# THE BERMUDA SHORTS FORM

Issued by
XL INSURANCE (BERMUDA) LTD

**Form XL XS-BSF-02 (07/09)**

**Policy Number:** BM00026195L112A
**Renewal of:** BM00025502L111A
**Producer:** Aon (Bermuda) Ltd.

## DECLARATIONS

### Item 1.
a) **Named Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION
b) **Address of Named Insured:** One New Orchard Road Mail Drop 109 Armonk, NY 10504 U.S.A.

### Item 2.
**Policy Period:**
From: May 21, 2012 at 12:01 am standard time at the address of the Named Insured.
To: May 21, 2013 at 12:01 am standard time at the address of the Named Insured.

### Item 3.
**Retroactive Date:** NONE

### Item 4.
a) **Followed Policy:**
Company: ACE American Insurance Company
Policy Number: XOO G25915951
Coverage: Lead Umbrella - Occurrence
Policy Period: May 21, 2012 to May 21, 2013
Limits of Liability: USD 50,000,000 Each Occurrence USD 50,000,000 General Aggregate (where applicable)

b) **Underlying Policy(ies):** As per Endorsement No. 1 Section I - Schedule of Underlying Policy(ies)

c) **Quota-Share Policy(ies):** As per Endorsement No. 1 Section II - Schedule of Quota-Share Policy(ies)

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