# Excess Insurance Policy

## Liberty Insurance Underwriters Inc.

**(A Stock Insurance Company, hereinafter the "Insurer")**
55 Water Street, 23rd Floor New York, NY 10041
Toll-free number: 1-800-677-9163

**NOTICE:** THESE POLICY FORMS AND THE APPLICABLE RATES ARE EXEMPT FROM THE FILING REQUIREMENTS OF THE NEW YORK STATE INSURANCE LAW AND REGULATIONS. HOWEVER, THE FORMS AND RATES MUST MEET THE MINIMUM STANDARDS OF THE NEW YORK INSURANCE LAW AND REGULATIONS.

## EXCESS LIABILITY POLICY DECLARATIONS

- **Policy Number:** 1000040626-14
- **Renewal of:** 1000040626-13
- **Broker:** AON Risk Services
  - 199 Water Street
  - 8th Floor
  - New York, NY 10038

### Item 1: NAMED INSURED AND MAILING ADDRESS
- **International Business Machines Corporation**
  - One New Orchard Road
  - Mail Drop 109
  - Armonk, NY 10504
  (as per First Underlying Insurance Policy)

### Item 2: POLICY PERIOD
- From: May 21, 2015
- To: May 21, 2016
- 12:01 A.M. Standard Time at the address of the Named Insured shown.

### Item 3: POLICY PREMIUM
- **POLICY PREMIUM:** $87,500
- **POLICY MINIMUM PREMIUM:** 0.00%
- **TRIA Premium:** $0
- **Total Annual Premium:** $87,500

- **Premium Basis:** (x) Flat
  ( ) Auditable

### Item 4: LIMITS OF LIABILITY
- Our liability under this policy will not exceed the following limit: 25.00% percent of "loss" excess of the Underlying Insurance stated in Item 5 of the Declarations, but for no greater than:
- $25,000,000 – Each Occurrence

**1** **2**

100-XS (Ed. 03 00)
2 - 13000