**Y REPORT for use with "Policy Provisions — Part 1," Form TC 8202 and Declarations Page Form L4602.**

| Filing | Annual Audit | Monthly | Part. |
|--------|--------------|----------|-------|
| Prem. Finance | Semi-Annual | Bureau | Retro |
| Large Risk | Quarterly | Loss Control | Reinsurer |

**Co. Code** | **POLICY NO.** | **TXS 103585** |
|-------------|---------------|----------------|
| INSURER | Previous Policy No. | TXS 102830 |
| INTERNATIONAL BUSINESS MACHINES CORP., | | |
| ETAL | | |
| ARMONK, NEW YORK | | |
| 5-21-84 | To | 5-21-85 |
| 12:01 A.M., standard time at the address of the first named insured as stated herein. |

**1. First Named Insured and Address**
- **Producer's Name and Address:** JOHNSON & HIGGINS
- **Producer's Code:** 07-07001
- **Address:** 35 W. 42ND STREET, NEW YORK, NEW YORK 10005

**2. Policy Period:**
- From: 5-21-84
- To: 5-21-85

**Notice of cancellation by the company: 60 days.**

**3. Premium: $3,000.00**
- Which is: Flat Charge, Policy Period
- Not subject to adjustment in the event of cancellation.

**4. Limits of Liability**
- The limits of the company's liability under this policy shall, subject to all the terms of the policy relating thereto, be as follows:
  - $3,000,000 EACH OCCURRENCE/AGGREGATE WHERE APPLICABLE PART OF
  - $70,000,000 EACH OCCURRENCE/AGGREGATE WHERE APPLICABLE

**5. Total Limits of Liability — All Underlying Insurance Policies**
- $130,000,000 EACH OCCURRENCE/AGGREGATE WHERE APPLICABLE EXCESS PRIMARY

**6. Controlling Underlying Insurance Policy**
- This policy shall follow the terms, conditions, definitions and exclusions of the controlling underlying insurance policy #462 02 3954 issued by CENTENNIAL INS. CO.

**7. Form numbers of endorsements forming part of this policy at issue:**
- SEE UNIV. 2 ATTACHED

**The company located these documents in its business records. At this time, the company does not certify that these documents constitute a complete and accurate copy of the policy.**

Form L4602 (TC 4/81) Printed in U.S.A. (NS)