# Chubb Global Casualty

*Canadian premiums, taxes, fees and commission must be paid locally in Canada. Canadian policies will be issued locally in Canada. The premiums and limits are in US Dollar*

Non-premium surcharges and assessments are summarized in this section for illustration purposes only to show the total estimated cost associated with your insurance purchase. More detail about the calculation of each individual surcharge is located in Section G) Non-Premium Surcharges and Assessments of this Notice of Election.

## C) Claims Administration and Expense

### A. Claims Adjusting Service

| Policy Number | Claims Adjusting Service |
|---------------|--------------------------|
| HDOG7109490A  | ESIS                     |
| CGL 325142    | ESIS                     |
| ISAH25157564   | ESIS                     |

#### ESIS Claim Service Fees

ESIS will bill a non-refundable Claims Service Fee Minimum of $52,097 in a single, annual installment at Agreement inception. The Claims Service Fee Minimum will be exhausted by Claim Service Fee charges in amounts calculated by multiplying each Claim and Allocated Loss Expense payment issued by 6%. The total Claim Service Fee charges for any one claim will not exceed $10,000. Once the Claim Service Fee Minimum is fully exhausted, additional Claim Service Fee charges will be billed as incurred on a semiannual basis.

### D) Reimbursable Losses

| Policy Number(s) | Retention Type | Retained Amount ($) | ALAE Reimbursement | Expected Reimbursable Amount ($) |
|------------------|---------------|--------------------|--------------------|----------------------------------|
| HDOG7109490A     | High Deductible | 15,000,000         | 100% borne by Insured | 473,257                          |
| CGL 325142       | High Deductible | 15,000,000         | 100% borne by Insured | Included in HDOG7109490A          |
| ISAH25157564     | High Deductible | 5,000,000          | 100% borne by Insured | 1,178,165                        |

### E) Collateral & Paid Loss Deposit Fund

The collateral and paid loss deposit funds are subject to all the terms and conditions of the Collateral Agreement executed by you and us.

| Amount($) | Collateral Form |
|-----------|-----------------|
| Collateral Currently Held | 7,500,000 | Letter of Credit |
| Total Held | 7,500,000       |

| Amount($) | Collateral Form | Due Date |
|-----------|-----------------|----------|
| Additional Required Collateral | -1,500,000 | Letter of Credit | 5/21/2018 |
| Additional Required Collateral | 1,500,000 | Surety Bond* | 5/21/2018 |

*The Company will permit the Insured to provide a portion of the total required amount of collateral in the form of Surety Bond in an amount and form (including beneficiaries) and from an insurer acceptable to the Company. Nothing herein shall in any way affect or limit the Company's ability to require any additional or replacement amount of security from the Insured pursuant to the Collateral Agreement.*

International Business Machines Corporation
05/17/2018
Notice of Election Page 6 of 36