2011/10/05 Council Agenda Packet

ADDITIONAL INSURED - AUTOMATIC STATUS I Named Insured Jacobs Engineering Group, Inc. Endorsement Number 7 Policy Symbol I Policy Number Policy Period Effective Date of Endorsement HDO G25529030 07/01/11 to 07/01/12 07/01/11 Issued By(Name of Insurance Company) ACE AMER INS CO Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM • Additional Insured — Automatic Status SCHEDULE Name of Person or Organization: Any Person or Organization for whom you are required by written contract or agreement entered into prior to the loss to provide insurance. • Who is an insured (Section II)includes as an 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 insured exceed the scope of the coverage and/or limits required by said contract or agreement; and, if such insured's scope of coverage is not addressed in such contract or agreement, then such coverage is limited to its 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 non-contributory with the insurance provided hereunder to the extent specified in said contract agreement. .././0450/4" Authorized Agent CC-1E15 Ptd.In U.S.A. 31