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<br />Date: 11/29/05 Time: 03:09 ~. To: City Centerville @ 429-8629 <br /> <br />Page: 002-002 <br /> <br />IMPORTANT <br /> <br />- - <br /> <br />If the certificate holder is an ADDITIONAL INSURED, the polfcy(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 /> <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 /> <br />DISCLAIMER <br /> <br />., ; '. " ." <br /> <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 ~older, nor does it affirmatively or negatively <br />amend, extend or alter the coverage afforded by the policies listed thereon.' . <br /> <br />CORD 2S (2001/08) <br />15025 (0108).06 AMS <br /> <br />Page20f 2 <br /> <br />11 <br />