# Commercial Excess Liability Declarations Page

## 1. Named Insured and Address:
- **International Business Machines Corp.**
  - (As Per Underlying Insurance)
  - One New Orchard Road, Mail Drop 109
  - Armonk, NY 10504-1725

## 2. Policy Period:
- **12:01 A.M. Standard Time at the address of the Named Insured shown at left.**
- **From 05/21/2013 To 05/21/2014**

## 3. Premium:
- **Total Advance Premium:** $78,795
- **Service Charge:** $
- **Taxes:** $
- **Surcharges:** $
- **Total:** $78,795

## 4. Limits of Insurance:
- **$ Per GAI 6515 Each Occurrence**
- **$ Per GAI 6515 Aggregate Limit (Where Applicable)**

## 5. Underlying Insurance:
- **Carrier Information:** As Per GAI 6008 (06/97) Attached
- **Type of Coverage:** 
- **Limits of Insurance:**

## 6. Forms and Endorsements:
- **Forms and endorsements applicable to all coverage forms and made part of this policy at time of issue are listed on the attached Forms and Endorsements Schedule, GAI 6013 (Ed. 06/97).**

## Countersigned:
- **Date:** 06-27-13
- **Authorized Representative:**

**GAI 6600 (Ed. 06/97) PRO**
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