  upon written request from IGF,  promptly
appoint  such persons as agents of CCC or grant such persons a power of attorney
as requested by IGF.  CCC also agrees that it shall,  upon written  request from
IGF promptly file with appropriate  regulatory  authorities such forms and rates
as  requested by IGF.  IGF's staff shall  perform the  administrative  functions
necessary for CCC to make such appointment and grant such powers.

                     IV. CLAIMS AUTHORITY AND RELATED DUTIES

Section  4.1:  IGF is  authorized  and  agrees  on  behalf  of  CCC  to  adjust,
compromise,  process and pay all claims arising under the Policies  issued under
this Agreement,  including the right to litigate claims in CCC's name, except as
provided  in Section  4.5 of Article IV  herein.  IGF  warrants  that any claims
arising under the Policies will be handled in a timely and  professional  manner
by qualified  persons,  fully familiar with generally  accepted  claims handling
standards in the United States and Canada, as appropriate, and for the 1998 Crop
Year according to CCC's formal  written  guidelines as may be provided from time
to time to IGF. IGF is authorized and agrees to investigate, monitor, and handle
any claims under any of the Policies  issued under this  Agreement and reinsured
pursuant to the  Reinsurance  Contract on CCC'S behalf or retain any independent
claims consultant or adjuster as may be required.

Section 4.2: CCC and IGF shall provide the other with prompt notification of any
losses or  claims,  or any  information  that  makes a loss or claim  reasonably
likely under the Policies and as provided elsewhere in this Agreement.

Section 4.3: In recognition of statutory,  regulatory and legal duties to handle
claims  in a prompt  and  fair  manner,  CCC and IGF  agree  to  exercise  their
commercially  reasonable  best  efforts  and  cooperate  fully with the other to
handle claims in said manner and in full compliance with all such requirements.

Section  4.4:  Within 15 days after the end of each  calendar  month  while this
Agreement is in effect,  IGF shall promptly report to CCC on all open and closed
claims  handled by it during  such  month in the  reporting  format as  mutually
agreed to between CCC and IGF.


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Such  reports  shall  include  information  on all claims and  allocated  claims
expenses  reserved,  paid and  outstanding.  IGF shall report within thirty (30)
days of any such developments, significant developments on claims, including but
not limited to,  major  reserve  increases  or  decreases,  settlements,  or new
information  changing the liability  assessment or valuation previously reported
to CCC by IGF.  IGF shall send CCC a copy of any claim file upon request by CCC.
All claim files will be the joint property of CCC and IGF during the period this
Agreement is in effect.

Section 4.5: Upon termination of this Agreement,  or in the event of an order of
liquidation  of CCC during the period this  Agreement  is in effect,  such files
shall become the sole property of CCC or its estate.  IGF shall have  reasonable
access to, and the right to copy, any such claim files in CCC'S  possession on a
timely basis, if requested.

Section  4.6: IGF shall pursue  salvage or  subrogation  on behalf of CCC in all
appropriate cases, on any claims arising under the Policies.

Section 4.7: In the event this  Agreement  is  terminated  and unless  otherwise
mutually  agreed to  between  CCC and IGF,  IGF shall have the right and duty to
settle  and  handle all  subsequent  claims  and  losses  until such time as all
Policies issued, underwritten or serviced by IGF pursuant to this Agreement have
expired  and  the  Reinsurance  Contract  has  expired,  and  all  known  claims
thereunder  have been  paid or  settled,  have  runoff  or  otherwise  have been
disposed of in the  judgment of CCC,  and all  incurred  but not  reported  loss
reserves  have been  reduced to zero,  and any amounts  owed to CCC by others or
under the  Reinsurance  Contract in regard to any claims have been  collected by
CCC.  Reinsurance  indemnity  for any claim or loss  discussed  herein  shall be
provided  in  accordance  with  the  terms  and  conditions  of the  Reinsurance
Contract.

Section 4.8:  All claims  and/or  losses  handled by IGF pursuant to Section 4.7
herein shall be reported to CCC by IGF within forty-five (45) days after the end
of each calendar quarter in such reporting format as requested by CCC.

Section 4.9: IGF agrees to notify CCC immediately upon notice of any allegations
of bad faith as respects any Policy covered under the Reinsurance Contract, and,
of the receipt of any notice that a lawsuit has been filed  against  IGF, any of
its employees or agents,  and/or CCC by an insured on a Policy covered under the
Reinsurance Contract.  IGF shall furnish CCC, upon CCC's request, with copies of
all  pleadings  and related  file  material  pertaining  thereto in a prompt and
timely fashion.

 


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                  V. ACCOUNTING AUTHORITY AND RELATED DUTIES

Section 5.1: The parties  agree that IGF shall bill its  customers  directly for
the Policies and collect all premiums due and owing for such Policies. IGF shall
reimburse  CCC for all  premium  taxes due under such  Policies at such times as
requested by CCC to fulfill its filing and payment obligations.

Section 5.2: Within fifteen (15) days after the end of each month while this
Agreement is in effect, IGF shall provide CCC with an accounting report 
containing the following information (on an Agreement Year [meaning  each
January 1 - December 31 for which coverage applies under the Reinsurance
Contract], to date, on a state by state, basis):  1) limits of liability exposed
and number of policies written; 2) gross written premium; 3) paid losses and
number of losses paid; 3) reserves for outstanding losses and number of
outstanding losses; 4) unearned premium reserve; 5) amount of ceding commission
allowed under the Reinsurance Contract; and 6) loss adjustment expenses
(collectively, the information contained in 1- 6 is hereinafter referred to as
the "accounting information") and any other information mutually agreed to
between the parties in writing.

Section  5.3:  On or  before  December  15th of each  Agreement  Year for  which
coverage  applies  under the  Reinsurance  Contract,  IGF shall forward to CCC a
"provisional  final"  accounting  report of the accounting  information  for the
Agreement  Year. If the net premiums due CCC exceeds the ceding  commission  and
losses paid (including loss adjustment  expense),  IGF shall pay the balance due
as soon as possible to CCC, not later than December 31st of each Agreement Year.
If the ceding commission and losses paid (including loss adjustment expense) due
IGF exceeds the net premiums,  CCC shall pay the balance due as soon as possible
to IGF, not later than December 31st of each Agreement Year. Thereafter, a final
accounting  shall be made when all  cessions  have  expired or  terminated,  all
losses  have  been  settled  and all  liability  has  been  discharged  for each
Agreement Year to which coverage applies under the Reinsurance  Contract. If the
parties  dispute the amount of  premiums  owed,  IGF shall remit the  undisputed
portions of the premium owed CCC.

Section 5.4: As soon as possible after the  conclusion of each calender  quarter
and Agreement  Year the IGF will provide any other  information  CCC may require
for its  Convention  Statement  which may be reasonably  available to IGF. It is
understood and agreed that IGF and CCC shall each provide to the other any other
information mutually agreed to between the parties in writing.


         


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                  VI. REGULATORY COMPLIANCE AND RELATED DUTIES

Section 6.1: CCC and IGF agree to use their commercially reasonable best efforts
to achieve full compliance with all applicable  statutory,  regulatory and legal
requirements.

Section 6.2: CCC and IGF agree that IGF is authorized  to file rules,  rates and
forms on behalf of CCC within a state or province  to include  two (2)  separate
company filings per jurisdiction.  IGF will provide CCC with copies of all rule,
rate and form filings at least five (5) business days prior to filing.  CCC will
have  the  right  to  approve  such  filing,  but  CCC's  approval  will  not be
unreasonably withheld. CCC will have the opportunity to review all data relevant
to its rule, rate and form filing.

Section  6.3:  IGF  agrees  to advise  CCC of any  complaints  and/or  inquiries
concerning  rule, rate or form filings,  and to provide CCC with the opportunity
to respond to regulators  or consumers.  CCC and IGF agree to provide the other,
promptly  upon  request,  with all  information  and  support  required  for any
regulatory  compliance  obligation  and for any  reports,  statements  or  other
filings required by regulatory authorities.

Section  6.4:  IGF  agrees  to  monitor  all  legal,  statutory  and  regulatory
developments  affecting the Policies  hereunder and promptly report same to CCC.
Should any such changes  affect the  Policies  hereunder,  the parties  agree to
ensure  full   compliance   with  such  changes.   IGF  agrees  to  prepare  any
documentation necessary to assure such compliance. In the event that CCC becomes
aware of any such development, it shall report it promptly to IGF.

Section 6.5: In the event that any State,  by statute,  regulation or otherwise,
prohibits or restricts IGF'S authority  hereunder,  the parties agree that IGF's
authority to act on behalf of CCC shall be so restricted in that State.

                                VII. COMPENSATION

The parties agree that  compensation  for the  performance  of the mutual duties
specified  hereunder shall be as follows:  (i) for Agreement Year 1998 CCC shall
receive reimbursement, in such amount as the parties agree by April 1, 1998, for
its direct overhead  expenses/fixed  costs of operating and maintaining its crop
insurance program,  including but not limited to, office rent, staffing, premium
processing,  accounting and billing, claim handling, commissions, filing of 1998
crop hail forms,  rules and rates,  development and filing of hail endorsements,
marketing,  advertising,  licensing,  and other  expenses  incurred for business
already issued prior to the closing date of the transaction between IGF and CCC,
in the manner that the parties agree by April 1, 1998;  (ii) and in addition for
Agreement Year 1998 and subsequent  Agreement Years, IGF agrees to reimburse CCC
for all its reasonable fronting costs,  including its costs and expenses related
to the production of Policies  pursuant to this  Agreement,  related to rule, 
rate and form  filings  under  this  Agreement and related to the performance
of its obligations under this Agreement.



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                              VIII. INDEMNIFICATION

Section 8.1: In addition to the obligations of IGF pursuant to the terms of the
Reinsurance  Contract,  IGF shall  indemnify  CCC as follows in Sections 8.2 and
8.3.  However,  Sections  8.2 and 8.3 shall not apply to any  liability,  claim,
suit, demand,  damages  (including  punitive and exemplary  damages),  judgment,
cost,  interest and expense  (including  but not limited to attorneys'  fees and
disbursements)  or regulatory  fines or  administrative  penalties caused by the
action of or the  failure  to take  action  by any  employee  of CCC.  Nor shall
Sections  8.2 and 8.3  prevent  the  application  of any  available  reinsurance
proceeds.

Section  8.2: IGF shall  indemnify,  defend and hold  harmless  CCC, its agents,
employees,  subsidiaries and affiliates from and against all liability,  claims,
suits, demands,  damages (including punitive and exemplary damages),  judgments,
costs,  interest and expense  (including but not limited to attorneys'  fees and
disbursements)  arising out of, or in connection  with,  any Policy issued under
this Agreement and reinsured under the Reinsurance  Contract,  including but not
limited to production  activities (such as claims made by producers  against CCC
for commissions allegedly due them on Policies under the Agreement),  failure of
producers to be properly licenced,  producers,  underwriting activities,  policy
issuance,  claim  handling  and the  resolution  of  coverage  issues;  provided
however,  that  notwithstanding  any other  provisions of this  Agreement,  such
indemnification of IGF shall not extend to any matter subject to the obligations
of CCC or its affiliates  under the Reinsurance  Contract or the Crop Hail Quota
Share Agreement.

Section 8.3: IGF agrees to indemnify, defend and hold CCC harmless and make full
and prompt  reimbursement for any regulatory fines or  administrative  penalties
levied against CCC relating to IGF'S failure to fulfill any policy,  rate, claim
payment or other filing or obligations required by or to regulatory authorities.
CCC shall use its commercially  reasonable best efforts to advise IGF as soon as
possible of any such fine or penalty, or any information  indicating that a fine
or penalty may be levied.

Section  8.4:  Any  inadvertent  delay,  omission  or error shall not be held to
relieve  either  party  hereto  from any  liability  which  would  attach  to it
hereunder if such delay, omission or error had not been made.



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Section 8.5: CCC agrees to save,  indemnify,  and hold IGF harmless  against any
and all loss, liability or damage resulting from any misrepresentation or breach
of warranty by CCC under the terms of this Agreement.

Section 8.6: The indemnities  provided in Sections 8.1, 8.2, 8.3, and 8.5 herein
shall survive any termination of this Agreement.

                                 IX. ARBITRATION

In the event of an irreconcilable dispute between the parties to this Agreement,
such dispute  shall be submitted for decision to the process of  arbitration  in
the manner and pursuant to the procedure set forth in the ARBITRATION Article of
the Reinsurance Contract.

                                 X. MODIFICATION

There  will be no  modification  of or  change  in the  terms of this  Agreement
without the written approval of the parties to this Agreement.

                         XI. BINDING EFFECT OF AGREEMENT

This  Agreement  will be binding  upon and inure to the benefit of the  parties,
their successors and assigns.

                                XII. TERMINATION

Section  12.1:  This  Agreement  and IGF'S  obligations,  except as specified in
Article I,  Sections  4.5 and 4.7 of Article IV, and Section 8.6 of Article VIII
hereunder,  shall terminate automatically and without notice upon the occurrence
of any one or more of the following  events:  (a) termination of the Reinsurance
Contract;  or (b)  termination or  modification  of IGF'S  participation  in the
Reinsurance Contract.

Section 12.2: Any termination of this Agreement shall be subject always to IGF'S
duty to satisfy,  fulfill,  fully perform and  discharge all of its  obligations
pursuant to this Agreement.

Section 12.3: This Agreement, except as specified in Article I, Sections 4.5 and
4.7 of Article IV, and Section 8.6 of Article  VIII,  may be  terminated  at any
time by mutual written agreement.



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Section 12.4:  Notwithstanding  anything herein to the contrary,  should the Put
Right or Call Right be triggered,  then IGF must stop using CCC front at the end
of the crop year in which the Put or Call right was exercised.

Section  12.5:  Immediately,  following  receipt of written  notice from CCC, on
account  of IGF's  failure  to comply  with a  condition  or  provision  of this
Agreement  within  thirty  (30) days  after such  failure  is brought  the IGF's
attention in writing this Agreement shall terminate.

Section 12.6:  Unless  otherwise  directed by CCC in writing,  in the event this
Agreement is terminated,  IGF shall continue to perform the duties  necessary to
service all Policies,  at its own expense,  until all liability  underlying  the
Policies shall have been  terminated.  Such services shall consist of, but shall
not necessarily be limited to,  cancellations,  return  premiums,  endorsements,
account current reporting and claim  settlements.  IGF shall also issue, for and
on behalf  of CCC,  an  effective  notice of  non-renewal  to all  policyholders
terminating  their  coverage  upon the  expiration  of their  Policy  term  next
following the termination of this Agreement.  Should good cause exist for CCC to
assume such duties,  IGF shall  reimburse CCC for the expenses it shall incur in
performing  such duties.  IGF shall also provide CCC, at IGF's  expense,  with a
copy of all  insurance  records on unexpired  Policies and all  insurance  claim
files.

                               XIII. CONTRIBUTION

IGF,  upon  any  payment  hereunder,  shall  fully  share  in  the  subrogation,
contribution  and salvage rights of CCC, as  applicable,  to the extent of IGF'S
payment to CCC.

                      XIV. RESOLUTION OF CONFLICTING TERMS

In the event of any conflict or  inconsistency  between this  Agreement  and the
Reinsurance   Contract,   this  Agreement  shall  prevail  and  be  controlling.
Notwithstanding  anything to the contrary  contained  in Article IX herein,  any
irreconcilable  dispute  between the parties to this Agreement shall be resolved
by  arbitration,  in the manner and pursuant to the  procedure  set forth in the
Reinsurance Contract, as more fully set forth in Article IX of this Agreement.

                                XV. SEVERABILITY

In the event any  provision  of this  Agreement  shall be  declared  invalid  or
unenforceable by any regulatory body or court having jurisdiction, such validity
or  enforceability  shall not  affect  the  validity  or  enforceability  of the
remaining portions of this Agreement.

                                 XVI. ASSIGNMENT

IGF and CCC agree that this  Agreement is  non-assignable,  in whole or in part,
without the written consent of the other party.

                                  XVII. RECORDS

Section 17.1: Upon reasonable notice, IGF or its designated  representative,  or
CCC and its designated representative,  shall have access at any reasonable time
to  inspect  and audit the books and  records  which  pertain in any way to this
Agreement and may make copies of any records pertaining  thereto.  This right of
inspection,  audit and information  shall survive  termination of this Agreement
and  shall  run to the  natural  expiry of all  liabilities  under the  policies
covered under the Reinsurance Contract.

Section 17.2: Subject to provisions  regarding  ownership of policies and claims
files,  the records for the Policies shall be the property of IGF and be left in
IGF's possession,  provided IGF has then rendered and continues to render timely
accounts and payments of all monies due CCC. Otherwise, the records, and the use
and  control  of  expirations,  shall  be the  property  of CCC  and  IGF  shall
immediately thereafter forward all such records to CCC.

                             XVIII. ENTIRE AGREEMENT

This Agreement,  the Strategic Alliance  Agreement,  the MPCI Insurance Services
and Indemnity Agreement, the Ancillary Agreements, the Reinsurance Contract, the
Crop Hail Quota Share  Agreement,  the Multiple Peril Crop Insurance Quota Share
Contract,  and the Multiple Peril Crop Insurance Quota Share  Agreement  between
the parties hereto,  represent the entire agreement and understanding  among the
parties  signatory to this  Agreement.  No other oral or written  agreements  or
contracts relating to the risks reinsured  hereunder  currently exist and/or are
contemplated between the parties.

                            XIX. ADDITIONAL SERVICES

Section  19.1:  IGF is willing to assist CNA:

         A. In administering insurance products marketed or developed by CNA
outside the agreements listed in Article XVIII;


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         B. In  performing  services,  including  but not limited to  regulatory
compliance, processing, debt collection, accounting, or other activities related
to CNA's Business in years prior to the 1998 Crop Year;


         C. In performing loss adjustment and claims  processing  related to any
insurance  or other  products of CNA outside  the  agreements  listed in Article
XVIII; and


         D. Any other  services  outside  the the  agreements  listed in Article
XVIII that utilize the staff and  expertise of IGF that it is willing to perform
on behalf of CNA.


Any services  provided  under this Section shall be based on terms included in a
separate agreement or agreements or an amendment or amendments to this Agreement
outlining the terms,  conditions,  and  compensation for the performance of such
services. In general, the fees for services performed shall be those outlined in
Section 19.2.


Section  19.2:  Subject to specific  provisions  to the contrary in any separate
agreements or amendments to this Agreement regarding services to be performed by
IGF on behalf of CNA under  Section 19.1,  the following  schedule of fees shall
apply to all such separate agreements or amendments to this Agreement:


ADMINISTRATOR EMPLOYEE PROVIDING SERVICE RATE PER
HOUR


Executive - President, Executive Vice President      $205.00


Internal Legal Staff - Indianapolis and Des Moines    $150.00


Corporate Manager - I.e., Accounting, National Claims Mgt. Staff  $85.00


Field Manager Rate - Service Office Director, Regional Claims Mgt. $60.00


Field Service Rate - Claims Adjuster $40.00


After  April  1,  1999,  the  rates  contained  in this  fee  schedule  shall be
recalculated  annually for a five (5) year period  thereafter by multiplying the
effective rate for the prior year by a factor of 1.05. IGF shall provide the CNA
with a report that provides an  accounting  of functions  performed and expenses
incurred and the related fees and costs associated production of Policies
pursuant to this Agreement,  related to rule, rate and form filings under this
Agreement and related to the performance of its obligations under this
Agreement.



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Section  19.3:  Subject to specific  provisions  to the contrary in any separate
agreements or amendments to this Agreement regarding services to be performed by
IGF on behalf of CNA under Section 19.1, CNA shall  reimburse IGF for all actual
transportation, communication, meals, lodging, outside legal, and administrative
expenses  related to the functions  performed on behalf of CNA including  actual
computer service costs for processing data.




IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed
in duplicate by their duly authorized representatives.

CONTINENTAL CASUALTY COMPANY:

By:    _______________________________________________________________
Name:  _______________________________________________________________
Title: _______________________________________________________________
Date:  _______________________________________________________________



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IGF INSURANCE COMPANY
and its AFFILIATED COMPANIES


By:    _______________________________________________________________
Name:  _______________________________________________________________
Title: _______________________________________________________________
Date:  _______________________________________________________________