# ACE Bermuda Insurance Ltd.

**Policy No.** IBM-0015/BSF02

## THE BERMUDA SHORTS FORM – 02 (the "Policy")

### DECLARATIONS

#### Item 1
- **(a)** Named Insured: International Business Machines Corporation
- **(b)** Address of Named Insured:
  - One New Orchard Road
  - Mall Drop 109
  - Armonk, NY 10504
  - USA

#### Item 2
- **Policy Period:** From: May 21, 2013 at 12:01 am standard time at the address of the Named Insured.
- To: May 21, 2014 at 12:01 am standard time at the address of the Named Insured.

#### Item 3
- **Retroactive Date:** NONE

#### Item 4
- **(a)** Followed Policy:
  - **Company:** ACE Property & Casualty Insurance Company
  - **Policy Number:** XOO G27051169
  - **Coverage:** Commercial Umbrella Liability
  - **Policy Period:** From: May 21, 2013 To: May 21, 2014
  - **Limits of Liability:** USD50,000,000
- **(b)** Underlying Policy(ies) As per Endorsement No. 1 Schedule of Excess Policy(ies) Section I – Schedule of Underlying Policy(ies)
- **(c)** Quota Share Policy(ies) As per Endorsement No. 1 Schedule of Excess Policy(ies) Section II – Schedule of Quota Share Policy(ies)

#### Item 5
- **Limit of Liability:** (a) USD50,000,000 Each Occurrence, Claim or Loss (b) USD100,000,000 Aggregate

**BSF-02**

**ace bermuda**