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<br />Feb 17 05 OS:23a <br />. . <br />RightFax <br /> <br />T11ag1 <br />2/16/2005 6:34 <br /> <br />p.3 <br /> <br />PAGE 4/5 <br /> <br />RightFax <br /> <br />1 <br /> <br />Page 2 of 2 <br /> <br />IMPORTANT <br /> <br />II lhe oertlllGa'e holder i. an ADDITIONAL INSURED, Ihe polloy(le.) mu.' b. endorsed. A stalement <br />on this certUlGale does not confer rights 10 the ctrtiflcate holder In lieu 01 such endoBO""'nl(s). <br /> <br />If SUBROGATION IS WAIVED, subjecl 10 the lerms and condiUons 01 Ihe policy, _ain policies may <br />require an endorsement. A statemen' on this certificate does not conler rights to the certifiCate <br />hotder in lieu of such endorBGm&nt(s). <br /> <br />DISCLAIMER <br /> <br />The Gertifioate of Insuranc8 on the reverse aide of this form does not constitute a contract between <br />lhe Issuing Ir1surer(s), aulhorl<eO representallve or prodvoer, end the cortificato holder, nor do.. It <br />affirmallvely or nega1lvely amend, extend or aller the coverage afforded ~y the policies listed thereon. <br /> <br />APPROVED AS TO FORlVI <br /> <br />~'213 <br /> <br />/ Laura Stitt Sheedy <br />Assistant City Attorney <br /> <br />AC:QRD 25 (20011Ot) <br /> <br />0011,1167132 TPl,328926 COrt,$119$11 <br />