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10/26/2004 TUE 10:51 FAX 714+565 4020 CITY OF SANTA ANA 444 CITY ATTORNEY Z 003/006 <br />,r '-r�-CVJt94 ii;,L9 tKLA'I%r'CV1UU L1;-55CN=KKT e(u 631 tildf IU:1f145C by3 V -5-1b _ <br />IMPORTANT <br />If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. A statement <br />on this cenlficate does not confer rights to the certificate holder in lieu of such endorsement(s), <br />If SUBROGATION iS WAIVED, subject to the leans and conditions or the policy. cerlain policies may <br />require an endorsernent. A statement on [his certificale does not conrer rights to the certificate <br />holder in lieu of such endorsemenl(s). <br />DISCLAIMER <br />The Cenificate of Insurance on the reverse side of this form does not constitute a contract between <br />the issuing insurer(s), authorized representauwe or producer, and the certificate holder, nor does It <br />affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. <br />ACORO 26 po01101I <br />