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Exclusion Verification Form Disclaimer <br />This is to emphasize that insurance brokers cannot legally verify whether coverage will <br />exist under all possible circumstances with regard to any given policy of <br />insurance. Insurance brokers are not allowed to modify, amend or guarantee <br />coverage provisions or assumptions under any written contract where verification from <br />a broker may be sought. Brokers can provide certificates of insurance to, address <br />various general categories of insurance coverage as generally set forth in the attached <br />sample ACORD statement. Furthermore, brokers do not make the final determinations <br />of coverage in the event of a claim at some hypoffiefical point in fho future. Any <br />modifications suggested by any verified questionnaire will only represent the <br />reasonable opinion of an individual insurance broker subject to the standard of care <br />observed by similar insurqnce brokers providing similar services to their clients in the <br />design and consulting community at the time and in the jurisdiction where the <br />verification is made. You should also be advised that insurance laws and regulations <br />vary from state to state. In conclusion, any verification which attempts to modify <br />coverage of the underlying insurance product in any way is of no effect and void, <br />REVE1,NED E',Y� <br />