CTR064362 COI Kyndry ACCEPTED GL,AL,WC,TECH E&O 11.03.23-11.03.24 (1).pdf

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C e rt if ic a te N o

CERTIFICATE OF LIABILITY INSURANCE

DATE(MM/DD/YYYY)

12/14/2023

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 25038North American Capacity Ins CoINSURER 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: 570103037989 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 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

$15,000,000

Included

B 11/03/2023 11/03/2024Y Y HDOG48899353

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 11/03/2023 11/03/2024Y Y COMBINED SINGLE LIMIT

(Ea accident)

CAL H10818916

EXCESS LIAB

X OCCUR

CLAIMS-MADE AGGREGATE

EACH OCCURRENCE

DED

$3,000,000

$3,000,000

11/03/2023

UMBRELLA LIAB

E 11/03/2024XEUG72548668003

RETENTION

X

E.L. DISEASE-EA EMPLOYEE

E.L. DISEASE-POLICY LIMIT

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

X OTH-

ER

PER STATUTEC 11/03/2023 11/03/2024

SCFC55520343D 11/03/2023 11/03/2024

WLRC55513582B 11/03/2023 11/03/2024

$2,000,000

Y / N

(Mandatory in NH)

ANY PROPRIETOR / PARTNER / EXECUTIVE

OFFICER/MEMBER EXCLUDED? N / AN

WORKERS COMPENSATION AND

EMPLOYERS' LIABILITY

If yes, describe under DESCRIPTION OF OPERATIONS below

$2,000,000

WLRC55520264

Per Claim5360.1 11/03/2023 11/03/2024 $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)

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 listed as an Additional Insured on the General Liability policy 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 accordance with the

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.

a8812 Accepted policy provisions of the General Liability policy. The State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees are hereby listed as an additional insured on the Automobile Liability policy 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. 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 accordance with the policy provisions of the 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

570103037989

570103037989

ACORD 25 Certificate of Liability Insurance

Additional Description of Operations / Locations / Vehicles:

ACORD 101 (2008/01)

ADDITIONAL REMARKS SCHEDULE Page _ of _

Kyndryl Holdings, Inc., Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number

Policy Number Symbol: Number:

Policy Period

TO

Effective Date of Endorsement

Issued By (Name of Insurance Company)

Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy.

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT

We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.

This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.

Schedule

For the states of CA, UT, TX, refer to state specific endorsements.

This endorsement is not applicable in KY, NH, and NJ.

The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications.

For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A..

16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program.

Authorized Representative

WC 00 03 13 (11/05) Ptd. U.S.A. Copyright 1982-83, National Council on Compensation

KYNDRYL HOLDINGS, INC.

1 VANDERBILT AVE

NEW YORK NY 10017 WLR C55520264

11-03-2023 11-03-2024 11-03-2023

INDEMNITY INS. CO. OF NORTH AMERICA

ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS EXECUTED PRIOR TO THE DATE OF LOSS.