# CHUBB EXCESS LIABILITY INSURANCE - SL

## Premium Bill

**Policy Period:** MAY 21, 2016 To MAY 21, 2017  
**Effective Date:** May 21, 2016  
**Policy Number:** 7966-56-84  
**Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**Name of Company:** FEDERAL INSURANCE COMPANY  
**Date Issued:** June 8, 2016  
**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 REWRITE | $ 74,773.00 |

Total: $ 74,773.00

Portion of total premium attributable for Terrorism and statutory standard fire where applicable is: $ 740.00

Form 07-10-0542 (Ed. 10-06) Premium Bill Page 1