# Endurance American Insurance Company

**(Wilmington, Delaware)**

**Policy No.** XSC30000337800  
**Renewal of:** New

## COMMERCIAL EXCESS LIABILITY DECLARATIONS PAGE

1. **NAMED INSURED AND ADDRESS:**
   - International Business Machines Corporation Per Underlying Insurance
   - One New Orchard Road
   - Mail Drop 109
   - Armonk, NY 10504

2. **POLICY PERIOD:**
   - 12:01 a.m. Standard Time at the address of the Insured shown at the left
   - From: 05/21/2017
   - To: 05/21/2018

3. **PREMIUM:**
   - Total Advance Premium: $58,855
   - Service Charge: N/A
   - Taxes: N/A
   - Surcharge: N/A
   - Total: $58,855
   - BASIS OF PREMIUM: Non-Auditable (X) Auditable ( )

4. **LIMITS OF INSURANCE:**
   - SEE EXL 1181 FTZ
   - SEE EXL 1181 FTZ
   - Each Occurrence Limit
   - Aggregate Limit (Where Applicable)

These Limits of Insurance apply in excess of the "underlying limits of insurance" indicated in Item 5. of the Declarations.

5. **UNDERLYING INSURANCE:**
   - See attached schedule

6. **FORMS AND ENDORSEMENTS applicable to all Coverage Forms and made part of this policy at time of issue are listed on the attached Forms and Endorsements Schedule EXL 0101.**

**ISSUING OFFICE:**
- 750 3rd Avenue
- New York, NY 10017

**AUTHORIZED REPRESENTATIVE:**

---

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

**2-13000**

Endurance American Insurance Company
EXL 0001 0615