# CHUBB EXCESS LIABILITY INSURANCE - SL

## Schedule of Forms

| Policy Period | MAY 21, 2013 to MAY 21, 2014 |
|---------------|--------------------------------|
| Effective Date | May 21, 2013                   |
| Policy Number | 7966-56-84 DTO                 |
| Insured       | INTERNATIONAL BUSINESS MACHINES CORPORATION |
| Name of Company | FEDERAL INSURANCE COMPANY |
| Date Issued   | May 22, 2013                  |

## Form number

As of the effective date printed above, this is the Schedule of Forms applicable to this policy:

| Description                                                                 | Form number | Revision |
|------------------------------------------------------------------------------|-------------|----------|
| PREMIUM BILL                                                                  | 07-10-0542  | (10/06)  |
| IMPORTANT NOTICE TO POLICYHOLDERS-TRIPRA                                     | 99-10-0732  | (12/07)  |
| IMPORTANT NOTICE - OFAC                                                       | 99-10-0796  | (09/04)  |
| AOD IMPORTANT POLICYHOLDER NOTICE                                            | 99-10-0872  | (06/07)  |
| NY - EXCESS LIAB - SL DEC                                                     | 07-02-2325  | (12/09)  |
| CHUBB EXCESS LIAB-SL-NEW YORK CANCELLATION                                  | 07-02-1305  | (11/04)  |
| CHUBB EXCESS LIABILITY INSURANCE-SL CANCELLATION                            | 07-02-1351  | (12/97)  |
| NEW YORK AMENDATORY ENDORSEMENT                                              | 07-02-1439  | (11/98)  |
| INFORMATION DISTRIBUTION LAWS EXCLUSION                                      | 07-02-2174  | (11/04)  |
| NEW YORK LATE NOTICE MANDATORY                                               | 07-02-2313  | (01/09)  |
| CIVIL UNIONS OR DOMESTIC PARTNERSHIPS                                        | 07-02-2484  | (03/12)  |
| LIMITS OF INSURANCE - EXCESS LIAB. INS. SL                                   | 07-02-1334  | (12/97)  |
| CANCELLATION NOTICE CONDITION                                                 | 07-02-1576  | (02/00)  |
| CAP ON CERTIFIED TERRORISM LOSSES                                             | 07-02-1953  | (12/07)  |

Form 07-02-0975 (Rev. 5/95) Schedule of Forms
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