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<br />, <br />// <br />// <br />, / <br />,~CKEY & COMPANY/PHS <br />/ <br />//0 SOX 29611 <br />,:/ CHARLOTTE NC, 28229 <br /> <br />(J) <br /> <br /> <br />The City of Santa Ana, Its Officers, <br />Employees, Agents and Volunteers <br />20 civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />I <br /> <br />1 <br />I: <br />j:: <br />i <br /> <br />,:il' <br />"1\ <br /> <br />/ <br /> <br />() <br /> <br />ij <br /> <br />IMPORTANT <br />If the certificate holder is an ADDITIONAL INSURED. the policy(jasl must be endorsed. A statement on this certificate <br />does not confer rights to the certificate holder in lieu of such endorsement(sJ <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy. certain policies may require an endorsement <br />A statement on this cenificate does not confer rights to the certificate holder in lieu of such endorsement(sl. <br /> <br />DISCLAIMER <br />The Certificate of Insurance on the reverse side of this form does 'not constitute a contract between the issuing insurer{sl. <br />authorized representative or roduc r, and the certificate holder. nor does it affirmatively or negatively amend, extend or <br />\PP v m6il:feF licies listed thereon. <br /> <br /> <br />ACORD 25:S 17/~ -s:!? <br /> <br />Laura Stitt SLoedy <br />. "istant City Attorney <br />