# DocuSign Envelope ID: 36857BF5-BFB0-4F33-ACA9-8EE38BEA37BB

**Chubb Global Casualty**

## Notice of Election-Paid Loss Retention Program

**Insured's Name:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**Insured's Address:** One New Orchard Road, Armonk, New York 10504

### A) Schedule of Policies

| Line of Business | Policy Number | Effective Date | Expiration Date | Issuing Company |
|------------------|---------------|---------------|----------------|-----------------|
| General Liability | HDO G7296360A | 05/21/2023     | 05/21/2024      | ACE American Insurance Company |
| Automobile Liability | ISA H25579070 | 05/21/2023     | 05/21/2024      | ACE American Insurance Company |
| General Liability (Canada) | CGL 326131 | 05/21/2023     | 05/21/2024      | Chubb Insurance Company of Canada |
| Owners and Contractors Protective Railroad Liability (Metro North Railroad) | ORP G72963647 | 05/21/2023     | 05/21/2024      | ACE American Insurance Company |

And any other protective liability policies we issue at your request. We will prepare a final listing of all such policies and send you a copy of this list.

### B) Premium Calculation and Adjustment

#### Policy Number(s): HDO G7296360A, ORP G72963647

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Liability Premium | 202,500 | 100% | N/A | Flat Charge |
| Broker Commission | 0 | | | |
| Total Estimated Written Premium | 202,500 | | | |
| Non-Premium Surcharges & Assessments | 170 | | | |
| Total Estimated Cost | 202,670 | | | |

#### Policy Number(s): ISA H25579070

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Auto Liability Premium | 103,020 | 100% | N/A | Flat Charge |
| Broker Commission | 0 | | | |
| Total Estimated Written Premium | 103,020 | | | |
| Non-Premium Surcharges & Assessments | 231 | | | |
| Total Estimated Cost | 103,251 | | | |

#### Policy Number(s): CGL 326131

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Liability Premium | 10,000 | 100% | N/A | Flat Charge |
| Broker Commission | 0 | | | |
| Total Estimated Written Premium | 10,000 | | | |
| Non-Premium Surcharges & Assessments | Included | | | |
| Total Estimated Cost | 10,000* | | | |

**INTERNEA_05212023_William Overby**  
**04/28/2023**  
**Notice of Election Page 4 of 55**