# Commercial General Liability Declarations

**CHUBB**
ACE American Insurance Company
436 Walnut Street
Philadelphia PA 19106

**POLICY NUMBER:** HDO G27865355
**EXPIRING POLICY NUMBER:** HDO G27852105
**RENEWAL**

## ITEM ONE

- **Named Insured:** International Business Machines Corporation
- **Address:** One New Orchard Road, Armonk NY 10504
- **Producer Number:** 384287
- **Producer Name:** AON RISK SERVICES NORTHEAST INC
- **Producer Address:** 199 WATER STREET, 30TH FLOOR, NEW YORK NY 10038

## Form of Business:
- [X] Corporation
- [ ] Limited Liability Company
- [ ] Other

- **Named Insured's business:** Manufacturing

## Policy Period:
- Policy covers from 05/21/2017 to 05/21/2018 12:01 am standard time at the named insured's address stated above.

## Audit Period:
- None, unless otherwise stated:
  - [ ] Semi-Annual
  - [ ] Quarterly
  - [ ] 

## Total Advance Premium (including surcharges):
- $86,307.00
- Refer to Surcharge Endorsement for surcharge amounts and rates. (Does Not Apply in Puerto Rico)

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**LD-25211 (10/08)**
Copyright, Insurance Services Office, Inc. 2000
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