# COMMON POLICY DECLARATIONS

**POLICY NO:** RM GL 121-06-58  
**RENEWAL OF:** NEW  
1. NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA.  
2. AMERICAN HOME ASSURANCE COMPANY  
3. THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA  

**MEMBERS OF THE AMERICAN INTERNATIONAL GROUP, INC EXECUTIVE OFFICES:** 70 PINE STREET NEW YORK N.Y.  
**PRODUCER NO:** 07875 JOHNSON & HIGGINS 125 BROAD STREET NEW YORK NY 10004-0000  

**COVERAGE IS PROVIDED IN THE COMPANY DESIGNATED BY NUMBER A STOCK INSURANCE COMPANY (HEREIN CALLED THE COMPANY)**  

**NAMED INSURED:** INTERNATIONAL BUSINESS MACHINES CORPORATION  
**MAILING ADDRESS:** OLD ORCHARD ROAD ARMONK NY 10504-0000  

**POLICY PERIOD:** From 01/01/95 To 01/01/96 At 12:01 A.M. Standard Time at your mailing address shown above  
**BUSINESS DESCRIPTION:** COMPUTER MFG.  

**IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.**

**THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT**  

| Coverage Part | Premium |
|---------------|---------|
| Boiler and Machinery Coverage Part | $ NOT COVERED |
| Commercial Auto Coverage Part | $ NOT COVERED |
| Commercial Crime Coverage Part | $ NOT COVERED |
| Commercial General Liability Coverage Part | $ 325,071 |
| Commercial Inland Marine Coverage Part | $ NOT COVERED |
| Commercial Property Coverage Part | $ NOT COVERED |
| Farm Coverage Part | $ NOT COVERED |

**TOTAL:** $ 325,071  
**SURCHARGE:** $ 572  

**Premium shown is payable:** $ 325,643 at inception.  

**Forms applicable to all Coverage Parts:** SEE ATTACHED SCHEDULE. (Show numbers)  

**COUNTERSIGNED:** (Date) (Authorized Signature)  

**In Witness Whereof, we have caused this policy to be executed and attested, and, if required by state law, this policy shall not be valid unless countersigned by our authorized representative.**  

**Secretary:** National Union Fire Insurance Company of Pittsburgh PA. American Home Assurance Company The Insurance Company Of The State Of Pennsylvania  
**President:** William Smith National Union Fire Insurance Company of Pittsburgh, PA.

**Copyright:** Insurance Services Office, Inc., 1983, 1984  
**Date Issued:** 02/17/96