# Insurance Policy Declaration

**BROKER:** JOHNSON HIGGINS  
**CODE NO.:** C. KIND POOL COM. 12.5%  
**95 WALL STREET**  
**NEW YORK, NEW YORK 10005**  
**NUMBER:** 6483-5604  

**RENEWS:** 6482-5407 Members Of NEW HAMPSHIRE INSURANCE GROUP, INC.

**X GRANITE STATE INSURANCE COMPANY**
**□ NEW HAMPSHIRE INSURANCE COMPANY**

**PACIFIC STARR of NEW YORK, INC.**
**UNDERWRITING MANAGERS**
**NEW YORK**

## DECLARATIONS

1. **Assured:**
   - INTERNATIONAL BUSINESS MACHINES, ET AL
   - (AS MORE FULLY DEFINED IN UNDERLYING POLICY/IES)
   - Address: ARMONK, NEW YORK

2. **Policy Period:**
   - From MAY 21, 1983 TO MAY 21, 1984
   - both days at 12:01 A.M.
   - (Standard Time) at the location(s) of the risk(s) insured and in accord with the terms and conditions of the form(s) attached.

3. **Amount:**
   - $ 5,000,000. PART OF
   - $ 70,000,000. EXCESS OF
   - $130,000,000. EXCESS OF PRIMARY

4. **Coverage:**
   - EXCESS UMBRELLA LIABILITY

5. **Premium:**
   - A) Provisional or deposit premium $ 5,000.00
   - B) Minimum Premium $ 5,000.00
   - C) Basis of Adjustment (Rate) FLAT
   - D) Audit Period NONE
   - E) Currency: U.S. Dollars

**Assignment of this Policy shall not be valid except with the written consent of this Company.**

This Policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this Policy, together with such other provisions, stipulations, and agreements as may be added hereto, as provided in this Policy.

Unless otherwise provided herein, this Policy may be cancelled on the customary short rate basis by the Assured at any time by written notice or by surrender of this Policy to the Company. This Policy may also be cancelled, with or without the return or tender of the unearned premium, by the Company or by the Underwriting Managers in its behalf, by delivering to the Assured or by sending to the Assured by regular mail, at the Assured's address as shown herein, not less than 30 days written notice stating when the cancellation will be effective. In no case Insurers shall refund the paid premium less the earned portion thereof on demand, subject always to the retention by Insurers herein of any minimum premium stipulated herein (or proportion thereof previously agreed upon) in the event of cancellation either by Insurers or Assured.

Notwithstanding anything to the contrary contained herein and in consideration of the premium for which this insurance is written, it is understood and agreed that whenever an additional or return premium of $10.00 or less becomes due from or to the Assured on account of the adjustment of a deposit premium, or of an alteration in coverage or rate during the term or for any other reason, the collection of such premium from the Assured will be waived or the return of such premium to the Assured will not be made, as the case may be.

In Witness Whereof, the Company has caused this Policy to be executed and attested, but this Policy shall not be valid unless countersigned by a duly authorized representative of the Company.

**Marian E. Jaffe**  
**Secretary**  
**May 17, 1983**  
**1114 PSNY**

**Robert B. Jacobson**  
**President**  
**PACIFIC STARR OF NEW YORK, INC.**  
**UNDERWRITING MANAGERS**

**BRANCH OFFICE COPY**