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�tet,9/16/a004 Time: 10e01 7�6 To, Thomp lr Carla ® 1-714-647-6549 <br />IMPORTANT <br />If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement <br />on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may <br />require an endorsement A statement on this certificate does not confer rights to the certificate <br />holder in lieu of such endorsement(s). <br />DISCLAIMER <br />The Certificate of Insurance on the reverse side of this form does not constitute a contract between <br />the issuing insurer(s), authorized representative 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 />it <br />I <br />I <br />i <br />i <br />I <br />i <br />I <br />i <br />i <br />AWKU 2D (XW11O3) <br />