# FORMS SCHEDULE

**Named Insured:** International Business Machines Corporation  
**Policy Number:** 60703940  
**Effective 12:01 A.M.:** May 21, 2014  

| End't. No. | Form Name | Form No. | Edition Date |
|------------|-----------|----------|--------------|
| 1.         | The Bermuda Shorts Form - 03 Dec. | 117111   | 4/14         |
|            | The Bermuda Shorts Form - 03 Policy | 117111   | 4/14         |
| 2.         | Schedule of Excess Policy (ies) | 103281   | 4/11         |
| 3.         | Premium Payment Condition | 103280   | 11/09        |
| 4.         | Violation of Statutes in Connection with Sending, Transmitting or Communicating Any Material or Information Exclusion | 104228   | 11/09        |
| 5.         | Coverage Territory Endorsement | 89644    | 07/05        |
|            | Personal and Advertising Injury Endorsement Limitation – (Cyber) | Manuscript |            |

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Forms Schedule 2014