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HomeMy WebLinkAboutCAG2020-306 - Amendment - #3 - Jacobs Engineering Group, Inc. - Washington Ave S. Stormwater Pump Station - 11/23/2022Ap p r o v a l Originator:Department: Date Sent:Date Required: Approved by Law Date of Council Approval: Grant? Yes No Type: Re v i e w / S i g n a t u r e s / Ro u t i n g Date Received: City Attorney: Comments: Date Routed: Mayor’s Office City Clerk’s Office Ag r e e m e n t I n f o r m a t i o n Vendor Name:Category: Vendor Number:Sub-Category: Project Name: Project Details: Agreement Amount: Start Date: Local Business? Yes No* Business License Verification: If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace. Yes In-Process Exempt (KCC 5.01.045) Notice required prior to disclosure? Yes No Contract Number: This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms. (Print on pink or cherry colored paper) Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20 Budget Account Number: Budget? Yes No Dir Asst: Sup/Mgr: Dir/Dep: rev. 20210513 FOR CITY OF KENT OFFICIAL USE ONLY Agreement Routing Form For Approvals, Signatures and Records Management (Optional) Basis for Selection of Contractor: * Memo to Mayor must be attached Termination Date: Mayor's Signature Required Upload Interlocal Agreements to Website AMENDMENT - 1 OF 2 AMENDMENT NO. 3 NAME OF CONSULTANT OR VENDOR: Jacobs Engineering Group Inc. CONTRACT NAME & PROJECT NUMBER:Washington Avenue South Stormwater Pump Station ORIGINAL AGREEMENT DATE: September 29, 2020 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor’s work is modified as follows: 1. Section I of the Agreement, entitled “Description of Work,” is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: Provide additional design and bidding services for the project. For a description, see the Consultant's scope of work which is attached as Exhibit A-3 and incorporated by this reference. 2. The contract amount and time for performance provisions of Section II “Time of Completion,” and Section III, “Compensation,” are modified as follows: Original Contract Sum, including applicable WSST $169,891.24 Net Change by Previous Amendments including applicable WSST $81,490.84 Current Contract Amount including all previous amendments $251,382.08 Current Amendment Sum $4,863.24 Applicable WSST Tax on this Amendment $0 Revised Contract Sum $256,245.32 11/23/2022 Exhibit A-3 AMENDMENT NO. 3 SCOPE OF SERVICES City of Kent Washington Avenue South Stormwater Pump Station Replacement Engineering Design and Bidding Services Sizing Calculations Validation Jacobs Engineering Group Inc. October 2022 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 Washington Avenue South Stormwater Pump Station project. The proposed scope of services to be performed by Consultant for this Amendment No. 3 to this contract includes the following services: • Additional project management and administration associated with amendment work. • Reviewing and validating stormwater runoff and storage calculations prepared by the City relating to the planned downsized pump station. 2. ASSUMPTIONS This scope of services for Amendment No. 3 is based on the following assumptions: It is assumed that the pump station will be redesigned to pump in a narrower operational band, during wet weather conditions. The pump station will operate as an overflow facility, designed to pump when water levels in the Green River are high and pumping is necessary for discharge. Pumping during low river conditions will not be a normal operating condition and the City will design the upstream system to exclude inflow to the pump station during minor storm events with relatively low river conditions. City will maintain responsibility for work prepared by the City, independent of Consultant's work reviewing and validating the pump station capacity and storage volume calculations. City -Furnished Data: City will provide to Consultant all data in City's possession relating to Consultant's services on the project. Consultant will reasonably rely upon the accuracy, timeliness, and completeness of the information provided by City. Availability of records and data are beyond the Consultant's control. Unanticipated delays in receipt of data or need to collect additional data for validation could impact the delivery schedule or level of effort. October 2022 Page 1 of 3 Jacobs Engineering Group Inc. 3. DETAILED SCOPE OF SERVICES ADDED FOR AMENDMENT NO. 3 Below are the identified tasks for this amendment. 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 additional work associated with this amendment. Task 100 — Project Management The purpose of this task is to provide oversight and management of the additional work associated with this amendment, assumed to be for a period of up to two months. Activities: Provide additional project management associated Amendment No. 3 work, including managing staff and coordinating with the City through the Sizing Calculations Validation efforts. Obtain written or verbal notice to proceed from the City's Project Manager prior to initiating work for this task. Deliverables: The following Deliverables are included in this Task: • Monthly invoices with cover memos. Tasks 200 — 600 No changes. Task 700: Capacity and Storage Sizing Peer Review The purpose of this task is to provide a reasonableness review of the City's drainage calculations, proposed pumping capacity and upstream storage volume for this project. Consultant will perform selected validation calculations to verify results. Assumptions: • The Consultant will use and rely on data provided by the City for evaluation of the project. • Consultant will provide a high-level review of the calculations and methodology provided by the City for determining capacity of the proposed pump station and sizing of upstream storage in oversized piping. • Consultant will check Rational Method calculations provided be City and corresponding conveyance calculations. • City will provide information pertaining to upstream conveyance system, including pipe lengths, materials, slopes and drainage structure information, including invert elevations. Activities: Obtain written or verbal notice to proceed from the City's Project Manager prior to initiating work for each subtask. October 2022 Page 2 of 3 Jacobs Engineering Group Inc. Consultant will review data and calculations developed and provided by the City, provided selected verification calculations and a prepare a memo summarizing comments and questions to the City relating to the City's drainage calculations, capacity sizing and storage sizing. Deliverables: Memo summarizing Consultant's review of City -prepared drainage calculations and sizing determination, electronic (Word) version. 4. PROPOSED KEY CONSULTANT STAFF FOR AMENDMENT NO. 3 The following key staff members of the Consultant have been identified for this project: • Project Manager: Erik Brodahl • QA/QC: Paul Tissell • Lead Stormwater Engineer: Azar Takeshi 5. PROPOSED SCHEDULE FOR AMENDMENT NO. 3 Schedule to be determined by City, with review and input from Consultant for provided Consultant services. For time -based level of effort, such as overall project management and coordination, a two (2) month schedule from NTP has been assumed. The approximate schedule in calendar days following notice to proceed is provided below. Review of City -prepared drainage calculations and capacity sizing, perform validation calculations, prepare summary memo: 20 days END OF SCOPE OF WORK FOR AMENDMENT NO. 3 October 2022 Page 3 of 3 Jacobs Engineering Group Inc. 0 Hsel Aq sgooer - 71se1 Aq lso0 joge-1 71se1 Aq sjnOH O� Obi oo O � N 69 fi9 fA fA 69 fi9 Obi a o0 O 7 N r I m o Obi Obi N 7 � 0�0 es sz bs bs es sz V a OD O im N I O ID W N 113 U61sa4 pni0 I4s8>lel jezV U O N C Q o OO / Vie Ilassll fined c� rn c 7 V N N N m C c Nd 14ePOJ8 VJ3 w a 0 m v v ao o m sgooef walk Aq IelolgnS O U U m O U) m 7 o v o e O N O N O cn O M 7 � fA fi9 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) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY PER CLAIM/PER AGG X 06/17/2022 EON G21655065 013 1,000,000 Jacobs Engineering Group Inc. 3,000,000 07/01/22 ISA H25568230 WLR C6891453A STOP-GAP COV. 633 W. Fifth Street 3,000,000 A LIC #0437153 1-212-948-1306 Cert_Renewal X X N X 1000 Wilshire Blvd., Suite 1140 C/O Global Risk Management 5,000 ACE AMER INS CO 07/01/22 Kent, WA 98032 3,000,000 CIRTS_Support@jacobs.com Marsh Risk & Insurance Services 220 Fourth Avenue South 07/01/22 X 07/01/23 500,000 07/01/23 65826855 65826855 3,000,000 07/01/22 Los Angeles, CA 90071 07/01/23 1,000,000 Los Angeles, CA 90017 City of Kent A CONTRACTUAL LIABILITY 1,000,000 3,000,000 NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.* provision in favor of the holder. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE WILL excess and non-contributory. General Liability coverage includes the severability of interests/Cross Suits Liability services to cert holder under contract for captioned work. Coverage is primary and certificate holder's insurance is insured for general liability & auto liability as respects the negligence of the insured in the performance of insured's CONTRACT END DATE: 12/31/2023. PROJECT NUMBER: W3X81308. SECTOR: Public. City of Kent is added as an additional PROJECT MGR: Erik Brodahl. CONTRACT MGR: Teresa Amspacher. RE: Washington Avenue South Stormwater Pump Station CSS. A USA X HDO G72496176 07/01/23 1-212-948-1306 1,000,000 22667 A PROFESSIONAL LIABILITY SUPP (10/00) SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE NAME OF INSURED: 06/17/2022 Jacobs Engineering Group Inc. CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT Named Insured Jacobs Engineering Group Endorsement Number Inc. 163 Policy Symbol Policy Number Policy Period Effective Date of Endorsement HDO �G72496176 07/01 /2022 To 07/01 /2023 Issued By (Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM A. Subject to and eroding the General Aggregate Limit shown in the Declarations, for all sums which the insured becomes legally obligated to pay as damages caused by "occurrences" under COVERAGE A (SECTION 1), and for all medical expenses caused by accidents under COVERAGE C (SECTION 1), which can be attributed only to ongoing operations at your construction projects away from premises owned by or rented to you (such ongoing operations at such construction projects are hereinafter defined as "Your Projects"): 1. A separate Construction Project General Aggregate Limit applies to all of Your Projects, and that limit is equal to the amount required under written contract, but in no event greater than the General Aggregate Limit shown in the Declarations. 2. The Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under COVERAGE A, except damages because of "bodily injury" or "property damage" included in the "products - completed operations hazard", and for medical expenses under COVERAGE C, which damages and medical expenses can be attributed only to Your Projects, regardless of the number of: a. Insureds; b. Claims made or "suits" brought; or c. Persons or organizations making claims or bringing "suits". 3. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses that can be attributed to Your Projects shall reduce the Construction Project General Aggregate Limit and shall also reduce and erode the General Aggregate Limit shown in the Declarations. 4. The limits shown in the Declarations for Each Occurrence, Fire Damage and Medical Expense continue to apply. However, such limits will be subject to the Construction Project General Aggregate Limit, as well as the General Aggregate Limit shown in the Declarations. B. For all sums which the insured becomes 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 (SEC- TION I ), which cannot be attributed only to Your Projects: 1. Any payments made under COVERAGE A for damages or under COVERAGE C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products -Completed Operations Aggregate Limit, whichever is applicable; and 2. Such payments shall not reduce the Construction Project General Aggregate Limit. C. When coverage for liability arising out of the "products -completed operations hazard" is provided, any payments for damages because of "bodily injury" or "property damage" included in the "products -completed operations hazard" will reduce the Products -Completed Operations Aggregate Limit, and not reduce the General Aggregate Limit nor the Construction Project General Aggregate Limit. MS-22357 (07/17) ©Chubb. 2016. All rights reserved. Page 1 of 2 CONSTRUCTION PROJECT(S) GENERAL AGGREGATE LIMIT D. If any one or more of Your Projects has been abandoned, delayed, or abandoned and then restarted, or if the authorized contracting parties deviate from plans, blueprints, designs, specifications or timetables, the project will still be deemed to be the same construction project. E. The provisions of Limits Of Insurance (SECTION III) not otherwise modified by this endorsement shall continue to apply as stipulated. MS-22357 (07/17) ©Chubb. 2016. All rights reserved. Page 2 of 2 ADDITIONAL INSURED - AUTOMATIC STATUS Named Insured Jacobs Engineering Group Endorsement Number Inc. 149 Policy Symbol Policy Number Policy Period Effective Date of Endorsement HDO �G72496176 07/01 /2022 To 07/01 /2023 Issued By (Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Any person or organization for whom any Named Insured is required by written contract or agreement to provide insurance, entered into prior to the loss, where such written contract or agreement does not expressly identify a particular Insurance Service Organization Form to be applied to their additional insured status. Who Is An Insured (Section II) includes as an additional insured the person or organization shown in the Schedule, but the insurance shall not exceed the scope of coverage and/or limits of this policy. Notwithstanding the foregoing sentence, in no event shall the insurance provided such additional insured exceed the scope of the coverage and/or limits required by said contract or agreement; and, if such additional insured's scope of coverage is not expressly stated in such contract or agreement, then such coverage is limited to the additional insured's vicarious liability to the extent directly caused by the Named Insured's negligence during the Named Insured's ongoing operations. This insurance shall be primary insurance to the extent required by said contract or agreement, and any other insurance or self-insurance maintained by such person or organization shall be noncontributory with the insurance provided hereunder to the extent specified in said contract agreement. Where the contract or agreement provides that the additional insured's scope of coverage is for the Named Insured's indemnity obligations under such contract or agreement, then such coverage shall be limited to the extent such indemnity obligations are enforceable under applicable law. Notwithstanding the foregoing sentence, in no event shall the insurance provided such additional insured exceed the scope of coverage required by said contract or agreement Notwithstanding anything to the contrary, the coverage provided an additional insured under this endorsement shall be limited to the minimum coverage limits required to be provided by the Named Insured under the written contract or agreement. MS-15992 (07/18) ©Chubb. 2016. All rights reserved. Page 1 of 1 ADDITIONAL INSURED - DESIGNATED PERSONS OR ORGANIZATIONS Named Insured Jacobs Engineering Group Inc. Endorsement Number 174 Policy Symbol icy Number Policy Period Effective Date of Endorsement ISA P5568230 07/01/2022 To 07/01/2023 Issued By (Name of Insurance Company) ACE American Insurance Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: BUSINESS AUTO COVERAGE FORM Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured under a written contract, provided such contract was executed prior to the date of loss. -Project and/or Contract: All projects and/or contracts where you perform work for such additional insured pursuant to any such written contract. A. For a covered "auto," Who Is Insured is amended to include as an "insured," the persons or organizations named in this endorsement. However, these persons or organizations are an "insured" only for "bodily injury" or "property damage" resulting from acts or omissions of: 1. You. 2. Any of your "employees" or agents. 3. Any person operating a covered "auto" with permission from you, any of your "employees" or agents. B. The persons or organizations named in this endorsement are not liable for payment of your premium. C. With respect to the insurance afforded to these additional insureds, the following applies: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. If such additional insured's scope of coverage is not expressly stated in a contract or agreement, then such coverage is limited to the additional insured's vicarious liability to the extent directly caused by the Named Insured's negligence during the Named Insureds ongoing operations. This insurance shall be primary insurance to the extent required by said contract or agreement, and any other insurance or self-insurance maintained by such person or organization shall be noncontributory with the insurance provided hereunder to the extent specified in said contract agreement. Where the contract or agreement provides that the additional insured's scope of coverage is for the named insured's indemnity obligations under such contract or agreement, then such coverage shall be limited to the extent such indemnity obligations are enforceable under applicable law. MS-64638 (12/18) ©Chubb. 2016. All rights reserved. Page 1 of 1 NOTICE TO OTHERS ENDORSEMENT — SCHEDULE — EMAIL ONLY Named Insured Jacobs Engineering Group Endorsement Number Inc. 78 Policy Symbol Policy Number Policy Period Effective Date of Endorsement HDO �G72496176 07/01 /2022 To 07/01 /2023 Issued By (Name of Insurance Company) ACE American 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. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic 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 the e-mail address of such persons or organizations, and we will utilize such e-mail address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 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. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. 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 is mailed or delivered to the first Named Insured. E. We will endeavor to send such notice to the e-mail address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. 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 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 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 date and will not negate any cancellation of the Policy. G. 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 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. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. ALL-32685 (01 /11) Page 1 of 2 All other terms and conditions of the Policy remain unchanged. �2 Authorized Representative ALL-32685 (01 /11) Page 2 of 2 NOTICE TO OTHERS ENDORSEMENT - SCHEDULE - EMAIL ONLY Named Insured Jacobs Engineering Group Inc. Endorsement Number 23 Policy Symbol icy Number Policy Period Effective Date of Endorsement SA P5568230 07/01 /2022 To 07/01 /2023 Issued By (Name of Insurance Company) ACE American 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. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. A. If we cancel the Policy prior to its expiration date by notice to you or the first Named Insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic 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 the e-mail address of such persons or organizations, and we will utilize such e-mail address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 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. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. 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 is mailed or delivered to the first Named Insured. E. We will endeavor to send such notice to the e-mail address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. 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 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 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 date and will not negate any cancellation of the Policy. G. 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 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. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. ALL-32685 (01 /11) Page 1 of 2 All other terms and conditions of the Policy remain unchanged. Authorized Representative ALL-32685 (01/11) Page 2 of 2 Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number JACOBS ENGINEERING GROUP INC. 1000 WILSHIRE BLVD, STE 1140 Policy Number LOS ANGELES CA 90017 Symbol: WLR Number: C6891453A Policy Period Effective Date of Endorsement 07-01-2022 TO 07-01-2023 07-01-2022 Issued By (Name of Insurance Company) ACE AMERICAN 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. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. NOTICE TO OTHERS ENDORSEMENT — SCHEDULE — EMAIL ONLY A. If we cancel this Policy prior to its expiration date by notice to you or the first Named insured for any reason other than nonpayment of premium, we will endeavor, as set out below, to send written notice of cancellation, via such electronic 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 the e-mail address of such persons or organizations, and we will utilize such e-mail address that you or your representative provided to us on such Schedule. B. The Schedule must be initially provided to us within 15 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. C. The Schedule must be in an electronic format that is acceptable to us; and must be accurate. D. 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 is mailed or delivered to the first Named Insured. E. We will endeavor to send such notice to the e-mail address corresponding to each person or organization indicated in the Schedule at least 30 days prior to the cancellation date applicable to the Policy. F. 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 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 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 date and will not negate any cancellation of the Policy. G. 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 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. H. We may arrange with your representative to send such notice in the event of any such cancellation. I. You will cooperate with us in providing the Schedule, or in causing your representative to provide the Schedule. J. This endorsement does not apply in the event that you cancel the Policy. All other terms and conditions of this Policy remain unchanged. This Endorsement is not applicable in the states of AZ, FL, ID, ME, NC, NJ, NM,TX and WI. WC 99 03 68 (01/11) Page 1 Authorized Representative WC 99 03 68 (01/11) Page 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Named Insured Endorsement Number Jacobs Engineering Group, Inc. 23 Policy Symbol Policy Number Policy Period Effective Date of Endorsement EON G21655065 013 07/01/2022 to 07/01/2023 07/01/2022 Issued By (Name of Insurance Company) ACE American Insurance Company NOTICE TO OTHERS ENDORSEMENT — SCHEDULE A. 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. B. 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. C. The Schedule must be in a format that is acceptable to Us and must be accurate. D. 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. E. 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. F. 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. G. 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. H. 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) 9X0ZHN J. �LUPICA. President Authorized Representative