ACCEPTED_ANY_ALL_GL_AL_WC_TECH_E_O_11.03.24-11.03.25.pdf

H o ld e r Id e n ti fi e r

77777

77707 07070

00777 61616

04557 11107

77725 33703

65553 07662

00774 16353

00072 66144

61543 11130

74262 67572

56776 00762

15111 61166

12007 21714

41277 00020

07744 51531

62647 45077

74317 37127

44410 76727

24203 57720

00777 77770

70007 07007

77777

77707 07070

00735 25677

11545 60007

32051 11257

24531 07231

00406 12251

30077 71504

02567 31230

74677 36643

52355 40703

33763 06423

04007 03232

63531 62000

07022 33734

21720 11070

22336 34207

31000 77756

16335 17655

40777 77770

70007 07007

C e rt if ic a te N o

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DD/YYYY)

12/30/2024

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.

If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS

CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES

BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED

REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

PRODUCER

Aon Risk Services Northeast, Inc.

New York NY Office One Liberty Plaza 165 Broadway, Suite 3201 New York NY 10006 USA

PHONE

(A/C. No. Ext):

E-MAIL

ADDRESS:

INSURER(S) AFFORDING COVERAGE NAIC #

(866) 283-7122

INSURED 34916Swiss Re Corp Solutions Capacity Ins CorINSURER A:

22667ACE American Insurance CompanyINSURER B:

43575Indemnity Insurance Co of North AmericaINSURER C:

20702ACE Fire Underwriters Insurance Co.INSURER D:

20699ACE Property & Casualty Insurance Co.INSURER E:

INSURER F:

FAX

(A/C. No.): (800) 363-0105

CONTACT

NAME:

Kyndryl Holdings, Inc., including Kyndryl, Inc.

& any other subsidiary corp. majority owned or controlled by the insured 1 Vanderbilt Avenue New York NY 10017 USA

COVERAGES CERTIFICATE NUMBER: 570110131950 REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD

INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS

CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, Limits shown are as requested

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

(MM/DD/YYYY)

SUBR

WVD

INSR

LTR

ADDL

INSD POLICY NUMBER TYPE OF INSURANCE LIMITS

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

POLICY LOC

EACH OCCURRENCE

DAMAGE TO RENTED

PREMISES (Ea occurrence)

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

X

X

X

GEN'L AGGREGATE LIMIT APPLIES PER:

$15,000,000

$10,000,000

$25,000

$15,000,000

$20,000,000

Included

B 11/03/2024 11/03/2025Y Y HDOG48902327

PRO-

JECT

OTHER:

AUTOMOBILE LIABILITY

ANY AUTO

OWNED

AUTOS ONLY

SCHEDULED

AUTOS

HIRED AUTOS

ONLY

NON-OWNED

AUTOS ONLY

BODILY INJURY ( Per person)

PROPERTY DAMAGE

(Per accident)

X

BODILY INJURY (Per accident)

$2,000,000C 11/03/2024 11/03/2025Y Y COMBINED SINGLE LIMIT

(Ea accident)

CAL H10822713

EXCESS LIAB

X OCCUR

CLAIMS-MADE AGGREGATE

EACH OCCURRENCE

DED

$5,000,000

$5,000,000

$25,000

11/03/2024UMBRELLA LIABE 11/03/2025XEUG72548668004

RETENTIONX

X

E.L. DISEASE-EA EMPLOYEE

E.L. DISEASE-POLICY LIMIT

E.L. EACH ACCIDENT $2,000,000

X OTH-

ER

PER STATUTEC 11/03/2024 11/03/2025

SCFC72629863D 11/03/2024 11/03/2025

$2,000,000

Y / N

(Mandatory in NH)

ANY PROPRIETOR / PARTNER /

EXECUTIVE OFFICER/MEMBER N / A

Y

N

WORKERS COMPENSATION AND

EMPLOYERS' LIABILITY

If yes, describe under DESCRIPTION OF OPERATIONS below

$2,000,000

WLRC72629784

Per Claim5360.1 11/03/2023 04/01/2025 Prof Liability/E&O/Cyber $10,000,000Aggregate

E&O - Professional Liability - Primary

A $10,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

RE: All operations incidental to the conduct of Named insured business in the United States of America. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees are hereby included as Additional Insured on the General Liability and Automobile Liability policies but only to the extent that their interest may appear with respect to liability arising out of the activities performed by or on behalf of the Contractor. General Liability and Automobile Liability evidenced herein is Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees in

CANCELLATIONCERTIFICATE HOLDER

AUTHORIZED REPRESENTATIVEState of Arizona and/or ADOT 1324 N. 22nd Avenue Phoniex AZ 85009 USA

ACORD 25 (2016/03)

©1988-2015 ACORD CORPORATION. All rights reserved

The ACORD name and logo are registered marks of ACORD

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION

DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

Cindy Lewis Accepted accordance with the policy provisions of the General Liability, Automobile Liability policy and Workers' Compensation policies. Umbrella Liability policy limits are Excess over each: Commercial General Liability, Automobile Liability and Employer's Liability Insurance policies.

FORM TITLE:FORM NUMBER:

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

ADDITIONAL REMARKS

EFFECTIVE DATE:

CARRIER NAIC CODE

POLICY NUMBER

Aon Risk Services Northeast, Inc.

NAMED INSUREDAGENCY

LOC #:

570000086258 AGENCY CUSTOMER ID:

© 2008 ACORD CORPORATION. All rights reserved.

See Certificate Number:

See Certificate Number:

The ACORD name and logo are registered marks of ACORD

570110131950

570110131950

ACORD 25 Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles:

ACORD 101 (2008/01)

ADDITIONAL REMARKS SCHEDULE Page _ of _

Kyndryl Holdings, Inc.,