**XL**

Form XL XS-BSF-03 (03/14)

**THE BERMUDA SHORTS FORM**

Issued by

XL INSURANCE (BERMUDA) LTD

**Policy Number:** BM00027784LI14A

**Producer:** Aon (Bermuda) Ltd

**DECLARATIONS**

**Item 1.**
a) **Named Insured:** International Business Machines Corporation
b) **Address of Named Insured:** One New Orchard Road, Mail Drop 109, Armonk, NY 10504 USA

**Item 2.** **Policy Period:**
From: May 21, 2014 at 12:01 am standard time at the address of the Named Insured.
To: May 21, 2015 at 12:01 am standard time at the address of the Named Insured.

**Item 3.** **Retroactive Date:** None

**Item 4.**
a) **Followed Policy:**
Company: ACE Property & Casualty Insurance Company
Policy Number: X00 G2 73 80 03 7
Coverage: Lead Umbrella - Occurrence
Policy Period: May 21, 2014 to May 21, 2015
Limits of Liability: USD 50,000,000 Per Occurrence USD 50,000,000 General Aggregate (where applicable)
b) **Underlying Policy(ies):** As per Endorsement No. 1 Section I - Schedule of Underlying Policy(ies) and/or Quota Share Policy(ies) Endorsement
c) **Quota-Share Policy(ies):** As per Endorsement No. 1 Section II - Schedule of Underlying Policy(ies) and/or Quota Share Policy(ies) Endorsement

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