# Declaration - Excess Insurance Policy

**Crum and Forster**

**Policy Number:** 531-205928-5

**Date Issued:** May 20, 1992
**Renewal or Replacement of:** 531-204473

**Item Named Insured & Address:**
1. **International Business Machines Corp.**
   - **Corporate Headquarters**
   - **Armonk, NY 10504**

**2. Policy Period:**
   - **Policy Covers from:** May 21, 1992 to May 21, 1993
   - **12:01 A.M. Standard Time at the Named Insured's Address Stated Above.**

**3. Coverage is Provided by:**
   - **Representative:**
     - **The London Agency, Inc.**
     - **Six Concourse Parkway**
     - **Suite 2700**
     - **Atlanta, Georgia 30328-5346**
     - **3177000 0175**

**4. Premium is Payable:**
   - **$55,000.00 in Advance Adjustable at a Rate of N/A per Flat Charge**
   - **Annual Exposure is Estimated at: N/A**
   - **$55,000.00 Annual Minimum Premium**

**Tax: Local**
   - **N/A**

**Surplus Lines**
   - **N/A**

**5. Underlying Insurance:**
   - **$25,000,000 Each Occurrence; $25,000,000 General Aggregate;**
   - **$25,000,000 Products/Completed Operations Aggregate Umbrella Liability as Provided by National Union Insurance, Policy Number to be Advised, which is Excess of the Primary Underlying Insurance or Self-Insured Retention.**

**6. Limit of Liability:**
   - **$5,000,000 Each Occurrence; $5,000,000 General Aggregate;**
   - **$5,000,000 Products/Completed Operations Aggregate Part of $25,000,000 Each Occurrence; $25,000,000 General Aggregate;**
   - **$25,000,000 Products/Completed Operations Aggregate Excess of the Limits Indicated in Item 5 of the Declarations.**

**Policy Jacket Forms and Endorsements Attached to This Policy at Inception 1 Thru 6**

**Oper/Underwriter No.:** 247/073
**Jacket No.:** FM 101.0.302 (2-82)

**Countersigned by:** C. Winston Triple
**Authorized Representative**

**051 (9-87)**