# AON SHORT EXCESS FORM (LONDON) 10-13 (OCC) (SELF PROCURED BASIS)

## DECLARATIONS

**Item 1.**
- **a) Named Insured:** International Business Machines Corporation and as more fully set forth in the Followed Policy.
- **b) Address of Named Insured:** IBM Corporation, One New Orchard Road, (Mail Drop 109), Armonk, New York 10504, United States of America

**Item 2.** **Policy Period:**
- **From:** 21st May 2014 at 12:01 a.m. standard time at the address of the Named Insured.
- **To:** 21st May 2015 at 12:01 a.m. standard time at the address of the Named Insured.

**Item 3.**
- **a) Followed Policy:**
  - **Company:** ACE Property & Casualty Insurance Company
  - **Policy Number:** XOO G2 73 80 03 7
  - **Coverage:** Umbrella Liability
  - **Policy Period:**
    - **From:** 21st May 2014
    - **To:** 21st May 2015
  - **Limits of Liability:** USD 50,000,000
- **b) Underlying Policy(ies):** As per Endorsement Number One – Schedule of Underlying Policy(ies).

**Item 4.** **Limit of Liability: (Insuring Agreement 2):**
- **a) USD 200,000,000 each Occurrence.**
- **b) USD 200,000,000 Aggregate where stated in the Followed Policy.**

**Item 5.** **Underlying Limits: (Insuring Agreement 2):**
- **a) USD 200,000,000 Each Occurrence.**
- **b) USD 200,000,000 Aggregate where applicable.**

Which in turn is excess of various insurances and/or retentions as more fully set forth in the Followed Policy.

**Market Submission - Wording**  
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**PB 20/05/14 06**