ACCEPTED ANY_ALL GL,AL,WC,PROFESSIONAL LIAB 07.01.24-07.01.25 (1).pdf
PDF 6 MB Posted
- Attached to
- Master Agreement AZ|CTR062474
- Contract number
- CTR062474
- Issued by
- Arizona
About this file
This document is a comprehensive insurance certificate and related endorsements for Jacobs Solutions Inc., covering various insurance policies issued by ACE American Insurance Company and other insurers. The policies apply to Jacobs Engineering Group Inc. and are specifically relevant to the State of Arizona, with the Arizona Department of Transportation named as a certificate holder. The insurance coverage includes Commercial General Liability, Automobile Liability, Workers' Compensation, and Professional Liability, with policy periods running from 07/01/2024 to 07/01/2025.
The insurance policies provide coverage limits ranging from $1,000,000 to $2,000,000 across different categories, with additional endorsements that extend coverage to various state entities, departments, agencies, boards, commissions, and universities. The policies cover activities performed by or on behalf of the contractor, including work in ADOT's right of way, and include provisions for additional insured status for the State of Arizona and its associated entities. Specific policy details include a Commercial General Liability policy with a $1,000,000 per occurrence limit, Workers' Compensation coverage for multiple states (Arizona, Ohio, Wisconsin), and provisions for waiving subrogation rights and transfer of recovery rights against others.
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Text version
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
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
1,000,000
2,000,000
750868506
750868506
C/O Global Risk Management 555 South Flower Street, Suite 3200
State of Arizona Arizona Department of Transportation
07/01/25PROFESSIONAL LIABILITY
500,000
22667
1,000,000
43575
X
OFFICE LOCATION: Phoenix, AZ. PROJECT MGR: Jeanne Work. CONTRACT MGR: Connie Hodes. SECTOR: Public. RE: For any
1-212-948-1306
X and the public entity and its officers, officials, agents, and employees shall be named as additional insureds with and all work performed in ADOT's right of way. The State of Arizona, its departments, agencies, boards, commissions, The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, respect to liability arising out of the activities performed by or on behalf of the contractor for general liability.
or on behalf of the Contractor involving automobiles owned, leased, hired or borrowed by the Contractor for auto and employees shall be named as additional insureds with respect to liability arising out of the activities performed by
07/01/24
USA
07/01/25
WCU C57256564 (OH)*
SCF C57256710 (WI)
Jacobs Engineering Group Inc.
WLR C57256667 (AZ)
WLR C5072041A (AOS)
07/01/24
1-212-948-1306
1,000,000
07/01/25
X nyumdo_newgalexy
1,000,000
X
Phoenix, AZ 85007-3276
633 W. Fifth Street
5,000CONTRACTUAL LIABILITY
INDEMNITY INS CO OF NORTH AMER
ACE AMER INS CO
2,000,000
1,000,000
A
07/01/24
07/01/24
07/01/24
07/01/24
ISA H10739585
X
07/01/24
Los Angeles, CA 90071 USA
N
A
A
B
A
A HDO G4892007A
1,000,000A
05/24/2024
07/01/25
EON G21655065 015
07/01/25
07/01/25
X
1,000,000
LIC #0437153
1739 W. Jackson St., Suite A, MD100P
Los Angeles, CA 90071 USA
07/01/25
PER CLAIM/PER AGG
CIRTS_Support@jacobs.com Marsh Risk & Insurance Services
G0171 Accepted
SUPP (05/04)
SUPPLEMENT TO CERTIFICATE OF INSURANCE
DATE
NAME OF INSURED:
Additional Description of Operations/Remarks from Page 1:
Additional Information:
*$2,000,000 SIR FOR STATE OF: OHIO
Jacobs Engineering Group Inc.
TO UNDER THE APPLICABLE CONTRACT.*
UNDER THIS CERTIFICATE OF INSURANCE WILL NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED its officers, officials, agents, and employees for GL, AL and WC. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED
Engineering Group, Inc. and The State of Arizona, its departments, agencies, boards, commissions, universities and
05/24/2024
Exhibit 21
JACOBS SOLUTIONS INC.
LIST OF SUBSIDIARIES
The following table sets forth all subsidiaries of the Company but may not include those subsidiaries that, when considered in the aggregate, would not constitute a significant subsidiary.
Jacobs Engineering Group Inc., a corporation of Delaware…………………………………... 100.00% Jacobs Government Services Company, a corporation of California 100.00% Jacobs Engineering Inc., a corporation of Delaware 100.00% Jacobs Group Australia Investments Pty Ltd., a corporation of Australia…………….. 100.00% Jacobs Australia Holdings Company Pty Ltd., a corporation of Australia 100.00% Sinclair Knight Merz Management Pty Ltd., a corporation of Australia 100.00% Jacobs Group Australia Holding Ltd., a corporation of Australia 100.00% Jacobs Group (Australia) Pty Ltd., a corporation of Australia 100.00% Aquenta Consulting Pty Ltd., a corporation of Australia……………….. 100.00% Jacobs E&C Australia Pty Ltd., a corporation of Australia 100.00% Jacobs Project Management Australia Pty Ltd., a corporation of Australia 100.00% Jacobs Architecture (Australia) Pty Ltd., a corporation of Australia 100.00% Jacobs (Thailand) Co., Ltd., a corporation of Thailand 49.00% Jacobs Projects (Philippines) Inc., a corporation of the Philippines 100.00% Sinclair Knight Merz (Ireland) Ltd., a corporation of the Republic of Ireland.. 100.00% Sinclair Knight Merz (Kenya) Limited, a corporation of Kenya……….. 100.00% Jacobs New Zealand Limited, a corporation of New Zealand 100.00% PT Jacobs Group Indonesia, a corporation of Indonesia 99.50% Sinclair Knight Merz International Holdings LLC, a limited liability company of
Delaware………………………………………………………………………… 100.00%
Jacobs Engineering Group Malaysia Sdn Bhd, a corporation of Malaysia… 100.00% Perunding Mahir Bersatu Sdn Bhd, a corporation of Malaysia… .. 100.00% Jacobs Engineering Services Sdn Bhd, a corporation of Malaysia… 100.00% Jacobs Consulting Services Sdn Bhd, a corporation of Malaysia… 100.00% Sinclair Knight Merz (Hong Kong) Limited, a corporation of Hong Kong …. 100.00% Sinclair Knight Merz International (Hong Kong) Ltd, a corporation of Hong Kong 100.00% Jacobs Korea Limited, a Republic of Korea corporation………………………………… 100.00% CODE International Assurance Ltd., a corporation of Nevada 100.00% CODE II International Assurance Ltd., a corporation of Vermont……………………….. 100.00% Jacobs Engineering España, S.L.U., a corporation of Spain 100.00% Jacobs Europe Holdco Limited, a corporation of England and Wales 100.00% Jacobs NL B.V., a corporation of the Netherlands……………………………… 100.00% Jacobs Solutions Hellas S.A., a Societas Europaea of Greece………….. 100.00% Jacobs Services Suomi Oy, a limited liability company of Finland……………. 100.00% Jacobs Danmark ApS, a Denmark corporation………………………………….. 100.00% Jacobs UK Holdings Limited, a corporation of England and Wales 100.00% Jacobs Switzerland GmbH, a corporation of Switzerland 100.00% Jacobs U.K. Limited, a corporation of England and Wales 100.00%
Energy, Safety and Risk Consultants (UK) Limited, a corporation of England and Wales…………………………………………………..
100.00%
Jacobs Clean Energy International Limited, a corporation of England and Wales…………………………………………………
100.00%
Jacobs Clean Energy Limited, a corporation of England and Wales……………………………………………………………. 100.00% Jacobs E&C Limited, a corporation of England and Wales……… 100.00% National Nuclear Corporation Limited, a corporation of England and Wales…………………………………………………………..
100.00%
Jacobs Field Services Limited, a corporation of England and Wales.. 100.00% Jacobs Solutions India Private Ltd., a corporation of India 100.00% Jacobs GMBH, a corporation of Germany…………………………. 100.00% Jacobs Stobbarts Ltd, a corporation of England and Wales 100.00% Jacobs Engineering U.K. Ltd., a corporation of England and Wales………. 100.00% Jacobs One Limited, a corporation of Scotland 100.00% Jacobs China Limited, a Hong Kong corporation 100.00% BEAR Scotland Limited, a corporation of Scotland 25.00% Growing Concern Scotland Limited, a corporation of England and Wales…………………………………………
100.00%
Ringway Jacobs Limited, a corporation of England and Wales 50.00% JacobsGIBB Limited, a corporation of England and Wales 100.00% Jacobs Engineering Ireland Limited, a corporation of the Republic of Ireland 100.00% Jacobs Italia, SpA, a corporation of Italy 100.00% Jacobs International Limited, a corporation of the Republic of Ireland 100.00% Jacobs Nucléaire SAS, a corporation of France 100.00% Jacobs Belgium B.V., a corporation of Belgium………………………………………. 100.00% Jacobs Brazil Limited Inc. a corporation of Texas 100.00% JEG Acquisition Company Limited, a corporation of England and Wales 100.00% Defence Contractor Management and Operations Limited, a corporation of England and Wales…………………………….
24.50%
Jacobs Puerto Rico Inc., a corporation of Puerto Rico 100.00% Jacobs Holdings Singapore Pte. Limited, a corporation of Singapore 100.00% Jacobs International Consultants Pte. Ltd. a corporation of Singapore……………. 100.00% Jacobs Canada Holding Company, a corporation of California…………………………. 100.00% Jacobs Consultancy Canada Inc., a corporation of Canada………………………… 100.00% Jacobs Advisers, Inc., a corporation of California 100.00% Jacobs Civil Consultants Inc., a corporation of New York 100.00% Jacobs Technology Inc., a corporation of Tennessee 100.00% Blacklynx Inc., a corporation of Delaware………………………………………………… 100.00% Blue Canopy Group, LLC, a limited liability company of Virginia……………………….. 100.00% Buffalo Group LLC, a limited liability company of Delaware……………………………... 100.00% Federal Network Systems LLC, a limited liability company of Delaware 100.00% Jacobs Aerospace Test Operations LLC, a limited liability company of Delaware……. 100.00% Jacobs Australia Pty limited, a corporation of Australia 100.00% Jacobs Telecommunications, Inc., a corporation of New Jersey……………………….. 100.00% The KeyW Holding Corporation, a corporation of Maryland 100.00% The KeyW Corporation, a corporation of Maryland…………………………………… 100.00%
Exhibit 21
Automotive Testing Operations, LLC, a limited liability company of Delaware 100.00% Hanford Progress EcoPartners, LLC, a limited liability company of Delaware………… 35.00% Jacobs Engineering New York Inc., a corporation of New York 100.00% Iffland Kavanagh Waterbury, P.L.L.C., a limited liability company of New York 100.00% Jacobs Project Management Co., a corporation Delaware 100.00% JE Associates, Inc., a corporation of Missouri 100.00% Bechtel Jacobs Company LLC, a limited liability company of Delaware 40.00% LeighFisher Inc., a corporation of Delaware 100.00% LeighFisher Canada Inc., a corporation of Canada 100.00% LeighFisher Holdings Ltd. a corporation of England and Wales 100.00% LeighFisher Ltd., a corporation of England and Wales 100.00% KlingStubbins Inc., a corporation of Delaware 100.00% Sverdrup Asia Limited, a corporation of India 100.00% Jacobs Engineering and Construction (Thailand) Limited, a corporation of Thailand……. 99.98% Mission Support & Test Services, LLC, a limited liability company of Delaware……………. 37.00% Streetlight Data, Inc., a corporation of Delaware……………………………………………….. 100.00% CH2M HILL Companies, Ltd., a corporation of Delaware 100.00% CH2M HILL, Inc., a corporation of Florida 100.00% CH2M HILL New York, Inc., a corporation of New York………………………. 100.00% Halcrow, Inc., a corporation of Delaware….…………………………………… 100.00% CH2M HILL Constructors, Inc., a corporation of Delaware………………………………… 100.00% CH2M Facility Support Services, LLC, a limited liability company of Delaware… 100.00% CH2M HILL Plateau Remediation Company, a corporation of Washington…… 100.00% CH2M HILL International, Ltd., a corporation of Delaware 100.00% CH2M HILL (India) Private Limited, a corporation of India..…………………… 90.00% CH2M HILL International Engineering, Inc., a corporation of Delaware…….. 100.00% CH2M HILL One Limited, a corporation of England and Wales....……………. 100.00% CH2M HILL Holdings Limited, a corporation of England and Wales…..………. 100.00% CH2M HILL Europe Limited, a corporation of England and Wales…..…... 100.00% Halcrow Holdings Limited, a corporation of England and Wales……. 100.00% Halcrow Consulting Limited, a corporation of England and Wales…….……………………………………………………
100.00%
Halcrow Group Limited, a corporation of England and Wales………..…………………………………………………..
100.00%
Halcrow International Limited, a corporation of England and Wales……..………………………………………………….
100.00%
Halcrow Consulting India Pvt Limited, a corporation of India…. 62.94% CHNG B.V., a corporation of the Netherlands……………………………..… 100.00% CH2M HILL Netherlands Holding B.V., a corporation of the Netherlands……………………………………………………………..
100.00%
CH2M HILL Canada Limited, a corporation of Canada…………… 100.00% CH2M HILL International B.V., a corporation of the Netherlands.. 100.00% CH2M HILL Arabia Co. Ltd., a limited liability company of Saudi Arabia……………………………………………………………..
90.00%
CH2M Saudi Limited, a limited liability company of Saudi Arabia……………………………………………………………
75.00%
CH2M HILL International Nuclear Services Limited……………. 100.00%
CH2M HILL Singapore Pte. Ltd., a corporation of Singapore…………… 100.00% CH2M HILL United Kingdom, a corporation of England and Wales..……. 100.00% Jacobs Sverige Aktiebolag, a corporation of Sweden……………… 100.00% CH2M HILL International Services, Inc., a corporation of Oregon……………………. 100.00% Operations Management International, Inc., a corporation of California………….....… 100.00% CH2M HILL Global, Inc., a corporation of Delaware 100.00% CH2M HILL Engineers, Inc., a corporation of Delaware 100.00% Jacobs Solutions Puerto Rico, Inc., a corporation of Delaware………………. 100.00% CH2M HILL Constructors International, Inc., a corporation of Delaware………………. 100.00% PA Holdings Limited, a corporation of England and Wales……………………………………. 65.00%
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