# General Automobile Liability Policy Declarations

**Form 950**

**Policy No.:** B6-68-700
**Renewal of:** 86-36-900
**Agency No.:** 50-515-000
**Broker No.:** 1
**Check Install:** Yes
**Account No.:** 66017

**Coverage Parts and Endorsements Attached:**
- C51
- C76

**Item 1. Name of Insured and Address:**
- **Name:** International Business Machines Corporation
- **Address:** Armonk, N.Y.

**Item 2. Policy Period:**
- From December 31, 1970 to January 1, 1974

**Item 3. The insurance afforded is only with respect to such of the following parts and coverages as are indicated. The limit of the company's liability against each such coverage shall be as stated herein, or in the applicable Coverage Part Schedule, subject to all the terms of the policy having reference thereto.**

**Parts (As indicated by an "X" in the applicable box):**
- Comprehensive General Liability Insurance
- Premises Medical Payments Insurance
- Comprehensive Automobile Liability Insurance
- Automobile Medical Payments Insurance

**Coversages (Indicated by specific premium charge specified in this item 3 or in the applicable Coverage Part Schedule):**
- Bodily Injury Liability
- Property Damage Liability
- Each Person
- Each Occurrence
- Each Accident

**Limits of Liability:**
- EACH PERSON: $500,000
- EACH OCCURRENCE: $1,000,000
- EACH ACCIDENT: $5,000,000

**Advance Premium:**
- $329,164

**Item 4. The declarations are completed on an accompanying schedule designated as (1) General Liability Hazards (2) Automobile Liability Hazards.**

**Item 5. During the past three years no insurer has cancelled insurance issued to the named insured similar to that afforded hereunder, unless otherwise stated herein.**

**Audit Period: Annual, unless otherwise stated.**

**NSMR:**
- 12/11/70

**Countersigned on behalf of Zurich Insurance Company:**
- Duly authorized agent: [Signature]

**THIS DECLARATIONS PAGE IS USED IN CONJUNCTION WITH AND IS A PART OF POLICY SERIES 950**

**Z 007091**