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' :te: 9/7/2005 Time: 11:24 AM To: ® 96476515 <br />714-905-1910 Paqe: 002-006 <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 certrficate <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), authored representative or producer, and the certrficate holder, nor does it <br />affirmatwely or negatively amend, extend or after the coverage afforded by the policies listed thereon. <br /> <br />~~ ~_ <br />._.-_.__-. _...- iL~ <br />~J1__ ~~ <br />~: SI~~ ,_ <br />HI:VKU 20 (2UU1/08) <br />