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Item J4 J.4 `, County of Monroe y,4 ' �, "tr, BOARD OF COUNTY COMMISSIONERS Mayor Michelle Coldiron,District 2 �1 `ll Mayor Pro Tem David Rice,District 4 -re Florida.Keys ��� � � Craig Cates,District 1 Eddie Martinez,District 3 w Mike Forster,District 5 County Commission Meeting February 17, 2021 Agenda Item Number: J.4 Agenda Item Summary #7776 BULK ITEM: Yes DEPARTMENT: Airports TIME APPROXIMATE: STAFF CONTACT: Richard Strickland(305) 809-5200 No AGENDA ITEM WORDING: Approval of Jacobs Project Management Task Order 12/15-95 in the amount of $82,797.00 for Resident Project Representative (RPR) Services during the Florida Keys Marathon International Airport Terminal Interior Rehabilitation project. The RPR will provide part-time RPR services, including but not limited to, checking construction activities to ensure compliance with plans and specifications, coordinate quality assurance tests, review certifications, test reports, and payments requests. The task order is funded by FDOT Grant GIP52 (80%) and Marathon Airport Operating Fund 403 (20%). ITEM BACKGROUND: Five (5)bids were received at the bid opening held on November 3, 2020 and the lowest bidder, Design Center was awarded the bid and contract at the BOCC meeting held on November 17, 2020. Upon notice to proceed to Design Center for construction, RPR services will begin. PREVIOUS RELEVANT BOCC ACTION: CONTRACT/AGREEMENT CHANGES: New task order STAFF RECOMMENDATION: Approval DOCUMENTATION: Jacobs PSO 1215-95 MTH Terminal Interior Rehab RPR FINANCIAL IMPACT: Effective Date: Upon Notice to Proceed(NTP) Expiration Date: 548 days after NTP Total Dollar Value of Contract: $82,797.00 Packet Pg. 1180 J.4 Total Cost to County: $-0- Current Year Portion: Budgeted: Yes Source of Funds: FDOT Grant GIP52 (80%) and Airport Operating Fund 403 (20%) CPI: Indirect Costs: Estimated Ongoing Costs Not Included in above dollar amounts: Revenue Producing: If yes, amount: Grant: County Match: Insurance Required: Yes Additional Details: 02/17/21 403-63502 - MARATHON AIRPORT R & R $82,797.00 REVIEWED BY: Beth Leto Completed 01/21/2021 3:34 PM Richard Strickland Completed 01/29/2021 4:31 PM Pedro Mercado Completed 01/29/2021 4:40 PM Purchasing Completed 01/29/2021 4:46 PM Budget and Finance Completed 02/01/2021 10:13 AM Maria Slavik Completed 02/01/2021 10:18 AM Liz Yongue Completed 02/02/2021 9:41 AM Board of County Commissioners Pending 02/17/2021 9:00 AM Packet Pg. 1181 J.4.a MASTER AGREEMENT FOR PROFESSIONAL SERVICES CL TASK ORDER FORM Effective Date Upon execution Task Order No. 12/15-95 403-635111-560620- a, Client Project No. _ rAM_D$8-530310 Engineer Project No. ..E9Y37995 This Task Order is entered into on the effective date noted above pursuant to the "Master Agreement for Professional Services" between Monroe County, Florida ("Client") and JACOBS PROJECT MANAGEMENT CO. ("Consultant"), dated February 15, 2017 ("Agreement"). The Agreement is incorporated herein and forms an integral part of this Task Order. LO Services Authorized—MTH Terminal Interior Rehabilitation—RPR Services LO N Client authorizes Consultant to perform the Services described in Exhibit A attached hereto and N incorporated herein,which Exhibit A is marked with the above noted Task Order No. and consists of 2 page(s). l Pricing N/A Time and Expense per Agreement and Appendix B to the Agreement. X Firm Fixed Price of$_82,797.00CL W N/A Other(Describe): Schedule a, Services may commence on Execution Services will cease by 548 days Other (SEAL) BOARD OF COUNTY COMMISSIONERS ATTEST: KEVIN MADOK,CLERK OF MONROE COUNTY,FLORIDA By By 141) Deputy Clerk Mayor/Chairman 141) cv T- CONSULTANT: AC BS PROJECT MANAGEMENT CO CL Jeffp Digitally signed by Jeffrey D.Acton N 1 ey D. DN:cn=Jeffrey D.Acton,o=Jacobs UPMco1,ou, email=leffreyActon@Jacobs.com,c-US (B Jacqueline ®Ntc°. a, JRws"c=us � By Acton Date:2021.09.9992:25:22-05'00' o-Jawbs Enj...0% p .8Witness ROSS at.::za 19 12 49 �.00 Title S. Region PM/CM PM/CM Services group seeder W Digitally signed by Pedro Mercado OE 00 ATTORNEY f" DN:cn=Pedro Mercado,o=Monroe File: MSTR APS—Monroe County Dove FORtrt county,ou�ounty Attorneys ;ti ( .c - ---- •��. Office,email=mercado- Page I of 1 Aasl ArroRNEY pedro@monroecounty-fl.gov, Date._._.u. c=US Date:2021.01.1917:09:06-05'00' Packet Pg. 1182 J.4.a Exhibit A—Scope of Work(12/15 -95) Monroe County CL Florida Keys Marathon International Airport Terminal Interior Rehabilitation - RPR Services SCOPE OF WORK Jacobs Project Management Co. (Jacobs)will provide resident project representative (RPR) services for the"Terminal Interior Rehabilitation" project at Florida Keys Marathon International Airport(MTH). These construction services will provide the following: ASSUMPTIONS LO ■ RPR services are based on an anticipated duration of 180 calendar days of construction. In LO the event the construction duration exceeds the calendar days listed above, Jacobs reserves the right to revise our proposal. N • Jacobs will invoice on a percent complete, including expenses, to compensate the level of effort required for each assignment. i ARTICLE I PROJECT REPRESENTATIVE (RPR) 1. Attend pre-construction conference. 2. Coordinate and attend progress meetings with the contractor, Airport, and any other interested parties, as required prior to construction (e.g. Staging area coordination, setting up Contractor's trailer.). 3. Provide part-time RPR services for the work associated with the project. The RPR's for the project shall have field experience in the type of work to be performed, be fully qualified to make interpretations, decisions, field computations, and have knowledge of testing requirements and _ procedures. The RPR's shall be responsible for the following: • Checking of construction activities to ensure compliance with the plans and specifications. LO Inform the contractor and County of any work, which is in non-compliance. LO N • Coordinate quality assurance tests and verify they have been performed at the frequency 0 stated in the specifications. N • Review certifications for conformance with the specifications. • Maintain a set of working drawings on the job site, which can be used to prepare "As-Built" drawings. • Review the test reports and certifications for conformance with the specifications and maintain a file for all reports and certifications. Page 1 of 2 Packet Pg. 1183 J.4.a • Inform the County of deficiencies so corrections can be made and retesting performed. • Jacobs does not have control over or charge of and shall not be responsible for constructionCL means, methods, techniques, sequences or procedures of construction or for safety precautions and programs in connection with the work, since these are solely the Contractor's responsibility under the contract for construction. • Jacobs shall make every reasonable effort to ensure that the Contractor completes the work in accordance with the current approved schedule and carries out the work in accordance with the contract documents. 76 • Review close out documentation. • Review payment requests and certified payrolls from the contractor. LO • Maintain a diary, which will contain entries made and signed by the resident engineer. Each LO entry should include the following, plus any additional pertinent data: a. Date and weather conditions. b. Names of important visitors. c. Construction work in progress and location. i d. Size of contractor's work force and equipment in use. e. Number of hours worked per day for contractor and subcontractors. '✓ CL 4. Attend final inspection for punchlist. 5. Attend follow up site visit to confirm completion of punch list items. Services for Article E will be provided under a lump sum basis. , 76 E LO w LO cv o CL N 0 Page 2 of 2 Packet Pg. 1184 J.4.a JACOBS ENGINEERING GROUP JOB HOUR AND FEE ESTIMATE Monroe County CL Airport: Florida Keys Marathon International Airport cc Project: MTH Terminal Interior Rehabiliation-RPR Services C .0 FEE SUMMARY BASICSERVICES Hours Fee DBE AMOUNT Article :RPR Services 600 $ 82,797 $ Total Basic Services Lump Sum Fee 600 $ 82,797 $ uO w TOTAL LUMP SUM PROJECT FEE $ 82,797 $ uO r- cv r N C CL C .0 E u7 a) u7 r- N r- CL o C Page 1 of 2 Packet Pg. 1185 ACC Rf> CERTIFICATE OF LIABILITY INSURANCE 07 J.4.a 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 POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE 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 endorse If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement t L 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 A/c No Ext: A/C No: 1-212-948-131 E-MAIL 633 W. Fifth Street ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 1 Los Angeles, CA 90071 INSURERA: ACE AMER INS CO 22667 L INSURED INSURER B: Jacobs Project Management Co. INSURER C C/O Global Risk Management INSURERD: I" 1000 Wilshire Blvd. , Suite 2100 INSURERE: Los Angeles, CA 90017 LO INSURERE: COVERAGES CERTIFICATE NUMBER: 59742119 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERK INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI- CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS 0 LTR INSD WVD POLICYNUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY HDO G71452694 07/01/20 07/01/21 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ] OCCUR PREM �a SES oNcur ante $ 500,000 X CONTRACTUAL LIABILITY MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICYEl PRO LOC PRODUCTS-COMP/OPAGG $ 1,000,000 JECT Ww OTHER: $ CL A AUTOMOBILE LIABILITY ISA H25307306 07/01/20 07/01/21 COMBINEDSINGLELIMIT $ 1,000,000 Ea accident X ANY AUTO )S _ BODILY INJURY(Per person) $ OWNED SCHEDULED I v BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED ry - - -M PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY 7•_ _., •• z' -s Per accident 7/28/2020 $ L UMBRELLALIAB 1 -`"`"-' „�„,�„„. a,,. .L OCCUR '"'""'^ EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I X"Wl AGGREGATE $ DED RETENTION$ $ A AND EMPLOYERS'LIABILITY WORKERS COMPENSATION YIN WCU C67460340 (OHIO Only @17/Ol/20 07/01/21 X STATUTE OERH A ANYPROPRIETOR/PARTNER/EXECUTIVE NIA SCF C67460388 (WI) 07/01/20 07/01/21 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/M EMBER EXCLU DED? O7/O1/21 1,000,000 L A (Mandatory in NH) WLR C67460303 (AOS) 07/01/20 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A PROFESSIONAL LIABILITY EON G21655065 011 07/01/20 07/01/21 PER CLAIM/PER AGG 1,000,000 "CLAIMS MADE" AGGREGATE 2,000,000 DEFENSE INCLUDED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) OFFICE LOCATION: Jacksonville, FL 32202. PROJECT MGR: Ryan Forney. CONTRACT MGR: Jack Renton. SENIOR CONTRACT MG] Christopher Bowker. RE: Monroe County Airports - General Consulting Services Master Agreement with Jacobs Project Management Company for Professional Services at Key West International Airport and The Florida Keys Marathon International Airport. CONTRACT END DATE: 02/14/2022. PROJECT NUMBER: E9Y16700. SECTOR: Public. *$2,000,000 SIR STATE OF: OHIO. The Monroe County Board of County Commissioners, its employees and officials are added as an CL additional insured for general liability & auto liability as respects the negligence of the insured in the performat (h of insured's services to cert holder under contract for captioned work. *THE TERMS, CONDITIONS, AND LIMITS PROVIDEI CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOI Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street 0 AUTHORIZED REPRESENTATIVE � Key West FL 33040 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Packet Pg. $6 Cert Renewal 59742119 JAa SUPPLEMENT TO CERTIFICATE OF INSURANCE o710612020 NAME OF INSURED: Jacobs Project Management Co. UNDER THIS CERTIFICATE OF INSURANCE WILL NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREI L TO UNDER THE APPLICABLE CONTRACT.* .L LO LO L V- 04 O CL LO LO L .L L V- 04 - CL Cn O O SUPP(10/00) Packet Pg. 1187 J.4.a From: Nyari.Yumdo@jacobs.com To: monroecountyfl; Rickard, Melody W monroecountyfl@Ebix.com,Melody.Rickard@jacobs.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): LO LO Hi All, Attached is the renewal copy of Certificate of Liability Insurance for your reference. Please confirm, if this is the certificate you are 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. I If there are any further questions in regards to this matter, please email CIRTS_Support@jacobs.com. Regards, Nyari Yumdo CL Global Risk Management Support Nyari.Yumdo@jacobs.com From: Customer Service<monroecountyfl@ebix.com> Sent:07 July 2020 01:09 L To: Rickard, Melody<Melody.Rickard@jacobs.com>;CIRTS_Support<CIRTS_Support@jacobs.com> Subject: [EXTERNAL] Monroe County Florida Certificate of Insurance Req ll' 1`P3LO \ . LO 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 must be properly insured while doing business with L Monroe County Florida and comply with insurance requirements. As of the date of this notice we have not received proper evidence of insurance coverage. Please review the attached notice as it includes the information needed for compliance and where to send your Certificate of Insurance. Packet Pg. 1188 JAa Vendor Instructions:The attached notice is being sent to you and your agent, if we have their email address on file. Agent Instructions: Please review the attached notice as it includes the information .L needed for compliance. Please send your Certificate of Insurance via email to monroecountyfl@ebix.com; if you have any questions, please contact Ebix by calling(951) 925-1213; thank you for your prompt attention to this matter. L EB' X Ebix,lnc. One Ebix way Johns Creek, GA 30097 Web- LO I CL LO LO .L F— F— V- V- CL Cn Packet Pg. 1189 J.4.a 4 NOTICE TO OTHERS ENDORSEMENT-SCHEDULE- EMAIL ONLY Named Insured ,Jacobs Engineering Group Inc. Endorsement Number i 15 .L Policy Symbol Policy Number Policy Period Effective Date of Endorsement HDO �G71452694 07/01/2020 To 07/01/2021 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. L THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Ln 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 LO 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 I ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. Uj 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 CL 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 L 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 I nor your representative provides us with e-mail address information with respect to a particular person or I organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. LO H. We may arrange with your representative to send such notice in the event of any such cancellation. L TO V_ 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. CL ALL-32685(01111) Page 1 of 2 Packet Pg. 1190 J.4.a 1 NOTICE TO OTHERS ENDORSEMENT-SCHEDULE- EMAIL ONLY Named Insured ,Jacobs Engineering Group Inc. Endorsement Number i 3 .L Policy Symbol Policy Number Policy Period Effective Date of Endorsement ISA �H25307306 07/01/2020 To 07/01/2021 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. L THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Ln 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 LO 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 I ii. This endorsement has been added to the Policy, if this endorsement is effective after the Policy period commences. Uj 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 CL 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 L 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 I nor your representative provides us with e-mail address information with respect to a particular person or I organization, then we shall have no responsibility for taking action with regard to such person or entity under this endorsement. LO H. We may arrange with your representative to send such notice in the event of any such cancellation. L TO V_ 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. CL ALL-32685(01111) Page 1 of 2 Packet Pg. 1192 X. I K.4.h Primary Anchorages in the Florida Keys with Number and Location of Anchored Vessels receiving Mobile Vessel Pumpout Service 6-16-2020 Overview The Monroe County Mobile Vessel Pumpout Service is provided to vessel owners throughout the Florida 00. Keys as a means of reducing or eliminating the adverse environmental impacts associated with the illegal :5 discharge of sewage into the federally designated No-Discharge Zone. The Service's first priority is L providing service to anchored-out vessels. This report provides information on the number and locations of anchored-out vessels that currently receive 0) pumpout service by Monroe County's pumpout vendor, Pumpout USA. In addition, nearby shoreside pumpout facilities (including cost per pumpout) are provided on the following maps for reference. A CL summary table is also provided below. W 0 This report is based on best available data from pumpout logs for the month of June 2019. This period is considered"off-season" for vessels at anchor. Therefore, these numbers are conservative and anticipated to 0 be higher during the winter months when activity is greater. Number of Proximity to Region Primary Anchorages Anchored Nearest Shoreside W Vessels Pumpout Facility Serviced (in miles)* Wisteria 42 2 Fleming Key 55 1 Lower Keys Cow Key (North) 10 <1 (Key West to Stock Island) Cow Key (South) 12 2 Boca Chica Basin 20 4 SUBTOTAL 139 0 Sugarloaf Sound 5 22 0 Lower Keys Niles Channel 2 14 (Sugarloaf to Big Pine Key) Newfound Harbor 9 14 Koehn Basin 2 8 W SUBTOTAL 18 0 Middle Keys N/A N/A N/A Little Basin 4 <1 Big Basin 4 <1 Windley(Wilson Key) 3 4 0. Upper Keys Windley(OV Basin) 6 3 0 CL Community Harbor 9 <1 Buttonwood Sound 3 10 Tarpon Basin 5 5 Jewfish Creek 8 6 SUBTOTAL 42 CL GRAND TOTAL 199 *dependent on vessel draft and mast height restrictions. Nearest facility may not be appropriate for all vessels. 0 Packet Pg. 1993 JAa THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. L Named Insured Endorsement Number L Jacobs Engineering Group Inc. 29 Policy Symbol Policy Number Policy Period Effective Date of Endorsement EON G21655065 011 07/01/2020 to 07/01/2021 07/01/2020 Issued By(Name of Insurance Company) ®" ACE American Insurance Company L NOTICE TO OTHERS ENDORSEMENT—SCHEDULE I A. If We cancel or non-renew the Policy prior to its expiration date by notice to You for any reason other 141) 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 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. CL 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 L cancellation or non-renewal date applicable to the Policy. L 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 L 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 I responsible for any incorrect information that You or Your representative provide to Us. If You or LO 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 CL 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) JOHN J. LUPICA, President Authorized Representative Packet Pg. 1195