# Affiliated FM Insurance Company
## Appalachian Insurance Company

**Policy No. XL 98512**

**DECLARATIONS**
- **International Business Machines Corporation and as per Endorsement No. 1**
- **PO Address:** Armonk, New York 10504.
- **Location of Coverage:** As above
- **Policy Period:** From May 21, 1979 To May 21, 1980 (12:01 A.M. Standard Time at the address of the insured stated above)
- **Primary Insurance Insurer(s) and Policy Number(s):** National Union, N. Brook

**Item 5. Description of Coverage:** Excess Third Party Liability

**Item 6. Limits of Liability:** The limit of the Company's liability shall be as stated herein, subject to all the terms of this policy having reference thereto.

| SECTION I | IN EXCESS OF | SECTION II | SECTION III |
|-----------|---------------|------------|-------------|
| **Coverage** | **Company Limits** | **Underlying Limits** | **Total Limits** |
| A. Bodily Injury | $ | Each Person | $ | $ |
| B. Property Damage Automobile | $ | Each Accident or Occurrence | $ | $ |
| C. Property Damage Except Automobile | $ | Each Accident or Occurrence | $ | $ |
| D. Combined Single Limit Bodily Injury and/or Property Damage | $ | Each Accident or Occurrence | $ | $ |
| E. Other Excess Liability | See Endorsement No. 2 | | |

**Item 7. Premium Computation**
- **Premium Basis:** Flat Charge
- **Estimated Exposure:** DNA
- **Rate:** DNA
- **Estimated Premium:** $11,500.00

**Deposit Premium:** $11,500.00
**Minimum Premium:** $11,500.00
**Audit Period:** DNA

**Named Insured - End. No. 1**
**Limit of Liability - End. No. 2**
**E.R.I.S.A. Exclusion - End. No. 3**
**Aircraft Products Exclusion - End. No. 4**

**Date of Issue:** May 18, 1979
**Counter-signed by:** Thomas C. Rodman
**Authorized Representative:**