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q <br />App- 03 09 11:44a T1'=ig1 <br />IMPORTANT <br />If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this <br />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 require an <br />endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such <br />endorsement(s). <br />DISCLAIMER <br />The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing <br />insurer(s), authorized representative or producer, and the certificate holder, nor does R affirmatively or negatively <br />amend, extend or alter the coverage afforded by the policies listed thereon. <br />M+ nw w Jaw uvo) <br />INs025 (010M M. Pape z d 2 <br />p.2 <br />