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HomeMy WebLinkAboutCintas Corporation No. 2; 2023-04-24; PSA23-2139FACPSA23-2139FAC City Attorney Approved Version 12/28/2022 1 AGREEMENT FOR CUSTODIAL SUPPLIES AND DELIVERY SERVICES AT STC CINTAS CORPORATION NO. 2 THIS AGREEMENT is made and entered into as of the ______________ day of ___________________, 2023, by and between the City of Carlsbad, California, a municipal corporation ("City") and Cintas Corporation No. 2, a Nevada corporation ("Contractor”). RECITALS City requires the services of a company that provides custodial supplies and services for environmentally safe alternatives to facility cleaning operations. Contractor has the necessary experience in providing these services, has submitted a proposal to City and has affirmed its willingness and ability to perform such work. NOW, THEREFORE, in consideration of these recitals and the mutual covenants contained herein, City and Contractor agree as follows: 1. SCOPE OF WORK City retains Contractor to perform, and Contractor agrees to render, those services (the “Services”) that are defined in Exhibit “A,” attached and incorporated by this reference in accordance with the terms and conditions set forth in this Agreement. 2. TERM This Agreement will be effective for a period of three (3) years from the date first above written. 3. COMPENSATION The total fee payable for the Services to be performed will be ten thousand dollars ($10,000). No other compensation for the Services will be allowed except for items covered by subsequent amendments to this Agreement. City reserves the right to withhold a ten percent (10%) retention until City has accepted the work and/or the Services specified in Exhibit “A.” 4. STATUS OF CONTRACTOR Contractor will perform the Services as an independent contractor and in pursuit of Contractor’s independent calling, and not as an employee of City. Contractor will be under the control of City only as to the results to be accomplished. 5. INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City and its officers, officials, employees and volunteers from and against all claims, damages, losses and expenses including attorneys fees arising out of the performance of the work described herein caused by any negligence, recklessness, or willful misconduct of the Contractor, any subcontractor, anyone directly or indirectly employed by any of them or anyone for whose acts any of them may be liable. The parties expressly agree that any payment, attorney’s fee, costs or expense City incurs or makes to or on behalf of an injured employee under the City’s self-administered workers’ compensation is included as a loss, expense or cost for the purposes of this section, and that this section will survive the expiration or early termination of this Agreement. 6. INSURANCE Contractor will obtain and maintain policies of commercial general liability insurance, automobile liability insurance, a combined policy of workers' compensation, employers liability insurance, and DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 April 24th PSA23-2139FAC City Attorney Approved Version 12/28/2022 2 professional liability insurance from an insurance company authorized to transact the business of insurance in the State of California which has a current Best's Key Rating of not less than "A-:VII"; OR with a surplus line insurer on the State of California’s List of Approved Surplus Line Insurers (LASLI) with a rating in the latest Best’s Key Rating Guide of at least “A:X”; OR an alien non- admitted insurer listed by the National Association of Insurance Commissioners (NAIC) latest quarterly listings report, in an amount of not less than one million dollars ($1,000,000) each, unless otherwise authorized and approved by the Risk Manager or the City Manager. Contractor will obtain occurrence coverage, excluding Professional Liability, which will be written as claims- made coverage. The insurance will be in force during the life of this Agreement and will not be canceled without thirty (30) days prior written notice to the City by certified mail. City will be named as an additional insured on General Liability which shall provide primary coverage to the City. The full limits available to the named insured shall also be available and applicable to the City as an additional insured. Contractor will furnish certificates of insurance to the Contract Department, with endorsements to City prior to City’s execution of this Agreement. 7. NOTICES The name of the persons who are authorized to give written notice or to receive written notice on behalf of City and on behalf of Contractor under this Agreement. For City For Contractor Name Charles Balteria Name Rebecca Gibboney Title Program Manager Title Service Manager Department Public Works Address 460 W. California Ave. City of Carlsbad Vista, CA 92083 Address 405 Oak Ave. Phone No. 760-941-8422 Carlsbad, CA 92008 Email gibboneyr@cintas.com Phone No. 760-802-7530 Each party will notify the other immediately of any changes of address that would require any notice or delivery to be directed to another address. 8. CONFLICT OF INTEREST Contractor shall file a Conflict of Interest Statement with the City Clerk in accordance with the requirements of the City of Carlsbad Conflict of Interest Code. The Contractor shall report investments or interests in all categories. Yes No 9. COMPLIANCE WITH LAWS Contractor will comply with all applicable local, state and federal laws and regulations prohibiting discrimination and harassment and will obtain and maintain a City of Carlsbad Business License for the term of this Agreement. /// /// DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 □ PSA23-2139FAC City Attorney Approved Version 12/28/2022 3 10. TERMINATION City or Contractor may terminate this Agreement at any time after a discussion, and written notice to the other party. City will pay Contractor's costs for services delivered up to the time of termination, if the services have been delivered in accordance with the Agreement. 11. CLAIMS AND LAWSUITS By signing this Agreement, Contractor agrees it may be subject to civil penalties for the filing of false claims as set forth in the California False Claims Act, Government Code sections 12650, et seq., and Carlsbad Municipal Code Sections 3.32.025, et seq. Contractor further acknowledges that debarment by another jurisdiction is grounds for the City of Carlsbad to terminate this Agreement. 12. JURISDICTIONS AND VENUE Contractor agrees and stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this Agreement is the State Superior Court, San Diego County, California. 13. ASSIGNMENT Contractor may assign neither this Agreement nor any part of it, nor any monies due or to become due under it, without the prior written consent of City. 14. AMENDMENTS This Agreement may be amended by mutual consent of City and Contractor. Any amendment will be in writing, signed by both parties, with a statement of estimated changes in charges or time schedule. /// /// /// /// /// /// /// /// /// /// /// /// /// DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 PSA23-2139FAC City Attorney Approved Version 12/28/2022 4 15. AUTHORITY The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR CINTAS CORPORATION NO. 2, a Nevada corporation CITY OF CARLSBAD, a municipal corporation of the State of California By: By: (sign here) Paz Gomez, Deputy City Manager, Public Works, as authorized by the City Manager Garrett Morley, General Manager (print name/title) By: (sign here) (print name/title) If required by City, proper notarial acknowledgment of execution by contractor must be attached. If a corporation, Agreement must be signed by one corporate officer from each of the following two groups: Group A. Group B. Chairman, Secretary, President, or Assistant Secretary, Vice-President CFO or Assistant Treasurer Otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CINDIE K. McMAHON, City Attorney By: City Attorney DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 PSA23-2139FAC City Attorney Approved Version 12/28/2022 5 EXHIBIT “A” SCOPE OF SERVICES 1. Contractor is a member of U.S. Communities, a government purchasing alliance. The U.S. Communities’ fee schedule will be used in pricing custodial supplies and services for the Carlsbad Safety Training Center (STC) located at 5750 Orion Street, Carlsbad, California 92010. 2. Contractor will provide weekly delivery, restocking and servicing of facility custodial supplies. Contractor will confirm scheduling of routine deliveries and services with the City project manager. Business hours, excluding City recognized holidays, are Monday through Friday from 8:00 a.m. to 5:00 p.m. 3. Contractor service will include free professional installation of dispensers; weekly inspections of dispensers to ensure proper function; repairs and replacements done by Cintas on damaged dispensers; weekly recording and monitoring of chemical usage; employee training (upon request); SDS sheets, posted instructions, and labeling of all chemical spray bottles. *Contingency funding for special events or City emergencies where additional custodial supply stock or services may be required. CLEANING/DUST CONTROL INVENTORY TOTAL PER UNIT WEEKLY TOTAL MONTHLY TOTAL ANNUAL BUDGET Orange Microfiber Towel 25 $.16 $4.00 $17.34 $208.00 RR1 Disinfectant Cleaner 2 $2.80 $5.59 $24.24 $290.89 Z1 Hard Surface Sanitizer 2 $3.07 $6.14 $26.61 $319.28 GL1 Glass & Multi-Surface Cleaner 1 $1.83 $1.83 $7.93 $95.16 Cleaning Chemical Dispenser 2 $2.75 $5.50 $23.84 $286.10 24 " Dust Mop 2 $0.83 $1.66 $7.18 $86.22 Wet Mop 4 $1.86 $7.43 $32.19 $386.26 Sig Air Service 10 $4.18 $41.80 $181.13 $2,173.60 Sig Auto Soap Aluminum Dispenser 6 $0.50 $3.00 $13.00 $156.00 Disposal Urinal Mat 5 $3.31 $16.55 $71.72 $860.60 Commode Mat 4 $3.31 $13.24 $57.37 $688.48 Gray Microfiber Towel 50 $0.16 $8.00 $34.67 $416.00 Sig hand Sanitizer Service 6 $2.79 $16.74 $72.54 $870.48 3x5 Logo Mat 1 $2.40 $2.40 $10.42 $125.01 4x6 Logo Mat 2 $6.30 $12.60 $54.60 $655.20 Additional Funding for Contingency* (As Approved by City Project Manager*) 1,383.04 Totals $146.48 $634.78 $10,000.00 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 20 D Ho l d e r I d e n t i f i e r : 777 7 7 7 7 7 0 7 0 7 0 7 0 0 0 7 7 7 6 1 6 1 6 0 4 5 5 7 1 1 1 0 7 7 7 6 1 7 1 1 6 3 0 4 5 5 7 2 0 7 4 5 3 1 3 6 7 7 2 4 0 6 3 1 0 0 7 3 6 5 0 5 6 6 1 5 7 3 3 0 0 2 0 7 3 6 0 5 1 1 1 3 0 6 2 0 1 0 3 0 7 0 6 2 0 1 1 7 6 6 2 2 1 4 5 7 0 7 4 2 7 3 2 6 5 7 2 1 7 7 7 6 0 0 7 2 7 2 0 0 0 1 7 2 0 5 3 3 1 3 0 7 7 0 0 4 1 1 7 5 2 6 7 4 1 3 0 0 7 6 7 2 7 2 4 2 0 3 5 7 7 2 0 0 0 7 7 7 7 7 7 7 0 7 0 0 0 7 0 7 0 0 7 777 7 7 7 7 7 0 7 0 7 0 7 0 0 0 7 3 5 2 5 6 7 7 1 1 5 4 5 6 0 0 0 7 2 2 0 1 1 4 1 7 1 2 7 3 1 3 3 0 7 0 2 3 3 3 7 2 4 3 0 6 2 0 0 1 0 7 0 3 3 3 2 6 2 4 2 1 6 2 1 1 0 0 7 1 2 2 2 2 7 2 4 3 0 7 3 1 1 1 0 7 1 2 2 3 3 7 3 4 2 1 6 3 1 0 0 0 7 0 2 2 3 3 6 2 5 2 1 7 3 0 0 0 0 7 0 2 2 3 3 7 2 5 2 0 6 2 1 1 0 0 7 1 2 2 3 2 7 3 5 3 1 7 2 0 1 0 0 7 7 7 5 6 1 6 3 3 5 1 7 6 5 5 4 0 7 7 7 7 7 7 7 0 7 0 0 0 7 0 7 0 0 7 Ce r t i f i c a t e N o : 5 7 0 0 9 8 0 4 9 7 8 6 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/28/2023 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. PRODUCER Aon Risk Services Northeast, Inc. c/o Aon Client Services4 Overlook PointLincolnshire IL 60069 USA PHONE(A/C. No. Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (866) 283-7122 INSURED 23035Liberty Mutual Fire Ins CoINSURER A: 33600LM Insurance CorporationINSURER B: 42404Liberty Insurance CorporationINSURER C: 10030Westchester Fire Insurance CompanyINSURER D: INSURER E: INSURER F: FAX(A/C. No.):(800) 363-0105 CONTACTNAME: Cintas Corporation and its SubsidiariesCintas Fire Protection6800 Cintas Blvd, P.O. Box 625737Cincinnati OH 45262 USA COVERAGES CERTIFICATE NUMBER:570098049786 REVISION NUMBER: 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, Limits shown are as requested POLICY EXP (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)SUBRWVDINSR LTR ADDL INSD POLICY NUMBER TYPE OF INSURANCE LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR POLICY LOC EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG X X X X GEN'L AGGREGATE LIMIT APPLIES PER: $2,000,000 $1,000,000 $5,000 $1,000,000 $2,000,000 $1,000,000 Contractual Liability A 07/01/2022 07/01/2023YTB2651004227092 PRO-JECT OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON-OWNED AUTOS ONLY BODILY INJURY ( Per person) PROPERTY DAMAGE(Per accident) X X BODILY INJURY (Per accident) $5,000,000A07/01/2022 07/01/2023Y Comp/Coll $0 Ded. COMBINED SINGLE LIMIT(Ea accident)AS2-651-004227-072 EXCESS LIAB X OCCUR CLAIMS-MADE AGGREGATE EACH OCCURRENCE DED $5,000,000 $5,000,000 $10,000 07/01/2022UMBRELLA LIABD Y 07/01/2023G22035277017 RETENTIONX X E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT E.L. EACH ACCIDENT $2,000,000 X OTH-ERPER STATUTEB07/01/2022 07/01/2023 WA765D004227112C 07/01/2022 07/01/2023 WC5651004227122B 07/01/2022 07/01/2023 $2,000,000 Y / N (Mandatory in NH) ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER N / A Y N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY If yes, describe under DESCRIPTION OF OPERATIONS below $2,000,000 WA565D004227102 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Carlsbad/CMWD is included as Additional Insured on the General Liability, Automobile Liability and Umbrella Liability policies, but only with respect to work performed under contract between the Certificate Holder and the Insured. On the Workers' Compensation policy, a Waiver of Subrogation exists in favor of the Certificate Holder, only to the extent required bywritten contract and that negligent acts of the Additional Insured are excluded. CANCELLATIONCERTIFICATE HOLDER AUTHORIZED REPRESENTATIVECity of Carlsbad/CMWDc/o Exigis Insurance Compliance ServicesAttn: Janean HawneyPO Box 947Murrieta CA 92564 USA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 ~ I AC~Re>® ~ I -D □ - =7 □ □ - -- -- -- -H I I I I I C DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 POLICY NUMBER: TB2-651-004227-092 COMMERCIAL GENERAL LIABILITY CG20101219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): All persons or organizations with whom you have entered into a written contract or agreement, prior to an "occurrence" or offense, to provide additional insured status. Location(s) Of Covered Operations All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG20101219 © Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 POLICY NUMBER: TB2-651-004227-092 COMMERCIAL GENERAL LIABILITY CG20371219 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART A. Section II -Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section Ill -Limits Of Insurance: 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; whichever is less. This endorsement shall not increase the applicable limits of insurance. SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): All persons or organizations with whom you have entered into a written contract or agreement, prior to an "occurrence" or offense, to provide additional insured status. Location And Description Of Completed Operations All locations as required by a written contract or agreement entered into prior to an "occurrence" or offense. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. CG20371219 © Insurance Services Office, Inc., 2018 Page 1 of 1 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 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 anyone not named in the Schedule. Not applicable in Kentucky, New Hampshire and New Jersey Schedule Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. Where required by contract or written agreement prior to loss and allowed bylaw. In the states of Alabama, Arizona, Colorado, Delaware, Dist. of Col., Georgia, Idaho, Illinois, Indiana, Kansas, Maine, Michigan, Mississippi, Missouri, Neveda, New Mexico, North Carolina, Pennsylvania, Rhode Island, South Carolina, Vermont, West Virginia, the premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. In the state of Connecticut, Florida, Iowa, Maryland, Nebraska, Oregon, the premium charge is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Hawaii, the premium charge is $465 and determined as follows: The premium charge for this endorsement is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. In the state of New York, Oklahoma and Tennessee, the premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Virginia, the premium charge is 5% of the total manual premium, subject to a minimum premium of $250 per policy Issued by LM Insurance Corporation 27243 For attachment to Policy No. WA5-65D-004227-102 Effective Date Issued to Cintas Corporation WC 00 0313 Ed. 04/01/1984 © 1983 National Council on Compensation Insurance. Premium$ Endorsement No. Page 1 of 1 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 2% of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $250 Person or Organization Where required by contract or written agreement prior to loss and allowed by law. Issued by LM Insurance Corporation 27243 For attachment to Policy No. WAS-65D-004227-102 Issued to Cintas Corporation WC 0403 06 R1 Ed. 08/01/2013 Effective Date Job Description Premium$ Endorsement No. Page 1 of 1 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us. This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. The premium for this endorsement is shown in the Schedule. Schedule 1 . ( ) Specific Waiver Name of person or organization (X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: All Texas Operations 3. Premium: The premium charge for this endorsement shall be .2 percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Advance Premium: Issued by LM Insurance Corporation 27243 For attachment to Policy No. WA5-65D-004227-102 Issued to Cintas Corporation Effective Date Premium$ Endorsement No. WC420304B Ed. 06/01/2014 © Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. Page 1 of 1 DocuSign Envelope ID: 7F58D21A-F7FE-4A7C-AD9A-7AD7128F9032 UTAH WAIVER OF SUBROGATION ENDORSEMENT This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page. 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 anyone not named in the Schedule. Our waiver of rights does not release your employees' rights against third parties and does not release our authority as trustee of claims against third parties. Schedule Where required by contract or written agreement prior to loss and allowed bylaw. Issued by LM Insurance Corporation 27243 For attachment to Policy No. WAS-65D-004227-102 Effective Date Issued to Cintas Corporation WC 4303 05 Ed. 07/2000 © 2000 National Council on Compensation Insurance. Premium$ Endorsement No. Page 1 of 1