# IBM Risk Management Insurance Document Review Master Coding Sheet

**Date of Document:** [Date]
**Box No.:** 187
**Cust. Box No.:** 32217

**Name of Insurance Company:** Fidelity
**Name of Insured:** IBM

## Insurance Policy:
- Primary: ☐
- Excess: ☑
- Umbrella: ☐

**Policy period:** 5/21/73 - 5/21/76
**Policy number:** LX633 11 34

**Type of coverage:**
- GL: ☐
- WC: ☐
- Auto: ☐
- Directors: ☐
- E & O: ☐
- Other: ☐

- Certificate of Insurance: ☐
- Endorsement/Rider: ☐
- Other: ☐

## Document related to Insurance:
- Document Type:
  - Manual: ☐
  - Brochure: ☐
  - Article: ☐
  - Govt. Regs.: ☐
  - Letter: ☐
  - Memo: ☐
  - Email: ☐
  - Record: ☐
  - Drawings: ☐
  - Contract: ☐
  - PO/Invoice: ☐
  - Chart/Graph: ☐
  - Report/Study: ☐
  - Bid Info.: ☐
  - Certificate/Licenses: ☐
  - Other: ☐

**Description of Content:** [Description]

## IBM Internal:
- Letter: ☐
- Memo: ☐
- Email: ☐
- Notes: ☐
- Record/Form: ☐
- Company Wide Correspondence: ☐
- Other: ☐

**Description of Content:** [Description]

## Confidentiality:
- Not Confidential/Public: ☐
- Confidential: ☐
- Highly Confidential: ☐
- Restricted: ☐
- Other: ☐

**C&S Attorney:** [Signature]

**Cerussi & Spring Confidential Work Product**