# Allianz Global Corporate & Specialty

## Excess Liability Following Form Short Excess Form Declarations
### Schedule of Excess Policy(ies)

**Binder For:** International Business Machines Corporation

**Terms & Conditions:**
- Per Coverage Form and the following Endorsements:

  - **Allianz - Endorsements:**
    - AGR-D5 1002 (11-03)
    - AGRIL IL 8NY01 01 21
    - AGR-IL 8003 (01-05)
    - AGR-IL 8001 (12-19)
    - AGRILXS 5124 (02-16)
    - AGRILXS 5125 (02-16)
    - AGR-XS 5008 (01-15)
    - AGRILXS 5120 (02-16)
    - AGRILXS ASF 5001 10 20
    - AGRIL IL NY01 08 19
    - M-AGRIL XS ASF 5002 01 21

  - **Forms and Endorsement List**
  - **Important Notice New York Free Trade Zone Filing Exemption and Class Code Disclosure**
  - **Policyholder Notice - OFAC**
  - **Policyholder Notice - All States (Claims Reporting Information)**
  - **Nuclear Energy Liability Exclusion Endorsement (Broad Form)**
  - **Asbestos Exclusion**
  - **Cap on Losses from Certified Acts of Terrorism**
  - **Economic or Trade Sanctions Endorsement**
  - **Non Following Form Endorsement**
  - **New York Amendatory**
  - **Definition of Pollutant(s) (Indiana) Endorsement**

**Premium:**
- Term Premium: $198,088.00 Flat
- $3,962.00 Certified Terrorism
- Total Term Premium: $202,050.00

**New York Office**
- 28 Liberty Street
- 37th Floor
- New York, New York 10005
- Phone: 646-472-1500
- Fax: (212) 524-9362
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