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<br />IMPORTANT <br /> <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 /> <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 /> <br />DISCLAIMER <br /> <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 /> <br />APPROVED AS TO FORM <br /> <br />~2/{j <br /> <br />/Laura Stitt Sheedy <br />Assistant City Attorney <br /> <br />ACORD 25-5 fT197) <br />lM: lPW vl.9.B on 9/16/05.16:25 by UserName <br /> <br />LP: LPWvl.9.8 on 9116105- 16:25 by UserName <br /> <br />PFvl.0.1 <br />