# CHUBB EXCESS LIABILITY INSURANCE - SL

## Premium Bill

**Policy Period:** MAY 21, 2015 To MAY 21, 2016  
**Effective Date:** May 21, 2015  
**Policy Number:** 7966-56-84  
**Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**Name of Company:** FEDERAL INSURANCE COMPANY  
**Date Issued:** May 14, 2015  
**Producer:** AON RISK SERVICES NORTHEAST, INC.

THIS BILLING IS TO BE ATTACHED TO AND FORM A PART OF THE POLICY  
PLEASE SEND PAYMENT TO AGENT OR BROKER, IF APPLICABLE

| Coverage | Premium |
|----------|---------|
| Commercial Excess | $ 87,500.00 |

Total: $ 87,500.00

Portion of total premium attributable for Terrorism and statutory standard fire where applicable is: $ 866.00

Form 07-10-0542 (Ed. 10-06) Premium Bill  
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