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<br />_'; '" .... __I 1..__.... ...-, ._, 1 . .,." ,___ <br /> <br />'-'..''-' W"-II,.J _-'oI.""'t r-....I-' <br />~lIItf.."VJllt~C. .... , &.11.-- <br /> <br />, <br /> <br />IMPORTANT <br /> <br />If the certificate holder is an ADDITIONAL INSURED. the policy{ies) muat be endorHCl. A statement <br />on this Gertifi....le dge$ riot confer rights to the ,ertitica~ holdar in lieu of svch &ndOlSemem(s}. <br /> <br />If SUBROGATION IS WAIVED subject to the terms al'\d conditions of the policy, certain policies may <br />require if' endorsement A statement 00 this certificate does not confer right& to the certificate <br />holder in lieu of such endorHmtnt(S}. <br /> <br />DISCLAIMER <br /> <br />The CfJi/'tlncate at Insural'l~ on the I'tvefti.f1 $iell! of this form does not cOnstitute a contract between <br />thi iSi1,liog insurer(s), authorized representative or producer, and the certificate holder. nor does. it <br />atrifJllalively Of negatively amend, extend or alter the C:O\Ierage afforded by the po~cies listed thereon, <br /> <br />APPROVED AS TO F01ZM <br /> <br />~~/) <br />Laura SU t Sl.vcuy <br />;\S~lstaat t Ity Allof!<CY <br /> <br />I&Ofm H (%001/01' <br />