# Employee Benefits Liability Coverage Endorsement

This endorsement changes the policy. Please read it carefully.

| POLICY NO. | EFF. DATE OF POL. | EXP. DATE OF POL. | EFF. DATE OF END. | AGENCY NO. | ADD'L PREMIUM | RETURN PREMIUM |
|------------|-------------------|------------------|------------------|------------|---------------|----------------|
| GLO 63-47-605-00 |                |                  |                  |            | $             | $              |

**Named Insured:** INTERNATIONAL BUSINESS MACHINE CORP.

**Address (including ZIP code):**

This endorsement is issued by the company designated in the Declarations which is the insurer under the above numbered policy issued to the named insured and forms a part of said policy as of the effective date hereof, at the hour stated in the policy Declarations.

This endorsement changes such insurance as is afforded by provisions of the policy relating to the following:

**Commercial General Liability Coverage Part**

**SCHEDULE**

| Limits of Insurance: | RATE PER EMPLOYEE | NUMBER OF EMPLOYEES |
|----------------------|-------------------|---------------------|
| $5,000,000 each "negligent act" | $                 | 0–100               |
| $5,000,000 aggregate | $                 | 101–500             |
| $                    | $                 | 501–1,000           |
| $                    | $                 | 1,001–2,000         |
| $                    | $                 | over 2,000           |

**Deductible Amount:** $1,000 each "negligent act"

**Premium Basis — estimated number of employees:** IF ANY

**A. Coverage:**

We will pay those sums that the "insured" becomes legally obligated to pay because of damages because of a "negligent act" in the "administration" of "your employee benefits program." No other obligation or liability to pay sums or to perform acts or services is covered unless explicitly provided for under SUPPLEMENTARY PAYMENTS — COVERAGE A and B of the Commercial General Liability Coverage Form to which this endorsement is attached.

**B. Deductible:**

This insurance applies only to damages over $1,000 per "negligent act." We will only pay that part of the damages which exceed the deductible up to the LIMITS OF INSURANCE.

**C. Policy Territory and Period:**

This insurance applies only to "negligent acts" committed by an "insured" during the policy period within the United States of America, its territories or possessions.

**D. Definitions:**

1. "Administration" means the performance of the following ministerial functions for "your employee benefits program":
   a. Advising "employees" eligible to participate in "your employee benefits program" of their rights and options;
   b. Handling of records in connection with "your employee benefits program";
   c. Enrolling, terminating, or cancelling of

IBM 063046
U-GL-264-A (ed. 7/88)