# Limits and Coverages

**Automobile**

**Policy Number:** ISAH25157564

## Policy Limits - Automobile Liability

| Coverage | Symbol | Limit |
|----------|--------|-------|
| Liability | 1      | 5,000,000 |
| Medical Payments | 2 | 5,000 |
| Personal Injury Protection | 5 | Stat & Reject |
| Additional Personal Injury Protection | N/A | Not Covered |
| Uninsured Motorist | 6 | Stat Min/Reject |
| Underinsured Motorist | 6 | Stat Min/Reject |

## Policy Form and Endorsements

- The policy forms and endorsements offered may be different than those requested.
- State mandatory endorsements will be attached to the policy in addition to those listed below.

| Title | Form # | Ed. | Restriction in Coverage from Prior Year | Comments |
|-------|--------|-----|--------------------------------------|-----------|
| BUSINESS AUTO | CA 00 01 | 10-13 | | |
| ADDITIONAL INSURED - DESIGNATED PERSONS OR ORGANIZATIONS | DA9U74c | 0316 | | 1. Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss.<br>2. Clark County, Government Center c/o Purchasing and Contracts Division<br>3. Doral Bank Vendor Management Department |
| ADDITIONAL INSURED - LESSOR | CA2001 | 1013 | | Additional Insured: Any Lessor whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss; Description of Leased Autos: All autos leased by you; Limit: as per dec page |
| AUTO MEDICAL PAYMENTS COVERAGE | CA9903 | 1013 | | |
| CONTRACTUAL LIABILITY COVERAGE | DA21916 | 0507 | | |
| DEFINITION OF BODILY INJURY | DA22185b | 0614 | | |
| DIRECT ACTION EXPENSES | ALL44289c | 1116 | | |
| DRIVE OTHER CAR COVERAGE - BROADENED COVERAGE FOR NAMED INDIVIDUALS | CA9910 | 1013 | | Any employee assigned a company auto who is not covered under a personal auto liability policy. Limits: as per dec page |
| EARLIER NOTICE OF | ALL10617b | 0614 | 90; 90 | |

**International Business Machines Corporation**
**05/17/2018**
**Limits and Coverages Page 28 of 36**