# Declaration - Excess Insurance Policy

**Policy Number:** 531-204473-7

**Date Issued:** May 28, 1991
**Renewal or Replacement of:** 531-203213

**Item Named Insured & Address:**
1. **International Business Machines Corp. (As per underlying insurance)**
   - Corporate Headquarters
   - Armonk, NY 10504

**2. Policy Period:** Policy covers from May 21, 1991 to May 21, 1992 at 12:01 A.M. standard time at the named insured's address stated above.

**3. Coverage is provided by:** International Insurance Company

**4. Premium is payable:**
- $60,000.00 in advance per each annual premium

**5. Underlying Insurance:**
- $25,000,000 General Aggregate
- $25,000,000 Products/Completed Operations Aggregate Umbrella Liability as primary underlying insurance, policy number to be advised, where applicable, over the primary underlying insurance or self-insured retention.

**6. Limit of Liability:**
- $5,000,000 Each Occurrence; $5,000,000 General Aggregate
- $5,000,000 Products/Completed Operations Aggregate Part of $25,000,000 Each Occurrence; $25,000,000 General Aggregate
- $25,000,000 Products/Completed Operations Aggregate Excess of the limits indicated in Item 5 of the declarations.

**Policy Jacket Forms and Endorsements Attached to this Policy at Inception 1 thru 5**

**Oper/Underwriter No.:** 247/073
**Jacket No.:** FM 101.0.302 (2-82)

**Countersigned by:** C. Vinson Tipper
**Authorized Representative:**