# Schedule of Forms and Endorsements

**ace group**

| NAMED INSURED | POLICY NUMBER | POLICY PERIOD |
|---------------|---------------|---------------|
| International Business Machines Corporation | XOO G25915951 | 05/21/2012 to 05/21/2013 |

| Endorsement Number | Form Number - Edition Date | Title |
|--------------------|----------------------------|-------|
| 19                 | MS-9613 (05/12)            | Employee Benefit Plan Follow Form Endorsement [Claims Made] |
| 20                 | MS-9612 (05/12)            | Electronic Chat Rooms or Bulletin Boards Exclusion Endorsement |
| 21                 | MS-9614 (05/12)            | Incidental Medical Malpractice and Good Samaritan Endorsement |
| 22                 | MS-9617 (05/12)            | Joint Venture Limitation Endorsement – Infoprint Solutions Company LLC and its Subsidiaries |
| 23                 | MS-9616 (05/12)            | Joint Venture Limitation Endorsement Scaled Limits Over Scaled Retention - Adjustment for Judgment or Award |
| 24                 | MS-9621 (05/12)            | Non-Pyramiding of Limits Endorsement |
| 25                 | MS-9620 (05/12)            | Named Peril and Time Element Pollution Exclusion with Limited Exceptions Including Auto, Mobile Equipment and Products-Completed Operations and Self-Insured Retention |
| 26                 | MS-9623 (05/12)            | Nuclear Liability Exclusion Endorsement |
| 27                 | MS-9628 (05/12)            | Professional and Financial Service Exclusion – Limited Exception for Resulting Bodily Injury and Property Damage |
| 28                 | MS-9630 (05/12)            | Punitive Damages – Most Favorable Jurisdiction Limitation Endorsement |
| 29                 | MS-9624 (05/12)            | Retained Limit Amendatory Endorsement - No Underlying Insurance |
| 30                 | MS-9606 (05/12)            | Technology Services Errors and Omission Exclusion Endorsement |
| 31                 | MS-9627 (05/12)            | Trade or Economic Sanctions Amendatory Endorsement |
| 32                 | MS-9626 (05/12)            | Watercraft Exclusion Amendatory Endorsement |
| 33                 | XS-18937 (11/05)           | Knowledge Of Occurrence |

XS-27991 (08/09)

© 2009

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