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Date : 12 /03/04 Time : 03 : 04 PM To : 978- 1796 Page : 002 -002 <br /> IMPORTANT <br /> If the certificate holder is an ADDITIONAL INSURED , the policy ( ies) must be endorsed , A statement <br /> on this certificate does not ccnfer rights to tha certificate no !Cer In Ileu of such endorsement(s) . <br /> If SUBROGATION IS WAIVED , subject to the terms and conditions of the policy, certain policies may <br /> require an endorsement. A statement on this certificate does not confer rights to the certificate <br /> holder in lieu of such endorsement (s) , <br /> DISCLAIMER <br /> The Cartifcate of Insurance on the reverse side of this form does not constitute a contract between <br /> the issuing insurer(s) , authorized representative or proa1acer, and the certificate holder, nor does it <br /> affirmatively or regatitee!y amend , extend or alter the coverage afforded by the policies listed thereon , <br /> ACO RD 25 (2001 im <br />