**ORIGINAL POLICY**

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

**Policy No. EXC 1862519 -**
**Renewal Of EXC 4647936 -**

**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 05/21/2014 To 05/21/2015**

**IN RETURN FOR PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.**

**PRODUCER'S NAME AND ADDRESS:**
- **Aon Risk Services Northeast, Inc.**
- **199 Water Street, 33rd Floor**
- **New York, NY 10038**

**Insurance is afforded by:** Great American Insurance Co. of New York

**3. PREMIUM:**
- **Total Advance Premium $** 78,795
- **Service Charge $**
- **Taxes $**
- **Surcharge $**
- **Total $** 78,795

**BASIS OF PREMIUM:** Non-Auditable (X) 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:**
- **$ Per GAI 6515 Each Occurrence**
- **$ Per GAI 6515 Aggregate Limit (Where Applicable)**

**These Limits of Insurance apply in excess of the Underlying Limits of Insurance indicated in Item 5. of the Declarations.**

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

**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, GAI 6013 (Ed. 06/97).**

**Countersigned 7/7/2014 By [Signature] Authorized Representative**

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