**GAI 6600 (Ed. 06 97)**

**Policy No.:** EXC 2101297
**Renewal Of:** EXC 2100825

**COMMERCIAL EXCESS LIABILITY DECLARATIONS PAGE**

**1. NAMED INSURED AND ADDRESS:**
- International Business Machines Corp.
  [As Per Underlying Insurance]
  One New Orchard Road, Mail Drop 109
  Armonk, NY 10504-1728

**2. POLICY PERIOD:**
- 12:01 A.M. Standard Time at the address of the Named Insured shown at left.
- From 06/21/2012 To 05/21/2013

**IN RETURN FOR PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.**

**PRODUCER'S NAME AND ADDRESS:**
- Aon Risk Services Northeast, Inc.
  199 Water Street, 33rd Floor
  New York, NY 10038

**Insurance is afforded by: Great American Insurance Co. of New York**

**3. PREMIUM:**
- Total Advance Premium: $160,000
- Service Charge: $
- Taxes: $
- Surcharge: $
- Total: $160,000

**BASIS OF PREMIUM:**
- Non-Auditable (X) Auditable ( )

**In the event of cancellation by the Named Insured, the company will receive and retain no less than $ as a policy minimum premium.**

**4. LIMITS OF INSURANCE:**
- $25,000,000 Each Occurrence
- $25,000,000 Aggregate Limit (Where Applicable)

**These Limits of Insurance apply in excess of the Underlying Limits of Insurance indicated in Item 5. of the Declarations.**

**5. UNDERLYING INSURANCE:**
- Carrier Information
- Type of Coverage
- Limits of Insurance
  As Per GAI 6008 06/97 Attached

**6. FORMS AND ENDORSEMENTS applicable to all Coverage Forms and made part of this Policy at time of issue are listed on the attached Forms and Endorsements Schedule, GAI 6013 Ed. 06/97.**

**Countersigned:**
- Date: 6-11-12
- By: [Authorized Representative]

**GAI 6600 (Ed. 06/97) PRO**
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