# FORMS SCHEDULE

**Named Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION

**Policy Number:** 5443148

**Effective 12:01 AM:** May 21, 2008

| End't. No. | Form Name | Form Number/ Edition Date |
|------------|-----------|--------------------------|
|            | UMB PRIME DEC | 80518 (10/04)             |
|            | UMB PRIME JACKET | 80517 (10/04)             |
| 1          | PRIME MISCELLANEOUS CHANGES ENDORSEMENT | 83864 (02/04)             |
| 2          | ECONOMIC OR TRADE SANCTIONS COND. ENDT | 87068 (11/04)             |
| 3          | VIOL. OF INFO. OR COMM. LAW EXCL. ENDT | 87241 (12/04)             |
| 4          | CRISISRESPONSE COVERAGE ENHANCEMENT ENDORSEMENT | 94621 (05/07)             |
| 5          | DUTIES IN THE EVENT OF AN OCCURRENCE, CLAIM OR SUI | 83687 (09/07)             |
| 6          | NEW YORK AMENDATORY ENDORSEMENT | 69898 (12/04)             |
| 7          | ACT OF TERRORISM SIR ENDORSEMENT | 83049 (03/06)             |
| 8          | NOTICE OF OCCURRENCE | 80454 (07/02)             |
| 9          | NAMED PERIL AND TIME ELEMENT POLL. SIR END. PCOH V | 89470 (06/05)             |
| 10         | AMDT. OF CONTRACTUAL LIAB. EXCL. ENDT. | 86454 (08/04)             |
| 11         | INDUSTRIAL AID AIRCRAFT LIMITATION ENDORSEMENT | 81912 (05/06)             |
| 12         | AIRCRAFT PROD. AND GROUNDING EXCL END. | 86428 (08/04)             |
| 13         | RETAINED LIMIT AMENDATORY ENDT. | 81583 (12/04)             |
| 14         | FI AND INSURANCE COMPANY EXCL. | 83076 (09/03)             |
| 15         | LIMITS. OF INS. AMEND. ENDT. DEL. OF PARA. E. | 86460 (08/04)             |
| 16         | AMEND.OF VARIOUS PER.INJ.AND ADV.INJ.EXCL.END.AMEN | 89452 (06/05)             |
| 17         | ADDITIONAL NAMED INSURED(S) | 80391 (07/02)             |
| 18         | NON PYRAMIDING OF LIMITS PRIME | 83857 (01/04)             |
| 19         | UNINSURED/UNDERINSURED MOTORIST COVERAGE END | 82610 (02/07)             |
| 20         | SATELLITE EXCLUSION | MNSCPT (04/08)             |
| 21         | PROF LIAB EXCL (W/EXCEPTION FOR INCID MED MAL) | MNSCPT (04/08)             |
| 22         | JOINT VENTURES LIMITATION ENDORSEMENT | MNSCPT (04/08)             |
| 23         | DATA PROCESSING ERRORS & OMISSIONS | MNSCPT (04/08)             |
| 24         | JOINT VENTURE RETAINED LIMITS | MNSCPT (04/08)             |
| 25         | NUCLEAR LIABILITY | MNSCPT (04/08)             |
| 26         | KNOWLEDGE OF OCCURRENCE | MNSCPT (04/08)             |

**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 CIFMSC INSURANCE LAW AND REGULATIONS. 2 - 13000 CI0226