# SCHEDULE OF FORMS AND ENDORSEMENTS

| Named Insured | International Business Machines Corporation |
|---------------|--------------------------------------------|
| Endorsement Number | (Page 4 of 4) |
| Policy Symbol | HDO |
| Policy Number | G24931407 |
| Policy Period | 05/21/2009 to 05/21/2010 |
| Effective Date of Endorsement | 05/21/2009 |
| Issued By (Name of Insurance Company) | ACE American Insurance Company |

Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.

| Endt. No. | Form No. | Description |
|-----------|----------|-------------|
| 76.       | IL02340908 | North Dakota Changes and Cancellation and Nonrenewal |
| 77.       | IL02590907 | Nebraska Changes - Cancellation and Nonrenewal |
| 78.       | IL01350908 | New Hampshire Changes - Cancellation and Nonrenewal |
| 79.       | IL01450108 | New Hampshire Changes - Civil Union |
| 80.       | CG26201093 | New Jersey Changes - Loss Information |
| 81.       | IL01410908 | New Jersey Changes - Civil Union |
| 82.       | IL02080907 | New Jersey Changes - Cancellation and Nonrenewal |
| 83.       | IL02980908 | New Mexico Changes - Cancellation and Nonrenewal |
| 84.       | IL02510907 | Nevada Changes - Cancellation and Nonrenewal |
| 85.       | CG01041204 | New York Changes - Premium Audit |
| 86.       | CG01630409 | New York Changes - Commercial General Liability Coverage Form |
| 87.       | CG26211091 | New York Changes - Transfer of Duties When A Limit Of Insurance Is Used Up |
| 88.       | IL02681105 | New York Changes - Cancellation and Nonrenewal |
| 89.       | IL02440907 | Ohio Changes - Cancellation and Nonrenewal |
| 90.       | CG01091185 | Kansas And Oklahoma Changes - Transfer of Rights |
| 91.       | IL02360907 | Oklahoma Changes - Cancellation and Nonrenewal |
| 92.       | IL01420908 | Oregon Changes - Domestic Partnership |
| 93.       | IL02790908 | Oregon Changes - Cancellation and Nonrenewal |
| 94.       | IL02460907 | Pennsylvania Changes - Cancellation and Nonrenewal |
| 95.       | IL02490908 | South Carolina Changes - Cancellation and Nonrenewal |
| 96.       | IL02320908 | South Dakota Changes - Cancellation and Nonrenewal |
| 97.       | IL02500907 | Tennessee Changes - Cancellation and Nonrenewal |
| 98.       | CG01030606 | Texas Changes |
| 99.       | CG01861204 | Utah Changes |
| 100.      | IL02660908 | Utah Changes - Cancellation and Nonrenewal |
| 101.      | CG01791107 | Virginia Changes |
| 102.      | CG01541207 | Vermont Changes - Pollution |
| 103.      | IL01090908 | Vermont Changes - Civil Union |
| 104.      | IL01260908 | Vermont Changes - Statutory Liability |
| 105.      | IL02190908 | Vermont Changes - Cancellation and Nonrenewal |
| 106.      | CG01810508 | Washington Changes |
| 107.      | IL01460907 | Washington Common Policy Conditions |
| 108.      | CG01240193 | Wisconsin Changes - Amendment of Policy Conditions |
| 109.      | CC1K11e | Signatures |

**Authorized Agent**

CC-IE15 Pld. In U.S.A.