**DECLARATIONS**

* **Item 1. Name of Insured:** INTERNATIONAL BUSINESS MACHINES CORPORATION, et al.
* **Address:** IBM Corporate Headquarters, Armonk, New York 10504
* **Policy Periods:**
    * From: 5/21/73
    * To: 5/21/76

**NORTHWESTERN NATIONAL INSURANCE COMPANY OF MILWAUKEE, WISCONSIN ORGANIZED 1889**

**EXCESS THIRD PARTY LIABILITY POLICY (EXCESS OVER [REDACTED]) Underlying**

**ITEM 3. PRIMARY INSURANCE**

* **INSURER'S NAME:** Per Schedule on File with Company
* **POLICY NO.'S (Including Renewals or Replacements):** Excess Umbrella Liability

**ITEM 4. 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 Automobile |
| $ | $ | $ | B. Bodily Injury Except Automobile |
| $ | $ | $ | C. Property Damage Auto |
| $ | $ | $ | D. Property Damage Except Automobile |
| $ | $ | $ | E. Combined Single Limit Bodily Injury and/or Property Damage |
| $ | $ | $ | F. Other |

**Per Endorsement No. 3**

**ITEM 5. PREMIUM COMPUTATION**

| PREMIUM BASIS | ESTIMATED EXPOSURE | RATE | ESTIMATED PREM. | DEPOSIT PREM. | MINIMUM PREM. | AUG. * PERIOD |
| --- | --- | --- | --- | --- | --- | --- |
| Flat Charge |  |  | $17,500 | $17,500 |  |  |

**Counter-signed at: ____________________________ on: ____________________________ by: ____________________________ Authorized Representative**

**THESE DECLARATIONS TOGETHER WITH FORM _______DATED_______ XLP SERIES, CONSTITUTE THE ABOVE NUMBERED POLICY HAS**

[XLP-800D]