12/15-84 Aircraft Overflow Parking-Phase I -aft r, Kevin Madok, CPA
ipis Clerk of the Circuit Court&Comptroller—Monroe County, Florida
DATE: October 28, 2020
TO: Beth Leto, Airports
Business Manager
FROM: Pamela G. Hannick, .C.
SUBJECT: October 21B0CC Meeting
Attached is an electronic copy of the following item for your handling:
C36 Jacobs Project Management Co.'s Task Order No. 12/15-84 in the amount of
$289,702.00 for Aircraft Overflow Parking Design Phase 1 at the Key West International Airport.
The project was identified in dre Master Plan completed in 2019 due to increased aircraft activity
and the need for aircraft apron parking.The Task Order is being funded by Airport Operating
Fund 404.
Should you have any questions please feel free to contact me at (305) 292-3550.
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
MASTER AGREEMENT FOR PROFESSIONAL SERVICES
TASK ORDER FORM
Effective Date Upon Execution Task Order No. 12/15-84 .
Client Project No. 404-63001-530310 Engineer Project No. E9Y37984 .
This Task Order is entered into on the effective date noted above pursuant to the "Master
Agreement for Professional Services"between Monroe County, Florida("Client")and JACOBS
PROJECT MANAGEMENT CO. ("Consultant"),dated February 15, 2017 ("Agreement"). The
Agreement is incorporated herein and forms an integral part of this Task Order.
Services Authorized—Aircraft Overflow Parking—Phase 1
Client authorizes Consultant to perform the Services described in Exhibit A attached hereto and
incorporated herein, which Exhibit A is marked with the above noted Task Order No. and
consists of 6 page(s).
Pricing
N/A Time and Expense per Agreement and Appendix B to the Agreement.
X Firm Fixed Price of S 289,702.00 .
N Other(Describe):
Schedulul e u4
PEOR M
�-,^-gces may commence on Execution . ASSI .(1,,t(e t1tl! RNEY
i " ; •will cease by 36.;;.�a� a Zt)
iSAs i
I i
�: BOARD OF COUNTY COMMISSIONERS
KEVIN MADOK,CLERK OF MONROE CO Y, ORIDA
c /. .wwsZ-- B
As Deputy Clerk y Mayor/ hai
CONSULTANT:
JACOBS PROJECT MANAGEMEN$CO g
Jeffrey D. �� :r,,,° ."'
O 1••••• P w°.d.WSCJ V
W"CGL« y
...tmm rr�i:me.�. 'rt
Jacqueline rG;^ .t.` By Afton Ao,o4��Gaa, _ o
ROSS � W "" S. Region PM/CM Group-Leader a �'
Witness Title
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File: MSJR APS-Monroe County
Page I of I
Exhibit A — (12/15 - 84)
Scope of Services
Monroe County Airports
Key West International Airport (EYW)
Aircraft Overflow Parking — Phase 1
SCOPE OF WORK
Jacobs will provide project management, coordination services, design, and permitting
for the expansion of the General Aviation Apron at Key West International Airport (EYW).
EXISTING CONDITIONS
Key West International Airport continues to see increase in aircraft activity and the need
for aircraft apron parking. In accordance with the Master Plan completed in 2019, the
additional Overflow Apron is recommended to support this increased demand.
The footprint of the proposed Aircraft Overflow Parking is located west of Taxiway Al
(131) and adjacent to an existing salt pond. The proposed Aircraft Overflow Parking will
have two stub taxiways connected to Taxiway A. Refer to Figure 1 for the proposed
overflow parking apron.
t Nei,li 2i x
Sf
Taxiway A
P
n
Proposed Survey Area
--------------------------
--------------
1
Figure 1: Proposed Aircraft Overflow Parking and Survey Area
Page 1 of 6
DESCRIPTION OF WORK
Phase 1 of the General Aviation Overflow Apron Expansion project includes the following
elements:
1. Develop a 30%design package for the proposed Overflow Apron
2. Develop a 30%design package for the on-site and off-site mitigation areas
3. Submit a United States Army Corps Engineers(USACE)for the proposed salt pond
impacts and mitigation areas
GFNERAL SCOPE
One construction package will be developed for this project. For this construction
package,Jacobs will provide the following services:
1. Management of the project from data collection, 30%design package, and
USACE permit submission
2. Coordination with the geotechnical subconsultant,survey subconsultant,and
permitting subconsultant.
3. Coordination with Monroe County, USACE,and SFWMD as required.
4. Preparation of minutes of meetings and phone conversations.
5. Program verification and site investigations.
ASSUMPTIONS/DESIGN PARAMETERS
1. This project will be funded with state, local,and CARES monies.
2. Jacobs will develop plans at a 30%design level for review.
3. USACE and SFWMD permits are required based on the current scope of the project.
4. A pavement design report is required and will be based on the airport's current
general aviation fleet mix.
5. The taxiway design criteria will be based on Taxiway Design Group 2. It is assumed
that this project will not utilize paved shoulders.
6. It is assumed the Airport will provide an escort for the survey.
7. The design will be in accordance with the most current FAA-AIP Advisory Circulars.
8. This scope of work does not include bid services,construction administration,
resident project representative nor quality assurance testing. This scope of work also
does not include the development of a construction management plan.These
services along with a construction management plan will be provided under a
separate purchase order.
9. It is assumed that this project does not require the creation of an AGIS project.
10.Any cost estimates provided by Jacobs will be in a basis of experience and judgement.
Since consultant has no control over market conditions or bidding procedures,Jacobs
Page 2 of 6
does not warrant that bids or ultimate construction costs will not vary from these cost
estimates.
ARTICLE A-DATA COLLECTION AND PRELIMINARY DESIGN
Data Collection:
1. Prepare for and attend project design kick off meeting.
2. Coordinate with subconsultants including but not limited to survey,geotechnical,and
environmental permitting as well as other Project Team members.
3. Perform a detailed topographic survey of existing apron, proposed apron expansion
footprint, mitigation areas,and wetland delineation as outlined in the attached survey
scope of work by O'Neal Surveying Company.
4. Perform a geotechnical investigation to assess the existing soil strata classifications in
the proposed mitigation areas.Geotechnical investigation will also include
cores/bores to determine existing pavement thickness,soil strength,estimated
ground water level,and estimated seasonal high ground water level table.The
geotechnical investigation will be performed as outlined in the attached scope of
work by Tierra South Florida.
5. Jacobs to provide full time badged escort for the geotechnical field crew. It is
assumed that the geotechnical field work will take approximately 5 - 8 hour shifts to
complete.
6. Research record drawings for underground utilities. (i.e.sewer,water,electric,gas,
communication,etc.).
7. Perform an inventory and inspections of the existing taxiway edge light bases and
guidance sign panel messages.All of the taxiway guidance signs at the airport will
need to be updated to accommodate the two additional stub taxiways.
8. Perform site walk through survey to locate and note any special site conditions that
would affect construction techniques or materials. Take photographs of the site and
provide written documentation,sketches, notes,or reports to confirm and record the
general conditions of the existing site. Field verify that all existing features in the field
were picked up during the topographic survey.
9. Assist Birkitt Environmental Services with preparation and attend Pre-Application
meeting with SFWMD.
10.Assist Birkitt Environmental Services with preparation and attend Pre-Application
meeting with SFWMD.
Page 3 of 6
11.Perform a wetlands and protected species impact and mitigation detailed site review
for the proposed Aircraft Overflow Parking area,three on-site mitigation areas,and
one off-site mitigation area.The environmental investigation will be performed as
outlined in the attached scope of work by Birkitt Environmental Services, Inc.
12.Perform QA/QC.
ARTICLE 8-30%DESIGN
Based on the information collected under Article A,the 30%design documents will be
developed for all elements identified in this scope of work.
1. Prepare for and attend one(1) design review meetings with the Airport to discuss
project progress and review the design submittals.
2. Prepare preliminary pavement design report. All analytical methods, results, and
recommendations will be summarized in a detailed written draft report.
3. Coordinate with Birkitt Environmental Services for the USACE permit.
4. Develop preliminary on-site and off-site mitigation design and report. The
designs, mitigation plans, and reports will be completed as outlined in the
attached scope of work by Birkitt Environmental Services, Inc.
5. Develop preliminary dewatering, shoulder stabilization, and erosion control
Aircraft Overflow Apron to be constructed adjacent to salt ponds.
6. Develop the following anticipated plans:
Overflow Apron/Mitigation Areas
0%Design Package
Sheet Name Number of Sheets
Title Sheet 1
Index of Drawings and 1
Notes
General Notes 1
General Plan 2
Survey Control Plan 3
Existing Conditions Plan 8
Page 4 of 6
Geotech/Borings Plan 8
Demolition/Clearing & 8
Grubbing Plan
Geometry Plan 2
Typical Sections 3
Grading Plan 8
Drainage Plan 2
Landscape Plan 6
Landscape Details 2
Erosion Control/Dewatering 2
Plan
Erosion Control/Dewatering 3
Details
Electrical Demolition Plan 2
Electrical Plan 2
Miscellaneous Details 4
Total Sheet Count 68
7. Jacobs will perform preliminary drainage design and attend the necessary pre-
application meeting with the South Florida Water Management District. Drainage
improvements will include connecting existing storm sewer systems to the newly
installed injection wells that were installed under a previous project.
8. Jacobs will perform preliminary airfield electrical design.The preliminary airfield
electrical design will include the installation of new taxiway edge lights,
installation of guidance signs,and providing new guidance sign panels due to the
re-naming of the taxiways.
9. Prepare preliminary cost estimate for 30%design.
10.Coordinate, distribute and print the following copies of the 30%design drawings
(plans and design report) for review by the Airport:
Monroe County: 2 copies of plans (1 full size; 1 half size); 2 copies of engineering
report
USACE: 2 copies of plans (1 full size; 1 half size); 2 copies of engineering
report
Page 5 of 6
11.Conduct an in-house QA/QC prior to the 30% design submission. The in-house
QA/QC check will involve an experienced independent individual, depending on
each discipline, to conduct a comprehensive check on all documents to be
submitted (e.g. plans and reports). Time will be required for engineers and CADD
technicians/designers to correct items listed under the in-house QA/QC checks.
12.Address comments from 30%design submission.
Services for Article B will be provided under a lump sum basis.
PROJECT SCHEDULE
The tentative project schedule from the Notice to Proceed date will be as follows:
Project Schedule
Article A-Data Collection NTP+ 30 Calendar Days
and Preliminary Design
Article B-30%Design NTP + 75 Calendar Days
Submit 30% Plans to January 2021
USACE Permit
Page 6 of 6
JACOBS ENGINEERING GROUP JOB HOUR AND FEE ESTIMATE
Monroe County
Airport
Key West International Airport
Project:
Aircraft Overflow Parking-Phase 1
FEE SUMMARY
RACK SFRV1CFS.
Hours Fee DBE AMOUNT
Article A:Data Collection and Preliminary Design 212 $ 124,152 $ 96.388.00
Article B:30%Design 882 $ 165,550 $ 63,822.00
Total Basic Services Lump Sum Fee 1,094 $ 289,702 $ 160,210
[TOTAL LUMP SUM PROJECT FEE 1,094 $ 289,702 $ 160,210
DBE Percentage 55.30%
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A`C1RO CERTIFICATE OF LIABILITY INSURANCE av06/2020
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 candlians 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 sack endorsements).
PRODUCER L/C 10437153 L-212-948-1306 C�ACt
Marsh Risk L Insurance Servtoee Pim,E F _1-212-948-1306
CtflS Support@jacohs.com N'
W. AOORERE
633 M Fifth Street Pee
IN4UREROe)AFFDROMG COMRADE _ NAM*
Los Angeles, CA 900II INSURER A ACE AMER INS CO 32661
INSURER INSURER B: _
Jacobs Project Management Co. wsuRvc
C/O Global Risk Management INSURER0:
1000 Wilshire Blvd., Suite 210E iNsunsa E:
Loe Angeles. CA 90017 INSURER F.
COVERAGES CERTIFICATE NUMBER:59142119 REVISION NUMBER:
THIS ISTO CERT:FY THAT THE FOL LIES OF'NSURANCE LISTED BELOW HAVE BEEN'SSJED TO THE INSURED NAMED ABOVE FOR THE POLICY PER'OD
NDICATEO. 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 TYE POLICIES DESCRIBED `_EREIN IS SUBiECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UNITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
eisit TYPEOF INSURANCE moo woo. POLICY NUMBER gq�Mpd vna POLICY YW LIMIR
IA X 00MWERCPLOENERALUAONrY I BOO G71452694 07/01/20 07/01/21 LLCHOcCURRENCE I$ 1,000,000
D,AGk IC RENTED
CTUNSim.or X OCCUR IEES I=_auc Puma) 1$ 500,00E
X CONTRACTUAL LIABILITY MED EWtAnyone mum. .$ 5,000
PERSONA_6w?V INJURY '$ 1,000,000
u APPLIES PER. Ru O - $ 1,000,000
X P°1-1C J� =C! LOC PPO9YT5-COMROP At S 1,000,000
OT- R:
A a net m _Ea ISA N25307306 0T/01/20 07/01/21 MNSL "MT !S S,coo ADO
X N VIOm� �� 2O0 U
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HOED ORLY AUTOS ONLY BY • 'p,°,"ono.Ty
7/28/2020
�I uMBRELIALNB OCCUR Lars L/y EACH OCcuiPLvcE s
EFCE9 w C.a AMs"MAn. WAI tR IMP-.. ACCREGATE 'S DED 9EIEN ION$ s
A oPE WCC C67460340 IOWIO Onlyy 87/01/20 07/01/21 Xls Tt PR
ANDEMPLO ERSWINL
A O vE O N SCE C67460388 EMI 07/01/20 07/01/21 E L.EACH ArelDeNi $ 1,000,000
A (Woodson NHI IA MLR C67460303 IAOS) 07/01/20 07/01/21 PL DISEASE•EA EMPLOYEE $ 1,000,000
If Ye.M,ce Ji e
DESC aERIPTION OF OPERATIONS Wl.s, E L.05Ea$E-POLIGy LMIlT 11,000,000
A PROFESSIONAL LIABILITY EON G2165S065 011 07/01/20 07/01/21 PER CLAIM/PER EGG 1,000,000
-CLAIMS MADE" ACCRICATS 2,000,000
DEFENSE INCLUDED
DESCRIPTION OF OPERAXN6 I LOCATIONSI VEXRLEl(*CORD ICI,AEemunu Ramvd COMMIE,My ea aNFnW Ilmanepao la rvVu,edl
OFFICE LOCATION: Jacksonville, FL 32202. PROJECT MGR- Ryan Forney. CONTRACT MGR: Jack Renton. SENIOR CONTRACT MGR:
Christopher Booker. RE; Monroe County Airports - General Consulting Services Master Agreement oath Jacobs Project
Management Company for Professional Services at Key West International Airport and The Florida Rays Marathon
Intethatienal Airport. CONTRACT END DATE; 02/14/2022. PROJECT NUMBER: E9Y16700. SECTOR: Public. A92,000,090 SIR FOR
STATE OF: OHIO. The Monroe County Board of County Coamissioners, its employees and officials are added as
additional insured
sured for general liability L auto Liability asrespects the negligence of the insured in the performance
of insured's ser
vices to cart holder under contract for captioned work. KBE TERMS, CONDITIONS' MID LIMITS PROVIDED
CERTIFICATE HOLDER CANCELLATION
SHOULD ANT OF THE ABOVE OEBCMBED POLICIES BE CANCELLED BEFORE
Monroe County Beard of County Commissioners THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED N
ACCORDANCE WT1 THE POLICY PROVISIONS.
1100 Simonton Street AUTHORIZE,REPREEENTATNE --.--a.y�f '
Rey West FL 3304E • '�
I OSA
O 1988.2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
Cart Renewal
59747119
11,
SUPPLEMENT TO CERTIFICATE OF INSURANCE Ol/DATE
O6/1010
NAME OF INSURED: Jacobs Project Management Co.
UNDER THIS CERTIFICATE OP INSURANCE IRLL NOT EXCEED OR BROADEN IN ANY MAY TN6 TERNS. CONDITIONS, AND LIMITS AGREED
TO UNDER THE APPLICABLE CONTRACT.*
SUPP 110100)
From: Nyari.Yumdo(ajacobs.com
To: monroecountyfi; Rickard, Melody
monroecountylkkEbitcom,Melody.Rickareiz/acobs.com
CC: CIRTS_Support@jacobs.com
Subject: Re: !EXTERNAL] Monroe County Florida Certificate of Insurance Req (Renewal
COI)
Date: 7/6/2020 5:19:38 PM
Attachment(s):
Hi All,
Attached is the renewal copy of Certificate of Liability Insurance for your reference. Please confirm, if this
is the certificate you ere looking for. If not,then kindly provide us the copy of expired certificate or
contract/project number in order to enable us to identify the certificate.
If there are any further questions in regards to this matter, please email CIRTS_Support@jacobs.com.
Regards,
Nyari Yumdo
Global Risk Management Support
Nyari.Yumdo@jacobs.com
From:Customer Service<rronroecountyfl@ebix.com>
Sent:07 July 2020 01:09
To:Rickard,Melody<Melady.Rickard@jacobs.com>;CIRTS_Support<CIRTS_Supnort@jacobs.com>
Subject:(EXTERNAL]Monroe County Florida Certificate of Insurance Req
Arifitir
cio
Int://r,
The attached notice is being sent to you on behalf of Monroe County Florida by Ebix
RCS. Monroe County Florida has engaged with Ebix to manage insurance compliance
verification on its behalf. You most be properly insgred while doing business with
Monroe County Florida and comply with'nsurarce requirements.
As of the date or this notice we have rot received proper evidence of insurance
coverage.Please review the attached notice as it includes the information needed
for comp lance and where to send your Certificate of Insurance.
Vendor Instructions:The attached notice is being sent to you and your agent,if we
have their email address on file.
Agent Instructions'. Please•eview the attached notice as it incl odes the information
needed for compl ance
Please send your Certificate of Insurance via email to menroecountyfl@ebix.com;P
you have any questions,please contact ESix by calling(951)925-1213; thank you fo'
your prompt attention to this matter.
Dith Ebix,Inc. I One rhix way I Johns Creek,GA 30097 I Web-
4
NOTICE TO OTHERS ENDORSEMENT—SCHEDULE—EMAIL ONLY
homed Insuree Jacobs Engineering Group Inc. Endorsement Number
15
Policy Symbol Policy Number Policy Period Effective Date of Erwarsenent
HOC, G71452694 07/01/2020 TO 07/01/2021
issued By(Name of Insurance company)
ACE American Insurance Company
linen l'e tci.'/n:mb,r.me.emaimei or the normnrrm 6 to be cniirpe'„d only„hen tb ennorse'rvni.s rssvf nbsq,w,n to the o,e er.,lln,dine noi_y.
THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY.
A. If we cancel the Policy pior to its expiration date by notice to you or the first Named Insured for any reason other than
nonpayment of premium,we w II endeavor,as set out below.to send written notice of cancellation,via such electronic
notifiotion 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 yoJr 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
it. This endorsement has been added to the Policy, if this endorsement is effective after the Potty 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 wit 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 Warned 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(East 30 days prior to the cancellation date applicable to the Policy.
F. The nctice referenced in this endorsement is intended only to he 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 actor 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 wit 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-32605(01111) Page I of 2
NOTICE TO OTHERS ENDORSEMENT—SCHEDULE—EMAIL ONLY
Named Igsorec Jecoos Engineering Group Inc. Encorsement Number
3
Polley Symbol Policy Number Policy Poops Effective Date of Endersenent
ISA H25307306 07(01/2020 To 07/012021
Issued By:Name or Insurance company)
ACE American Insurance Company
In5en to cIky numbr.ire emaitn rc ae mmrmai. is to 3emwieCd Orly when mm endorsement srsauee we equeM to the n,epeamo oI me oily.
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 ca-ice teflon,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-mai 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.
S. The Schedule must be initially provided to us within 15 days after:
i. The beginning of the Policy perod,if this endorsement is effective as of such date:or
H. This endorsement has been added to the Policy if this endorsement is effective after the Poky period
commences.
C. The Schedule must he 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 wit 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 corresponcing to each person or organization indicated in
Me Schedule at east 30 days prior to the cancellation date applicable to the Policy.
F. The niece referenced in this endorsement is intended only to he 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 organizafion(s). Our failure to provide advance notification of
cancellation to the person(s)or organization(s)shown in the Schedule sha't impose no obligation or liability of any
lord upon us, our agents or representatives, will not extend any Policy cancellation date and will riot negate any
cancellation of the Policy.
G. We are not responsible for verifying any information provided to us in any Schedule, ncr 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, tnen we shall have no responsibility for taking acllor 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 wil 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-32686 MTh)
Page I of 2
All other terms and conditions o'the Policy remain unchanged.
Autsoiized Representative
ALL-32585(Otl1 p Page 2 of 2
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Mimed urea
Jacobs Engineering Group Inc. 2"tO6e"'"'°"i°^
29
poky orb,' policy Mrnpm Pal 07) 1120Neve 07101 eau N Eccraeme+l
EON G21655065 011 07/01/2020 to 07/01/2021 07/01/2020
BY:Name Caimans)nr Insurance Caans)
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 representable 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 auurate.
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 leas(30 days prior to the
cancellation or not-renewal date applicable to the Policy.
F. The notice referenced in this endorsement is intended only to oe 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) a
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 cancel ation 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, 6 neither You nor Your representative provides Us with
e-mail address and/or physical address Information with respect to a particsla person or
organization, then We shall have no responsibility for faking 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 uncharged.
MS-36352(04P9) JCHN . WPICA. President
Author zed Representative - -