# Excess Liability Policy Declarations

**Berkley National Insurance Company**

215 Shuman Boulevard, Suite 200  
Naperville, IL 60563  
(herein called the company)

**Policy Number:** CEX09600213-01  
**Renewal/Rewrite of:** CEX09600213-00

## EXCESS LIABILITY POLICY DECLARATIONS

### 1. Named Insured and Address:
- **IBM Corporation (Per Underlying Insurance)**
  - One New Orchard Rd Maildrop 109
  - Armonk, NY 10504

### 2. Policy Term:
- **From:** 05-21-2014
- **To:** 05-21-2015
  - (12:01 a.m. Standard Time at on both dates, at the address of the Named Insured noted above.)

In consideration of the payment of premium, in reliance upon the statements herein or attached hereto, and subject to all of the terms of this policy, the company agrees with the Named Insured as follows:

### 3. Premium:
- **Deposit Premium:** $51,250.00
- **Minimum Annual Premium:** $51,250.00
- **Total:** $51,250.00

**Rating Basis:** (X) Non-Auditable

In the event of cancellation by the Named Insured, the company will receive and retain no less than $ as a policy minimum premium.

### 4. Limits of Insurance:
- **$25,000,000 Each Occurrence**
- **$25,000,000 Aggregate Limit (Where Applicable)**
- **$50,000,000 Each Occurrence**
- **$50,000,000 Aggregate Limit (Where Applicable)**

These Limits of Insurance apply in excess of the "controlling underlying limits of insurance" indicated in Item 5. of the Declarations.

### 5. Underlying Insurance:
See schedule of underlying policies

### 6. 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.

**Issued Date:** 5/28/2014  
**Issuing Office:** Los Angeles Office  
**Los Angeles, CA**  
**Authorized Representative:** [Signature]

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**Berkley National Insurance Company**  
CEX0002 0413