ACCEPTED CTR060473 GL,AL,WC,PROFESSIONAL LIAB 07.01.25-07.01.26.pdf
PDF 3 MB Posted
- Attached to
- Master Agreement AZ|CTR060473
- Contract number
- CTR060473
- Issued by
- Arizona
About this file
This document is a Certificate of Liability Insurance for Jacobs Engineering Group Inc., issued by Marsh Risk & Insurance Services, with ACE American Insurance Company and Indemnity Insurance Company of North America as primary insurers. The certificate covers professional liability for a multimodal transportation planning on-call contract (Contract No. CTR060473) with the Arizona Department of Transportation, specifically addressing solicitation BPM004111 for Planning On-Call services covering Disciplines 2, 3, 5, 6, and 8. The policy period runs from July 1, 2025 to July 1, 2026, and includes additional insured status for the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
The contract provides comprehensive insurance coverage with multiple policy limits, including $1,000,000 for commercial general liability, $1,000,000 for automobile liability, and $500,000 for professional liability on a per claim/per aggregate basis. The insurance policies are primary and non-contributory, with a waiver of subrogation granted in favor of the certificate holder. The contract appears to be a professional services agreement for multimodal transportation planning, with Jacobs Engineering Group Inc. performing work across multiple disciplines for the Arizona Department of Transportation. The policies include provisions for additional insured status and coverage that extends to the named organization's vicarious liability, directly caused by the named insured's negligence during ongoing operations.
View the file
Other files
Show all 15
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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
752026371
752026371
C/O Global Risk Management 555 South Flower Street, Suite 3200
Arizona Department of Transportation
07/01/26PROFESSIONAL LIABILITY
500,000
22667
1,000,000
43575
X
PROJECT MGR: Shanthi Krishnan. CONTRACT MGR: Connie Hodes. RE: Contract No. CTR060473 Multimodal Transportation
1-212-948-1306
X
DATE: 2026-MAY-23. SECTOR: Public. The State of Arizona, and its departments, agencies, boards, commissions, Planning On-Call per solicitation BPM004111 (Disciplines 2, 3, 5, 6 and 8). CONTRACT NUMBER: CTR060473. CONTRACT END liability as respects the negligence of the insured in the performance of insured's services to cert holder under universities, officers, officials, agents, and employees are added as an additional insured for general liability & auto certificate holder's insurance is excess and non-contributory. Waiver of subrogation is hereby granted in favor of the contract for captioned work. The General Liability and Auto Liability insurance policies are primary and the
07/01/25
USA
07/01/26
SCF C72792920 (WI)
Jacobs Engineering Group Inc.
WCU C72792932 (OH)*
WLR C72792919 (AOS)
07/01/25
1-212-948-1306
1,000,000
07/01/26
X
Cert_Renewal
1,000,000
X
Phoenix, AZ 85009
633 W. Fifth Street
5,000CONTRACTUAL LIABILITY
INDEMNITY INS CO OF NORTH AMER
ACE AMER INS CO
2,000,000
1,000,000
A
07/01/25
07/01/25
07/01/25
ISA H11371504
X
07/01/25
Los Angeles, CA 90071 USA
N A
B
A
A HDO G48977145
1,000,000A
05/28/2025
07/01/26
EON G21655065 016
07/01/26
X
1,000,000
LIC #0437153
1324 N. 22nd Ave
Los Angeles, CA 90071 USA
07/01/26
PER CLAIM/PER AGG
CIRTS_Support@jacobs.com Marsh Risk & Insurance Services
Cindy Lewis Accepted
SUPP (05/04)
SUPPLEMENT TO CERTIFICATE OF INSURANCE
DATE
NAME OF INSURED:
Additional Description of Operations/Remarks from Page 1:
Additional Information:
Jacobs Engineering Group Inc.
WILL NOT EXCEED OR BROADEN IN ANY WAY THE TERMS, CONDITIONS, AND LIMITS AGREED TO UNDER THE APPLICABLE CONTRACT.* and employees for GL, AL and WC. *THE TERMS, CONDITIONS, AND LIMITS PROVIDED UNDER THIS CERTIFICATE OF INSURANCE
State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents, 05/28/2025
*$2,000,000 SIR FOR STATE OF: OHIO
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%
Highlight
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%
ADDITIONAL INSURED -AUTOMATIC STATUS
Named Insured Jacobs Solutions Inc. Endorsement Number
Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement
HOO G48977145 07/01/2025 TO 07/01/2026
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
Highlight
POLICY NUMBER: HOO G48977145
Endorsement Number: 9
COMMERCIAL GENERAL LIABILITY
CG 24 041219
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV - Conditions:
We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.
CG 24 041219 © Insurance Services Office, Inc., 2018 Page 1 of 1
ADDITIONAL INSURED DESIGNATED PERSONS OR ORGANIZATIONS
Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement
ISA H11371504 07/01/2025 TO 07/01/2026
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 lnsured(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 lnsured'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
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS
Policy Symbol I Policy Number I Policy Period Effective Date of Endorsement
ISA H11371504 07/01/2025 TO 07/01/2026
Issued By (Name of Insurance Company)
ACE American Insurance Company
Insert the policy number. The remainder of the information 1s to be completed only when this endorsement 1s issued subsequent to the preparation of the policy.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This Endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIERS COVERAGE FORM
AUTO DEALERS COVERAGE FORM
We waive any right of recovery we may have against the person or organization shown in the Schedule below because of payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or organization shown in the SCHEDULE.
SCHEDULE
Any person or organization against whom you have agreed to waive your right of recovery in a written contract, provided such contract was executed prior to the date of loss.
Authorized Representative
DA-13115a (06/14) Page 1 of 1
Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number
JACOBS SOLUTIONS INC.
555 S. FLOWER STREET SUITE 3200 Policy Number LOS ANGELES CA 90017 Symbol : WLR Number: C72792919
Policy Period Effective Date of Endorsement
07-01-2025 TO 07-01-2026 07-01-2025
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.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.
This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule.
Schedule
ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR
RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS
EXECUTED PRIOR TO THE DATE OF LOSS.
For the states of CA, UT, TX, refer to state specific endorsements.
This endorsement is not applicable in KY, NH, and NJ.
The endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287 .150(6) of the Missouri statutes, a contractual provision purporting to waive subrogation rights against public policy and void where one party to the contract is an employer in the construction group of code classifications.
For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A. .
16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by liability or workers compensation insurance shall be against public policy and shall be void and unenforceable except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a consolidated or wrap-up insurance program.
Authorized Agent
WC 00 03 13 (11/05) © Copyright 1983-2017 National Council on Compensation Insurance, Inc. All Rights Reserved.
File details come from the government source that posted it. Updated .