# Excess Insurance Policy

## Liberty Insurance Underwriters Inc.

**(A New York Stock Insurance Company, hereinafter the "Insurer")**
55 Water Street, 18th Floor, New York, NY 10041
Toll-free number: 1-800-677-9163

**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.

## EXCESS FORMS AND ENDORSEMENTS SCHEDULE

| Effective Date | May 21, 2010 |
|---------------|--------------|
| Expiration Date | May 21, 2011 |
| Policy Number | LQ1B71078753092 |
| Issued To     | International Business Machines Corporation |

It is hereby understood and agreed the following forms and endorsements are attached to and are a part of this policy:

| Form Number | Form Name | Endorsement No. |
|-------------|-----------|-----------------|
| 0100-XS (03/00) | Excess Policy Liability Declarations | - |
| 0104-XS (Ed. 03/00) | Excess Forms and Endorsements Schedule | - |
| 0188-XS (Ed. 03/00) | Asbestos Exclusion | 1 |
| 0103-XS (Ed. 03/00) | Following Form Endorsement | 2 |
| 0102-XS (Ed. 03/00) | Nuclear Energy Liability Exclusion Endorsement | 3 |
| 0160-XS (Ed. 03/00) | Pollution Limitation Endorsement Follow Form | 4 |
| 190-XS-01/09 | Sub-Limit Exclusion | 5 |
| E-NY-XS (Ed. 10 00) | New York Amendatory Endorsement | 6 |
| OFAC 08/09 | U.S. Economic and Trade Sanctions Endorsement | 7 |
| TRIA-N004-0208 | Disclosure – Terrorism Risk Insurance Act | 8 |
| TRIA-E002-0208 | Cap on Losses from Certified Acts of Terrorism | 9 |
| TRIA-EX-003-1009 | Underlying Coverage Warranty for Certified Act of Terrorism | 10 |
| LIUILE001-NYFTZ-0109 | New York Liability State Amendatory Endorsement | 11 |

**1** **2**

0104-XS (03 00)
- 0