| Title | Form # | Ed. | Restriction in Coverage from Prior Year | Comments |
|---|---|---|---|---|
| CANCELLATION AND NON-RENEWAL |  |  |  |  |
| EMPLOYEES AS INSUREDS | CA9933 | 1013 |  |  |
| FELLOW EMPLOYEE COVERAGE | CA2055 | 1013 |  |  |
| HIRED AUTOS SPECIFIED AS COVERED AUTOS YOU OWN | CA9916 | 1013 | All autos hired for a period of 180 days or longer |  |
| KNOWLEDGE OF AN ACCIDENT | DA5X68b | 0614 |  | Vice President of IBM Risk & Insurance |
| KY LOCAL GOVERNMENT PREMIUM TAX SCHEDULE | ALL32677a | 0412 | Tax Code: 0288 Tax Amount:$ 50 |  |
| MOTOR CARRIER ENDORSEMENT | MCS90 | 0614 | Primary = 5,000,000 Limit |  |
| MEXICO COVERAGE ENDORSEMENT | DA9T51 | 0793 |  |  |
| NON-CONTRIBUTORY FOR ADDITIONAL INSUREDS | DA21886b | 0614 | Any additional insured with whom you have agreed to provide such non-contributory insurance, pursuant to and as required under a written contract executed prior to the date of loss. |  |
| NOTICE TO OTHERS ENDORSEMENT - SPECIFIC PARTIES | ALL32688 | 0111 | As required |  |
| NOTIFICATION OF PREMIUM ADJUSTMENT | ALL18057 | 1211 |  |  |
| NUCLEAR ENERGY LIABILITY EXCLUSION | IL0021 | 0908 |  |  |
| PUBLIC ENTITY ADDITIONAL INSURED | ALL22422 | 0507 | 1. The County of Orange, California<br>2. Los Angeles Department of Water and Power |  |
| NEW YORK DEDUCTIBLE ENDORSEMENT FULL ALAE REIMBURSEMENT, DEDUCTIBLE EQUALS LIMIT | DA49396 | 0617 | Deductible Amount: $ 5,000,000; Limit 5,000,000 |  |
| TRADE OR ECONOMIC SANCTIONS ENDORSEMENT | ALL21101 | 1106 |  |  |
| UNINSURED MOTORISTS AND UNDERINSURED MOTORISTS COVERAGE SUMMARY | DA40002 | 0413 |  |  |

International Business Machines Corporation<br>
05/17/2018<br>
Limits and Coverages Page 29 of 36