# Centennial Insurance Company

## Commercial Umbrella Policy

**Part Two: This Declarations page with "Policy Provisions Part One" completes the below numbered policy.**

### Declarations
- **Policy Number:** 462-01-09-72

### Named Insured
- **Name:** International Business Machines Corp.
- **Address:** 550 MADISON AVENUE, NEW YORK, N.Y. 10022
- **Attn:** Miss D. Warnecke, INS. DEPT.

### Policy Period
- **From:** 5/21/73
- **To:** 5/21/76

### Agent or Broker
- **Name:** Johnson & Higgins
- **Office Address:** 95 Wall St., New York, N.Y.

### Limit of Liability
- **Policy Limit:** SEE
- **Aggregate Limit:** CERTIFICATE
- **Retained Limit:** ATTACHED

### Premium
- **Three year term prepaid:** SEE
- **Minimum retained premium:** ATTACHED

### Form Numbers of Endorsements Attached to Policy at Inception:
- G1690A

### Schedule A of Underlying Insurance
| Type of Policy | Carrier, Policy Number and Policy Period | Applicable Limits |
|----------------|------------------------------------------|--------------------|
| (a) Comprehensive General Liability | SEE | $0,000 each person, $0,000 each occurrence, $0,000 aggregate products, $0,000 property damage liability, $0,000 each occurrence, $0,000 aggregate operations, protective, products and contractual, if applicable, $0,000 bodily injury liability, $0,000 each person, $0,000 each occurrence, $0,000 property damage liability, $0,000 each occurrence |
| (b) Comprehensive Automobile Liability Owned, Non-Owned and Hired Vehicles | CERTIFICATE | $0,000 each accident |
| (c) Employers' Liability | ATTACHED | $0,000 each accident |

**Countersigned by:** C. Mansfield (Authorized Representative)