IBM_Certificate_of_Insurance_No_2_-_Expires_5-21-2024.pdf

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INSURER(S) AFFORDING COVERAGE

INSURER F :

INSURER E :

INSURER D :

INSURER C :

INSURER B :

INSURER A :

NAIC #

NAME:

CONTACT

(A/C, No):

FAX

E-MAIL

ADDRESS:

PRODUCER

(A/C, No, Ext):

PHONE

INSURED

REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES

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.

OTHER:

(Per accident)

(Ea accident)

N / A

SUBR

WVD

ADDL

INSD

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.

$PROPERTY DAMAGE

BODILY INJURY (Per accident)

BODILY INJURY (Per person)

COMBINED SINGLE LIMIT

AUTOS ONLY

AUTOSAUTOS ONLY

NON-OWNED

SCHEDULEDOWNED

ANY AUTO

AUTOMOBILE LIABILITY

Y / N

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

OFFICER/MEMBER EXCLUDED?

(Mandatory in NH)

DESCRIPTION OF OPERATIONS below If yes, describe under

ANY PROPRIETOR/PARTNER/EXECUTIVE

E.L. DISEASE - POLICY LIMIT

E.L. DISEASE - EA EMPLOYEE

E.L. EACH ACCIDENT

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

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

EXCESS LIAB

UMBRELLA LIAB $EACH OCCURRENCE

$AGGREGATE

OCCUR

CLAIMS-MADE

DED RETENTION $

$PRODUCTS - COMP/OP AGG

$GENERAL AGGREGATE

$PERSONAL & ADV INJURY

$MED EXP (Any one person)

$EACH OCCURRENCE

DAMAGE TO RENTED

$PREMISES (Ea occurrence)

COMMERCIAL GENERAL LIABILITY

CLAIMS-MADE OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:

POLICY

PRO-

JECT LOC

CERTIFICATE OF LIABILITY INSURANCE

DATE (MM/DD/YYYY)

CANCELLATION

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2016 ACORD CORPORATION. All rights reserved.

CERTIFICATE HOLDER

The ACORD name and logo are registered marks of ACORD

HIRED

AUTOS ONLY

12/22/2023

Aon Risk Services Northeast, Inc.

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

+1 (866) 283-7122 +1 (800) 363-0105

ACE American Insurance Company 22667

International Business Machines Corp., including Red Hat, Inc., and any other Subsidiary Corp Owned or Controlled by the Insured One New Orchard Road Armonk, NY 10504 United States

657736

A X 25,000,000

10,000,000

X

X X

X

HDO G7296360A (USA) 5/21/2023 5/21/2024

25,000

15,000,000 30,000,000

Included

A 5,000,000

X

HIRED

AUTOS ONLY

X X ISA H25579070 (USA) 5/21/2023 5/21/2024

X

N

See Page 2 See Page 2 See Page 2

$10,000,000

$10,000,000

$10,000,000

The policies listed above are not intended to replace locally mandated (statutory) insurance policies in various countries, other than the USA.

Please see next page for any additional language.

State of Arizona Department of Child Safety 3003 N. Central Ave 20th Floor Phoenix, Arizona 85012 United States

Authorized Representative:

Aon Risk Services Northeast, Inc.

ACORD 101 (2008/01)

The ACORD name and logo are registered marks of ACORD

© 2008 ACORD CORPORATION. All rights reserved.

THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,

FORM NUMBER: FORM TITLE:

ADDITIONAL REMARKS

ADDITIONAL REMARKS SCHEDULE

AGENCY NAMED INSURED

EFFECTIVE DATE:

Aon Risk Services Northeast, Inc.

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

Various (see prior page)

25 Certificate of Liability Insurance

EMPLOYERS LIABILITY/WORKERS COMP POLICIES

Policy Number Eff. Date Exp. Date Company Affording Coverage EL6-621-004158-844 1/1/2024 1/1/2025 First Liberty Insurance Corporation (42404) EL7-621-004158-924 1/1/2024 1/1/2025 Liberty Insurance Corporation (42404) WA7-62D-004158-934 1/1/2024 1/1/2025 Liberty Insurance Corporation (42404) EW2-62N-004158-694 1/1/2024 1/1/2025 Liberty Mutual Fire Insurance Company (23035) WA5-62D-004158-444 1/1/2024 1/1/2025 LM Insurance Company WC5-621-004158-154 1/1/2024 1/1/2025 LM Insurance Company

State of Arizona Department of Child Safety is hereby listed as an additional insured on the Commercial General Liability Insurance Policy issued in the USA but only to the extent the interests may appear.

State of Arizona Department of Child Safety is hereby listed as an additional insured on the Automobile Liability Insurance Policy issued in the USA but only to the extent the interests may appear.

Waiver of Subrogation is applicable to the Commercial General Liability and Automobile Liability policy listed above.

With respect to Voluntary Compensation and Contingent Employers Liability:

All operations incidental to the conduct of Named Insured's business in the United States of America.

Commercial General Liability Additional Wording: The policy shall be endorsed, as required by this written agreement, to include the State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor.

Automobile Liability Additional Wording: he State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, and employees shall be named as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Contractor, involving automobiles owned, leased, hired or borrowed by the Contractor".

If there is a question regarding this certificate please contact Janelle Bardol (Email: janelle.bardol@ibm.com Phone: 7173815566)

International Business Machines Corp., including Red Hat, Inc., and any other Subsidiary Corp Owned or Controlled by the Insured One New Orchard Road Armonk, NY 10504 United States