# Chubb Global Casualty
## Notice of Election

**Insured's Name:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**Insured's Address:** One New Orchard Road, Armonk, New York 10504

### A) Schedule of Policies

| Line of Business | Policy Number | Effective Date | Expiration Date | Issuing Company |
|------------------|---------------|---------------|----------------|-----------------|
| General Liability | HDOG7109490A | 05/21/2018    | 05/21/2019     | ACE American Insurance Company |
| General Liability (CANADA) | CGL 325142 | 05/21/2018    | 05/21/2019     | Chubb Insurance Company of Canada |
| Automobile Liability | ISAH25157564 | 05/21/2018    | 05/21/2019     | ACE American Insurance Company |

*And any other protective liability policies we issue at your request. We will prepare a final listing of all such policies and send you a copy of the list.*

### B) Premium Calculation and Adjustment

#### Policy Number(s): HDOG7109490A

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Liability Premium | 96,753 | 100% | n/a | Flat Charge |
| Broker Commission | 0 |  |  |  |
| Total Estimated Written Premium | 96,753 |  |  |  |
| Non-Premium Surcharges & Assessments | 21 |  |  |  |
| Total Estimated Cost | 96,774 |  |  |  |

#### Policy Number(s): ISAH25157564

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Auto Liability Premium | 92,222 | 100% | n/a | Flat Charge |
| Broker Commission | 0 |  |  |  |
| Total Estimated Written Premium | 92,222 |  |  |  |
| Non-Premium Surcharges & Assessments | 6,779 |  |  |  |
| Total Estimated Cost | 99,001 |  |  |  |

#### Policy Number(s): CGL 325142

| Premium Component | Estimated Premium ($) | Minimum | Rate | Basis of Adjustment |
|-------------------|-----------------------|---------|------|--------------------|
| Estimated Liability Premium | 3,000 | 100% | n/a | Flat Charge |
| Broker Commission | 0 |  |  |  |
| Total Estimated Written Premium | 3,000 |  |  |  |
| Non-Premium Surcharges & Assessments | Included |  |  |  |
| Total Estimated Cost | 3,000* |  |  |  |

International Business Machines Corporation  
05/17/2018  
Notice of Election Page 5 of 36