# Iron-Starr Excess Agency Ltd.

**Address:** 141 Front Street, Hamilton HM 19, Bermuda  
**Telephone:** +441 279 7000

## THE BERMUDA SHORTS FORM - 03

### DECLARATIONS - attaching to and forming part of Policy No: IS0002343

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

#### Item 2.
- **Policy Period:**  
  From: May 21, 2015 at 12:01 am prevailing time at the address of the Named Insured;  
  To: May 21, 2016 at 12:01 am prevailing 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:** XOO G2763848A  
  - **Coverage:** Commercial Umbrella Liability  
  - **Policy Period:** From: May 21, 2015 To: May 21, 2016  
  - **Limits of Liability:** USD 50,000,000 Each Occurrence, USD 50,000,000 General Aggregate, USD 50,000,000 Products-Completed Operations Aggregate  

- **b)** Underlying Policy(ies): As per Endorsement No. 1 Schedule of Excess Policy(ies) Section I - Schedule of Underlying Policy(ies)

- **c)** Quota Share Policy(ies): As per Endorsement No. 1 Schedule of Excess Policy(ies) Section II - Schedule of Quota Share Policy(ies)

#### Item 5.
- **Limit of Liability:**  
  - **a)** USD 50,000,000 Each Occurrence, Claim or Loss  
  - **b)** USD 50,000,000 Aggregate

**Date of Issuance:** July 28, 2015  
**ISEABSF Declarations (8/14)**