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PW18-379 - Original - Green River Natural Resource Area - S. Stormwater Pump Station: Deferred Submittal Services - 01/16/2020
Agreement Routing Form KEN T For Approvals,Signatures and Records Management W.541NGTON This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Originator. Nancy for Steve Lincoln Department. Public Works Date Sent: 1/15/20 Date Required: 1/22/20 > Authorized Director or Designee Date of a, to Sign: ✓ Council N/A Ra Mayor Approval: Budget D20047 Grant? ❑ Yes ❑� No Account Number: Type: N/A Vendor Name: Jacobs Engineering Group Inc. Category: Contract C Vendor 1478604 Sub-Category 0 Number: o Project E Name: GRNRA South Stormwater Pump Station A.0 Project C Derails: Provide deferred submittal services. IV E Agreement 44r 900 Basis for 0 Amount: Selection of all ' Contractor.- as 4 Start Date: Mayor's signature 6 � Termination Date: 12 /31/Z0 Notice required prior to Yes No Contract Number: p' 1$ � disclosure? Date Prceived byCityAttorney: Comments: 0 OC ��/r•V,rry(J N iKENT LAW DEPT. RECEIVED cm Date Routed to the Mayor's Office: ar Date Routed to the City Clerk's Office: City of Kent & k office of the Mayor Date Sent to Originator. Visit Documents.KentWA.gov to obtain copies of all agreements adccW22373_6_19 40 " �0�. KENT W A s H i r G,o N CONSULTANT SERVICES AGREEMENT between the City of Kent and Jacobs Engineering Group Inc. THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Jacobs Engineering Group Inc. organized under the laws of the State of Delaware, located and doing business at 1100 112th Avenue NE, Suite 500, Bellevue, WA 98004, Phone: (425) 233-3102, Contact: Erik Brodahl (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: The Consultant shall provide deferred submittal services for the Green River Natural Resource Area (GRNRA) South Stormwater Pump Station Project. For a description, see the Consultant's Scope of Work which is attached as Exhibit A and incorporated by this reference. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Consultant shall complete the work described in Section I by December 31, 2020. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Forty Four Thousand, Nine Hundred Dollars ($44,900), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: CONSULTANT SERVICES AGREEMENT - 1 (Over$20,000) A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless, and Consultant's liability accruing from that obligation shall be only to the extent of the Consultant's negligence. CONSULTANT SERVICES AGREEMENT - 2 (Over$20,000) IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. The City's use or reuse of any of the documents, data, and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means CONSULTANT SERVICES AGREEMENT - 3 (Over$20,000) of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. CONSULTANT SERVICES AGREEMENT - 4 (Over$20,000) K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: CITY OF KENT: (signature) (signature] -- Print Name: SNCAF,1LL. l eRAN Print Name: Dana Ralph Its LEADg�C Its Mayor (title) DATE: t`� 0 DATE: t NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Erik Brodahl Timothy J. LaPorte, P.E. Jacobs Engineering Group Inc. City of Kent 1100 112th Avenue NE, Suite 500 220 Fourth Avenue South Bellevue, WA 98004 Kent, WA 98032 (425) 233-3102 (telephone) (253) 856-5500 (telephone) N/A (facsimile) (253) 856-6500 (facsimile) APPROVED AS TO FORM: � 'ZL� o Kent Law Department ATTE T: J Kent City Clerk ]acobs-GRNRA South PS 4/Lincoln CONSULTANT SERVICES AGREEMENT- 5 (Over$20,000) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: s -E-� SNERR I u_ 'P RArJ For: TAcvas 4ie/GINEE ;V6 6;zoup, yc. Title: /r9/;AKrr L—r*AbER Date: `� nn a0 C _ e EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 Exhibit A SCOPE OF SERVICES City of Kent GRNRA South Stormwater Pump Station Deferred Submittal Services Jacobs Engineering Group Inc. November 2019 1. SCOPE OF SERVICES Jacobs Engineering Group Inc. (Consultant) previously contracted with the City of Kent (City)for design engineering and bidding services associated with the GRNRA South Stormwater Pump Station project. The proposed scope of services to be performed by the Consultant for this phase of the GRNRA South Stormwater Pump Station project includes the following services: • Project management and administration • Deferred submittals for garage building relating to lighting and mechanical equipment for City Building Services review • Drawing and specification revisions for garage building required for deferred submittals. 2. ASSUMPTIONS This scope of services is based on the following assumptions: • Deferred electrical and mechanical equipment submittals will require a maximum of two submittals to the City. • These submittals shall consist of revisions to approximately 12 drawings and 16 additional technical specification sections required for Building Services deferred submittals for the project. • City will lead and administer the construction contract and be the main point of communications for the Contractor, including coordination for changes relating to the deferred submittals. 3. DETAILED SCOPE OF SERVICES Below are the identified tasks for this contract. Before the start of each task, Jacobs will obtain written or verbal notice to proceed from the City's Project Manager prior to initiating the work. Task 100 — Project Management The purpose of this task is to provide oversight and management of the deferred submittal services for this project. November 2019 Page 1 of 3 Jacobs engineering Croup Inc. Activities: Provide project plan for the efforts described below. Provide project management, including managing staff and coordinating with the City for deferred submittal services associated with the project. Coordinate work with multiple disciplines including civil/utility, electrical, architectural, structural, and HVAC/plumbing teams. Deliverables: The following Deliverables are included in this Task: • Scope and budget. • Status reporting. Task 900— Deferred Submittals for Garage Building The purpose of this task is to provide deferred submittals identified by the City during the Building Services review of the garage building. The deferred submittals relate to items that were requested by City Building Services, which were beyond the scope of Amendment No. 1, for the design services contract, generally relating to energy code and the garage building classification. The original assumed classification for the garage was unoccupied, but the assigned classification is occupied, with requires energy code compliance calculations and subsequent modifications to project components. Accessible features requirements to the building and site have also been added. Activities: Prepare drawing and specification revisions and deferred permit submittals consisting of the following items: • Prepare drawing and specification revisions relating to Building Services requirements for project. • Permitting coordination to address comments Building Services may have on the deferred submittals. • Prepare response letters to building services review comments, including reissued drawings with revision clouding. 2015 WSEC energy code forms for lighting and mechanical equipment. • Prepare two energy code additional efficiency package options required by 2015 WSEC, Section 406, including details of how the requirements were met. • Load calculations for each room for the heating equipment, including justifying the sizing • Add occupancy sensor locations on the floor plan. • Ventilation details meeting IMC, Chapter 4. Deliverables: • Drawing revisions for garage building (approximately 12 total). • Specification section revisions for garage building (approximately 16 total). • Up to two iterations/submittals of garage-related drawings with revision clouding for permit resubmittals. • Response letters to Building Services Plan Review Correction Letters. November 2019 Page 2 of 3 Jacobs Engineering Group Inc. • Electronic versions of deferred submittals identified above, and one iteration of revisions if required (up to two submittals). 4. PROPOSED SCHEDULE The schedule for this work is tied to the construction schedule and authorization of this contract, to be set by the City. Draft deferred submittals will be prepared within four weeks of notice to proceed on this contract, followed by two weeks for resubmittal after comments are received from the City's Building Services Department. Construction is anticipated to be completed on or before the end of the calendar year 2020. END OF SCOPE OF WORK November 2019 Page 3 of 3 Jacobs Fngincering Group Inc. � E a g&3 9 ��`146tyC1N �4� yl AY1�1Fy/Mk' � 1,• E o Nr@q:iV jfi�t'�YNgF {ti 3 � E is W e$ro 3 � �OWiW� AMA#4, t4YNu0#Y5�4 h' � f uN+aye+#5 unu4uusy C tt { EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Consultant's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. 3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $3,000,000 each occurrence, $3,000,000 general aggregate. EXHIBIT B (Continued) 3. Professional Liability insurance shall be written with limits no less than $3,000,000 per claim and $3,000,000 policy aggregate limit. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Consultant's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant's insurance and shall not contribute with it. 2. The Consultant's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The Consultant's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than ANII. E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. F. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. AC DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 12/13/2019 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. 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). PRODUCER LIC #0437153 1-212-948-1306 CONTACT NAME: Marsh Risk & Insurance Services PHONE FAX CIRTS Support@jacobs.com N Ex A/C No: 1-212-948-1306 E-MAIL 633 W. Fifth Street ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Los Angeles, CA 90071 INSURERA: ACE AMER INS CO 22667 INSURED INSURER B Jacobs Engineering Group Inc. INSURER C C/O Global Risk Management INSURER D: 1000 Wilshire Blvd., Suite 2100 INSURER E: Los Angeles, CA 90017 INSURERF: COVERAGES CERTIFICATE NUMBER: 57955061 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. LTRt" "OMNTRACTUAL TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS A MERCIAL GENERAL LIABILITY HDO G71565129 07/01/19 07/01/20 EACH OCCURRENCE $ 3,000,000 DAMAGE TO RENTED CLAIMS-MADE � OCCUR PREMISES Eaoccurrence $ 500,000 LIABILITY MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 POLICY� PRO- POLICY ElLOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ A AUTOMOBILE LIABILITY ISA H25295511 07/01/19 07/01/20 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE HIRED NON-OWNED $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A AND EMPSYERS'LIATIONILIT PERWLR C65892248 STOP-GAP C 97/01/19 07/01/20 STATUTE X ERH- AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUE � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A PROFESSIONAL LIABILITY EON G21655065 010 07/01/19 07/01/20 PER CLAIM/PER AGG 3,000,000 "CLAIMS MADE" AGGREGATE DEFENSE INCLUDED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) PROJECT MGR: Erik Brodahl. CONTRACT MGR: Pauline Kellum. RE: Construction phase of the Green River Natural Resources Area Pump Station Project. CONTRACT END DATE: 12/31/2020. PROJECT NUMBER: W3X76200. SECTOR: Public. City of Kent is added as an additional insured for general liability & auto liability as respects the negligence of the insured in the performance of insured's services to cert holder under contract for captioned work. Coverage is primary and certificat holder's insurance is excess and non-contributory. General Liability coverage includes the severability of interests/Cross Suits Liability provision in favor of the holder. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE WILL NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Kent THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Avenue South AUTHORIZED REPRESENTATIVE Kent, WA 98032 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD nyumdo newgalexy 57955061 CO NST1WCTION Pk0JE-,T(8)GENERAL AGGREGATE LIMIT Nilrroed wmuied Jacobs Engineeiiing Group Inc _ . � Erach��r + rs N.M t r Pa y bores 1 trr mntrr r�,Ihz:y rcd of -donemeM FW G71565129 071012019 To 07MI12020 ACE Arnert,an Insurance Coo any __J THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED CINDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. Subgect to and erodog the General Aggregate Urnit shown in the Declarations, for all sums w$rich the insured becornes legaAly ot>;ligate€i to pay as d&rnages caused by`occugre s' under COVERAGE A (SECTION 1), and for al rnedicat expenses caused by accidents under COVERAGE C (SECTK)& 1), w1hich can be attributed only to cN ing operations ai your construction pro cts away from premises owreed by or rented to you (such ongl6ng operations al such construction prc{ects are herei. def ='Y ur Ptrjecls.). 1. A separate Consttuctior, Prood General Aggregate Limit applies to sit of Your Projects, and that timit is equal to the arno+unt required under written contmt, but Kn no event greater than the Geperall Aggregate Urrtit shown in tf Declarations. 2. The Construction Project General Aggregate Limit is the most we will poy f*r tote sum of all damages erode; COVERAGE A, exempt damages because of *bodo irliu ' w "piwerty dan%aW tr►cluded in, the 'products- complelled operabons h;azatd , and W med>cal expenses under COVERAGE C, which damages and medical expenses can be attributed only to Pouf Projects, regardless of the number of. a. Insu , b, Claims made or'suits` brought oor ca Persoos of ofganizations making claims or bringing-suds". S. Any payments made +nder COVERAGE A for darmages of under COVERAGE C for medical expanses that can be attributed to Your Pro acts shall reduce the Cor..struction Project General Agg(r%)ale I strut and shall also reduce and erode the General Aggregate Uin t sno wn n the Declarations, 4, The timits shown $n the Declarations for factl Occurrence, Fire Damage and Medical Expense continue to apply. However, such limits will be subject to that Construction I'rr act General Aggregate Ormit, as well >a5 the General Aggregate Limit shown in the Doclara4ions. B. For all suns which the insured homes legally obligated to pay as damages caused by"occurrences'under COVERAGE A (SECTION I), and for all medical expenses caused by accidents under COVERAGE C (St CTION I), which cannot be attributed only to Your P jests: 1.. Any payments: made under COVERAGE A for damages or under COVERAGE C for med�cat expenses shad reduce the amount available under the G moral Aggregate Limit of the Prodt.rets-ComPleted Operations Aggregate Limit,whichever is apph^.able;and 2. Such payments shalt not reduce the Construction PTolect General Aggregate Lirnit, C. When coverage for liability airing out of the'produ -complele opereions hazard' is provided, any payments for damages because of'bodily iN'.rry''or*property ge"included in the'pfodu -completed cporat orls hazard'wgl reduce the Prcduct5-Ccsmpleted Operations Aggregate Limit, and not reduce vie General Aggregate Limit nor the MS-223 7 (07.17) Wtiu* 2010 AMai"rer�srv@4 Page.I of CONSTRUCTION PROJECT(S)OENCOAL A06REGATE UWT Cormftcfion Project General Aqg!egate Limit, D If arty one w more of Your Projects has teen abandoned. delayed, or abane-tined and there restarted, or it the, authonzed contracting parties deviate from plarks, bfieprints, designs spec fications or timetables, the project will sisal be deemed to be the same construction proW-I. E The provisions of Limits Of Insurance (SECTION 111) W oftirwise mod"ied by this endorsement shall connue Ic appiy as stipu, led. MS-22357(07117) ech" 201ei Al rots f"wvw Page 2 of 2 ADDITIONAL INSURED-AUTOMATIC STATUS 'jicobs Engire+enn5 group Inc Erdxsenwl Nufter 262 HDO IG71565129 074112019 To 07tolao2 fuoed ffy tNarne eF Aur xr i ACE Aitwhcan Insuramw ComWy THM ENDORSEMEUT CH FGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM It Name of Person or ClrgartiztNttm: Arty person or organization for whom any Named Insured is required by written contract or agreement to provide insurance,entcred into prior to the loss,where such written contract or agreement do" not expr sly identify,a particular Icmmn, Servioe Cwpnization Form to I*applied to their additional insured status. Who is An Insured (Section H)includes as an additional insured the person or organization shown in the Schedule,but the insurance shall not exceed the ape of coverage and/or limits of this policy.Notwithstanding the foregoing sentence, in no event shall the insuranac provided such additional insured exceed the scope of the cover and/or limits required by said contract or agreement and,if such additional insured's scope of+ ge is not expressly stated in such eu ttact or agreement,then such coverage is limited to the additional insvred's vknrious lia bili y to the extent directly caused by the Nadi Insur+ed's negligence during the Named lnstovd's ongoing oper-atitatts. This insurance shall be primary insurance to the extent required by said contract or agreement,and arty other insurance or, self-insurance maintained by such pemn or organization shall be noncontribvIory with the insurance pcoOded hereunder to the extent spocified in said to ntract agreement. Where the contract or agreement provides that the additional inset 's scope *(coverage is for the Naoted Insured's lndemnit},obligations under such eontmd Or agreement,then such coverage shall be limited to the extent such inodemnity obligations,are enforceable under applicable taw, Notwithstanding the foregoing sentence, in no event shall the insurance prow ded such additional insured exceed the scope of mxerage required by said contract or agrc unent Notwithstanding anything to the contrary, the coverage provided an additional insured under this endorrserrrent shalt be limited to the minimum coverage limits required to be provided lay the Named Insured tinder the written contract or agreement, I i i i MS-15992(07118,1 Oc:n+.trlj 21C tie Aa page 1 Of 1 ADDITIONAL INSURED-DESIGNATED PERSONS OR ORGANIZATIONS r am d it tr�U jiccbs Eng+nelringt Group Inc. Emkrrwmerd N 1�5 PWCY-ftwd M r t vE+Ems%0I . lSA >t2 t2JSb1l1 ,107001 019 70 07M120.20 ACE American Insuran-ce Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE ftOLLOWIt+fG: BUSINESS AUTO COVERAGE FORM Additional I nsur s). Any person or organaation whom you have agreed to include as an additional insured under a written contract, Provided such contract was executed " to the date of loss PrrojW anclPor Contract: Afl prciects ancillor contracts where you perform work for such additional insured pursuant to any such Witten colt . A. For a covered `auto," Who Is Insured is arnonded to include as an "insured,'tKt p sans of organizations named. in thfs endorsement However, these persons ot organktations are an `>irvured` only for ` ty i€Iury' or K propedy ohmage"resulting from ass or omissions of: 1. y . 2. .Any of your"employees` or agents, , .Any person operaing a Covered'auto"with pen-nission truant you, any of your'employees' or agents, 5 The pe`sons or organizat iflrs named in this endorsestent are not kabte for payment of your premium. C WO rftpect to tt}e inswance afforded to these additional insureds,the following apptes: If coycraSo provNciad tr ttm adctit1 at Wn5wled is required Lxy a ajr4wA-or agrereniens, tie moo,we Witt pa'y can behalf of the addiaionai insured is the a m rni of insura e i Required by true contract or agreement; or 2. Available under'the applicable Limits of Instgance shown in the Declarmons whichev is Sess if such,additional insured's scope of coWra+, is not expr stated fn a contract or agreement, thar`t such coverage is limited to the acdd. nal insta 's vicious liability to the extent directly caused by the Natined IrmireSs neghgence durmg the Nara ins eda ongoirl operations, This in"rance shall be primary u,s�arance to the evient required by said contrail or agreement. and any other insurance or self-insure a maintainec by such person or organizatx:tn shall be noncontributory with the insurance provided hereunder to the extent sWified in sad contract agree lent. W+lhere the contract of agreement provides I"I the additional sured's scope of coverage is for the named insured's irldemnity ob4arttons under such contract or agreement, than such coverage ehall be limited to the extent such indemnity ot+ligst ono are enforceable under appli aittle Iat.+r. ht"0621 (07118) CC " k 7016 Ajlf"t4s Page 1 of 1 1 NOTICE TO OTHERS ENWRSEMENT-SCMeOULE-EMAIL ONLY Nwftd Iftswed Jacobs Engmeenng Group inc. dwserriM NufnW 1 _. o= ectOm fatew... Endon nt 7113NSA :j!(0)71D1/W19 To J01,12E2} .., is�r�d�' �,surr rM�nP�r ACE American insurance any „��. ., . ii t+c4 y it ar"tw- 1fia tar Inijif rr the r4cfcra1xr it tt be crude caif'mrt .f tP its pf v THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Poo cy prior to its expiration date by notice to you or the first Named Insured lot any reasor,other than nonpayment of premium.we will endeavor; as set out below,to send written notice of cancellation, Via so clh etecttonic notification as we cteterms e, to the persons or organitatons "fisted in the tithadule that you or your representative provide or have provided to us. (the`Schediate"). You ,x your representative must provide us with the ei-mail address of such persons or organizations, and we wil: u1dize such e-matt address that you cc your representative provided to !3�i uri buck SL;tWUUle. S. The Schedule must he in tialfy provided to its WANn 15 days after. I. The t:eginning ofthe Pclty perm, if this endorsement is effeclive as of such date,or ii. This endorselMni has hewn added to [tits Policy, if this eriforsernent is effective after the -Policy period commences, C. The Schedule must be in an shb&onic formal that is acceptable to us, and must be accurate, Ca Our delivery of the notification as descrillbed in Paragr h A. of this endorsement will be based on the rmst recent Schedule in our records as of the date the ra ice of cancellation is maid or delivered to the first Named Insured. E,. We wil+endeavoir to send such not to the e-mail addlitess corresponding to each person or otganiMion indi c t in the Schadule at least Sty days pry to the eanWtation date applicable to the Policy. F. The notice referenced in this erdorsarrien is intended only to be a courtesy notificat4on to the person(s) of 0i'ganization(s) named in the Schedule in the every of a pending cancellation of covefage. Vtre have r`o legal o4aligat�ran of ariy kind to any such persora(s) or 0tga9ntzarhw(s). Out failure to provide advar>:,e D%ificgiuon of cancellation to the person(s) or organizations) shown in the Schedule shalt impose no ctiliogatior or hatailit'y of any kind upon us, our aWts or representatives, w,ll not ctxtend any Policy canCetlblion date and will not negate any ,cancellation of the Policy. G. We are not responsible for verify ng any Information provided to us in any Schedule, nor are we responsible for any inCOrrect infon atim that you of your repires"talive Provide to Lm If yoki or your representative dos not p�ovade us with a Schedule. we have no respons+briity for taking any action under this endorsement, Ir addition. if neither yo{ near your representative provioes us with e-mail address information with respect to a particular person or organizatiori, then we shall have no responsibi`ity for taking action with regard to such aersm or entity hider this endorsement- H. We may arrange with y0ar representative to send such notice in;they event of any Smh, cants ion I. You will cooperate MM us in Providing the Schedule, of in rausiq your representative to provide the Sche du , J. Th s endorsement does not apply in the event tttart you cancel the Pollicy, ALL-3 5(011111) Page 1 of All<rtlier tenrns and conditions of the Policy remain unchanged, Authwzed eprewnts _ . ALL-32M(01111) Page 2 f 2 NOTICE TO OTHERS ENDORSEMENT— SCHEDULE --EMAIL ONLY iris� ��,, M..,,,, _. �_. .v__... .fta9s �ntyertn arc« Inc +#� nafa�wsi�lurr�ex poky*uynitI , y h�.tntr rCE €ISA H25296511 VM112019 'to {t7dC}'1f2 20 American Insurance Company 9aAwstt awn a��r Wit+ 7ht ra<xxar•d.r+:f�s araarrear�rrr,�tra Ee: q�kd�ttM n�,+a srtd'v'�iwfur�t h h11v�erC wb ' —._ _ .., __. M�•i!i;b!Iw►anparatwn vt ihR eyr THIS EI DORSEMENT CHANGES THE POLICY,PLEASE REAEI IT CAREFULLY. A If We cancel tho Policy prior to its expilratien date by notice to you or Ithe first Nam,ed Insured for ' reason other than nonfaayrr*nt Of PfOrOum,we W4 er ,eevor,ss eel out below,to send wr&en notice of canoe at;on, via such eredronic notwotation as we determine, to tt persons of orgaNzabions listed in the schedii a thaat you of your represer4alrve Provide or have provided to us (the 'Scft uW) You of your repre nlotive mist provide us with the it-maid sddresa of such persons or organizations, and w*,jVp utilize such e-mail address that you Or Your representative provided to us on such Schedule S. The Schedule moist be inrt elly provided to ,rrsihin 15 bays after I. The bequi ping of the Policy period, it this endoisemeM Is effective as of such date, or 11, This erxsorsem#mt has been added to the Poles, if this endorse ent IS effective .after the Policy period Commences G. The Schedule must be In art electronti�fe-01141 that is accePlable to us,and rr, rt be a ;walt- Q, OW delivery of the notif catuwt as dosr~ribed in Peragraph A. of this endors neni will be based on the most to ent Schedule in our rtcoros,as of M le the notice of Cmncellwion is Mailed it del"red to the first Named Inwreti. E. We Will endeavor to send such notice to the e-mail address corresponding to each person of Organization wvdicated in the Sct iule at least 30 days prior to the cancellation date W011cable to the Policy. V The mice refer d in this endotsernent is IrAended only to t.e a courtesy nolsicabon to the person(s) or organ2afior^,5 j nsarried in the Schedule in the tyunt of a pendir g canceltation of coverage. We have >r.o I I obligation of any limd to .any supra person(s) or organizatiorMsj, Our jWure to provide adva g nottficatign of cancellali�ta to the pairs (s) or organization(a) shown in the Schedule shall impose no obligation of %ability of any kind upon us, our agietrts or tepresertrafiveis, will not extend any Policy canceilliatxm date and wim not negate any Cancellation of the Po4icy.. We are not responsible for verifyrr any err atgn Provided to us v` arty Scnouto, nor are vve responsiole for any incortset informaton that you or your representative provide to us. If You Oir your rWesantafive doitii not provide tas. with a Schedule, we have no responsibility for taking any aicho,n under this endorsement. In +addillon, if neither you not your rop4osentative rrrOlvide.5 vfl w4h a-maif address information wrath respect to a particular person oforganization, then we shag haru no resp 'ity for taking attiort wain r rd to such endorsernent. or entity under this ti. V*may arrange wilin YOut repro talive to send such notice in of any such cancellation, 1. YOU will CCIOPgrale With cis in providing the Schedule,Of is Causing your f6prosenlative to provide the.Schedu e J, This endors rnent does not apply in the event that you cancel the Policy. ALL-326M(01ii i) Page'12 All other 1 g and mndlioils of the 1`04,4 W.-lain unchar d ALL-32685 pim 1) page 2 Workem'Compensation a uAwaity Policy JACOBS ENGINEERANG GROUP INC, 1000 WILSHIRE BOULEVARD SUITE I DOO _4ii7jri Numfor LOSANGELES CA 90017 symbo WLR Numbec C65892248 !Jand Darr v of_Endo,"~ 07-01.2019 TO 07-012020 07-0 1 2019 iii �TQn—w0f h9V*MCe G0fhp&ry) ,ACE AMERICAN INSURANCIE COMPANY irefex Qt Me��' Oot)1&to be cuirow-ed Crjy;W-th—ts 14�7_00 11 i�S� NOTICE TO OTHERS ENDORSEMENT- SCHEDULE - EMAIL ONLY A. If we cancel this Policy plior to its expiration date by notte to yo Named immured for any re"on other than -u or the first* nonpayment of premourn,we wAl endeavor, ass set out below, to send written notice of cancellation, via such eterviroric notification as we determine, to The persons or organizations listed in the schedule that you or your representative provide ff have provided to us (the 'Scbedul&'). You cx your representative must PrOvde us with the e-mail address of such persons or organizations, and we wfil utilize such e-mail addrwt that you or your representative provided to us on such Schedule. B. The Schedule must oe Initially Provided to us within IS days after: i. The beginning of the Policy period,, if this endorsement is affect," as of such date- , or it. Tbis endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences C. The Schedule must be in an electronic forniAt that is acceptable to us;and must be accurate. D. Our delivery of the nobl'icaliort as described in Pwagraph A. of this endorsement will be based On thO most recenit Schedulie in oLw records as of the date the notice otc-ancellation is maned or delivered to the first Named linstired, Z, We vAl trideavor to send such notice to the e-mail address corresponding to each per%an or organization indk�ajed in the Sctiedule at least a0 days prior to the caftcePlation date applicabile to the policy. F, The notice referenced in this endorsement is intended only 10 be a courtesy notification to the person(s) or organization(s) named in the Schedule mi, thO "nit of a PendLnq came4lation of coverage Vie have no "I ail obligation of any kind to any such person(s) of organization(s). Our failure to provide advance notificailion of cancellation to the person(s) or organization( ) shown in the Schedule shall imoose no obligation or liability of any kind upon us, our agents or represe-datives, will not extend any Policy cancellation date a,Rd wi l rot negate any cancellation of the Policy. We are not respor bte for verifying any information provided to us in any Schedule, nor are we responsible tot any incorrect information, that you or your representative provide to us. 11 you or your representative does W. provk-k us w*h o Schedule, we have ;jor sperrrs b ltty for taking any action under this eindorserrivent. In add*orl, it neither you rear your representative provides us with e-mail address tformabqn with FeSPOCI, 10 a particular person or organization, then we shall have no responsibility for taking action with regard to such person or entity Lmder this endorsement H. We may arrange with your representative to send such notice in Ine event of any such cancellation- I. You will=perate with us in providing the Schedule,or in caijising your representalm to provide the Scfredule_ J. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain uncbanged, This Endorsement Is mt applicable in tne states of AZ, FL, IL, ME, K, N), NM,TX and W1. presentative 03�68 1 Page I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured Endorsement Number Jacobs Engineering Group Inc. 7 Policy Symbol Policy Number Policy Period Effective Date of Endorsement EON G21655065 010 07/01/2019 to 07/01/2020 07/01/2019 Issued By(Name of Insurance Company) ACE American Insurance Company NOTICE TO OTHERS ENDORSEMENT—SCHEDULE F. If We cancel or non-renew the Policy prior to its expiration date by notice to You for any reason other than nonpayment of premium, We will endeavor, as set out below, to send written notice of cancellation or non-renewal via such electronic or other form of notification as We determine, to the persons or organizations listed in the schedule that You or Your representative provide or have provided to Us (the Schedule). You or Your representative must provide Us with both the physical and e-mail address of such persons or organizations, and We will utilize such e-mail address and/or physical address that You or Your representative provided to Us on such Schedule. G. The Schedule must be initially provided to Us within 30 days after: i. The beginning of the Policy Period, if this endorsement is effective as of such date; or ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy Period commences. H. The Schedule must be in a format that is acceptable to Us and must be accurate. I. Our delivery of the notification as described in Paragraph A of this endorsement will be based on the most recent Schedule in Our records as of the date the notice of cancellation or non-renewal is mailed or delivered to You. J. We will endeavor to send or deliver such notice to the e-mail address or physical address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation or non-renewal date applicable to the Policy. K. The notice referenced in this endorsement is intended only to be a courtesy notification to the person(s) or organization(s) named in the Schedule in the event of a pending cancellation or non- renewal of coverage. We have no legal obligation of any kind to any such person(s) or organization(s). Our failure to provide advance notification of cancellation or non-renewal to the person(s) or organization(s) shown in the Schedule shall impose no obligation or liability of any kind upon Us, Our agents or representatives, will not extend any Policy cancellation or non-renewal date and will not negate any cancellation or non-renewal of the Policy. L. We are not responsible for verifying any information provided to Us in any Schedule, nor are We responsible for any incorrect information that You or Your representative provide to Us. If You or Your representative does not provide Us with a Schedule, We have no responsibility for taking any action under this endorsement. In addition, if neither You nor Your representative provides Us with e-mail address and/or physical address information with respect to a particular person or organization, then We shall have no responsibility for taking action with regard to such person or entity under this endorsement. M. With respect to this endorsement Our, Us or We means the stock insurance company listed in the Declarations, and You or Your means the insured person or entity listed in Item 1 of the Declarations page. All other terms and conditions of this Policy remain unchanged. MS-36362 (04/19) Authorized Representative DATE SUPPLEMENT TO CERTIFICATE OF INSURANCE 12/13/2019 NAME OF INSURED: Jacobs Engineering Group Inc. THE APPLICABLE CONTRACT.* SUPP(10/00)