# CHUBB EXCESS LIABILITY INSURANCE - SL

## Premium Bill

**Policy Period:** MAY 21, 2012 To MAY 21, 2013  
**Effective Date:** May 21, 2012  
**Policy Number:** 7966-56-84  
**Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**Name of Company:** FEDERAL INSURANCE COMPANY  
**Date Issued:** May 8, 2012  
**Producer:** AON RISK SERVICES NORTHEAST, INC.

**THIS BILLING IS TO BE ATTACHED TO AND FORM A PART OF THE POLICY**

PLEASE SEND PAYMENT TO AGENT OR BROKER, IF APPLICABLE

| Coverage | Commission Rate | Premium |
|----------|-----------------|---------|
| COMMERCIAL EXCESS RENEWAL | 0.00% | $ 97,000.00 |

**Total:** $ 97,000.00

**Portion of total premium attributable for Terrorism and statutory standard fire where applicable is:** $ 960.00

Reference Copy  
Form 07-10-0542 (Ed. 10-06) Premium Bill  
Page 1