# Liberty Mutual Insurance Excess Liability Policy Declarations

## Coverage Provided by:
The Ohio Casualty Insurance Company

## Policy Number:
ECO (15) 54 08 82 46

## Excess Liability Policy Declarations
Basis: Occurrence

### Item 1: Named Insured & Mailing Address
- **International Business Machines Corporation**
  - **Mail Drop:** 109
  - **Address:** 1 New Orchard Rd, Armonk, NY 10504-1722

### Item 2: Agent Mailing Address & Phone No.
- **AON Risk Services Northeast, Inc.**
  - **Address:** 199 Water St, New York, NY 10038-3526
  - **Phone:** (212) 441-1000

### Item 3: Policy Period
- **From:** 05/21/2014
- **To:** 05/21/2015 12:01 AM Standard Time at Insured Mailing Location

### Item 3: Premium Charges
- **Explanation of Charges**
  - **Excess Liability:** $97,011.00
  - **Certified Acts of Terrorism Coverage:** $961.00 (Included)
- **Total Advance Charges:** $97,011.00
- **Note:** This is not a bill

### Item 4: Basis of Premium
- **Basis of Premium:** NON-AUDITABLE(X)

### Item 4: Limits of Insurance
- **Each Occurrence:** $25,000,000
- **Aggregate (Where Applicable):** $25,000,000

### Item 5: Limits of Insurance
- **These limits of insurance apply in excess of the underlying limits of insurance indicated in Item 5 of the declarations.**

### Servicing Office and Issue Date
- **New York - Metro Regional Office**
- **Issue Date:** 05/30/14

### Authorized Representative

## To report a claim, call your Agent or 1-800-362-0000

**DS 70 22 01 08**