# General Liability Policy – Declarations

## Insurers

- Bankers Standard Insurance Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- Century Indemnity Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- ACE Fire Underwriters Insurance Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- ACE American Insurance Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- ACE Property and Casualty Insurance Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- Indemnity Insurance Company of North America
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- Insurance Company of North America
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703
- Pacific Employers Insurance Company
  - Address: 436 Walnut Street, PO Box 1000, Philadelphia, Pennsylvania 19106-3703

## Policy Identification

- HDO
- G24931407

## Named Insured and Address

- International Business Machines Corporation
  - Address: One North Castle Drive, Armonk, NY 10504

## Policy Details

- **Policy Type:** New
- **Named Insured:** Corporation
- **Business of Insured:** Manufacturing
- **Policy Period:** From 05/21/2009 to 05/21/2010 at 12:01 A.M. Standard Time at your mailing address shown above.

## Premium Payment Conditions

- **Audit Period:** **
- **Payment Frequency:** **
- **Payment Schedule:** **
- Includes:
  - $48 2006 FIGA Regular Assessment
  - $54 FL Hurricane Catastrophe Fund
  - $54 FIGA Emergency Assessment
  - $12 KY Domestic, Foreign and Alien Insurers
  - $30 NJ Insurance Guarantee
  - $7 WV Insurance Premium

## Total Advance Premium: $*94,793*

## Notice

- These policy forms and the applicable rates are exempt from the filing requirements of the New York State Insurance Department.
- However, such forms and rates must meet the minimum standards of the New York Insurance Law and Regulations.

## Class Code: 2-14057