# EXCESS LIABILITY POLICY

**Insurer:** TWIN CITY FIRE INSURANCE COMPANY  
**HARTFORD, CONNECTICUT**

**SEND CORRESPONDENCE TO:**  
FIRST STATE MANAGEMENT GROUP, INC.  
150 FEDERAL STREET, BOSTON, MA 02110-1753

**Policy No.:** KA 0000561  
**International Business Machines Corp**  
**Old Orchard Park**  
**Armonk, New York 10504**

## DECLARATIONS

### Items
1. **Named Insured and Mailing Address**
   - **Previous Policy No.:** KA 0000528

2. **Policy Period**
   - **Inception Date:** MAY 21, 1997
   - **Expiration Date:** MAY 21, 1998

3. **Audit Period:**
   - **Not subject to Audit**

4. **Deposit Premium:** $35,000 (Flat Charge, Policy Period)

5. **Rate:** N/A
6. **Minimum Retained Audit Premium:** N/A
7. **Minimum Retained Premium:** N/A

## LIMITS OF LIABILITY
- **Each Occurrence Limit:** $10,000,000
- **Personal Injury and Advertising Injury Limit:** $10,000,000
- **Aggregate Limit:** $10,000,000

## TOTAL LIMITS OF LIABILITY – ALL UNDERLYING INSURANCE POLICIES
Refer to EXTENSION SCHEDULE forming a part of this policy.

## CONTROLLING UNDERLYING INSURANCE POLICY
Refer to EXTENSION SCHEDULE forming a part of this policy.

## FORM NUMBERS OF ENDORSEMENT FORMING A PART OF THIS POLICY:
See POLICY PROVISIONS Form 6146 AND LISTING OF ENDORSEMENTS FORMING A PART OF THE POLICY AT ISSUE.

**This policy will not be valid unless countersigned by our duly authorized representative.**  
**First State Management Group**  
**Countersigned by:** [Signature]  
**Authorized Representative**

**FTZ:** 2:13000  
**07/10/97 FL**  
**Form L-3923-1B (Ed.10/88)** Printed in U.S.A. (NS)  
**Copyright Hartford Fire Insurance Company, 1986**