The Insurance Year Book: Life and miscellaneous

judgment after trial of the issue; nor unless such action is brought within ninety (90) days after final judgment against the assured has been so paid and satisfied. The company does not prejudice by this condition any defenses against such action that it may be entitled to make under this policy.

G. In case of payment of loss under this policy the company shall be subrogated to all rights of the assured against any person or corporation, as respects such loss, to the amount of such payment, and the assured shall execute all papers required and shall co-operate with the company to secure to the company such rights.

H. If the assured carry a policy of another insurer, whether valid or not, against a loss covered by this policy, the assured shall not be entitled to recover from the company a larger proportion of the entire loss than the amount hereby insured bears to the total amount of his insurance.

I. If the business of the assured is placed in the hands of a receiver, assignee or trustee, whether by the voluntary act of the assured or othewrise, this policy shall immediately terminate, but such termination shall not affect the liability of the company as to any accidents theretofore occurring. If the assured is a corporation, a change of title, or if a firm or individual a change of title or of ownership, shall in like manner terminate this policy, unless such change is consented to by the company, by an endorsement hereon, signed by its president, vice-president or one of its secretaries.

J. The premium is based on the entire compensation whether for salaries, wages, piecework, overtime or allowances earned by the employees of the assured during the period of this policy; whenever employees are compensated, in whole or in part, by store certificates, board, merchandise, credits, or any other substitute for cash, the amount of compensation covered by such substitutes shall be included in the entire compensation on which the premium is based. If such entire compensation exceeds the sum set forth in the schedule, the assured shall immediately pay the company the additional premium earned; if such compensation is less than the sum set forth in the schedule, the company will return the unearned premium, when determined; but the company shall receive or retain not less than dollars ($ ), it being agreed that this sum shall be the minimum earned premium.

K. This policy may be canceled by the company at any time by written notice, served on or sent by registered letter to the assured at the address given herein, stating when the cancellation shall be effective. It may be canceled by the assured by like notice to the company. If canceled by the company, the company shall be entitled to the earned premium, pro ruta, when determined. If canceled by the assured, unless the assured has retired from business, the company shall receive or retain the customary short-rate premium. (In either case the earned premium shall be computed on the compensation for the year as indicated by the actual compensation earned by the employees of the assured during the time the policy shall have been in force.) In any case the company shall receive or retain the minimum earned premium stated in condition J. The company's check mailed to the address of the assured as given herein shall be a sufficient tender, but no return premium shall be payable until a statement of the actual compensation earned by the employees of the assured during the period the policy was in force shall have been furnished to the company by the assured.

L. Any of the company's authorized inspectors shall have the right and opportunity, whenever the company so desires, to inspect the plant, work, machinery and appliances of the assured; and the company or any of its inspectors may suspend this insurance, so far as any boiler or elevator is concerned, because of any defect or dangerous condition found in the same. Notice of such suspension and the reason therefor and of the reinstatement of the insurance must be in writing.

M. Any of the company's authorized auditors shall have the right and opportunity, whenever the company so desires, to examine the books and records of the assured as respects compensation earned by the employees of the assured, and the assured shall render reasonable assistance; but the company waives no right by failing to make such examination. The assured shall, whenever the company so requests, furnish the company with a written statement of the amount of compensation earned by his employees during any part of the period of the policy, and at the end of the period of the policy the assured shall furnish the company with such statement covering the full period of the policy. The rendering of any estimate or statement or any settlement shall not bar the examination herein provided for nor the company's right to additional premiums.

N. No erasure or change appearing on the face of this policy as originally printed and no change or waiver of any of its terms or conditions or statements shall be valid unless endorsed hereon and signed by the president, the vice-president or one of the secretaries of the company. Notice to or knowledge by any agent or any other person shall not be held to waive any of the terms, conditions or statements hereof.

O. No person shall be deemed an agent of the company unless such person is authorized in writing as such agent by the president, the vice-president or one of the secretaries of the company.

SCHEDULE.

2. Address of assured,

1. Name of assured, (state street, town, county and State where head office is located.) 3. The assured is (state whether individual, co-partnership, corporation, receiver, or other trustee.) 4. The place or places where work is to be carried on, the kind of work carried on at each such place, the estimated number of employees, and the estimated compensation of employees at each such place, are as follows:

Kind of Work.

Place Where Work is to
be Done.

Estimated Estimated Premium Estimated
Average Compensation
Rate per
Amount
Number of for Period of $100 of Com- of
Employees. Policy. pensation. Premium.

Drivers when the assured has no concurrent teams insurance in this company.

The estimated compensation covers the wages or salaries of all persons to whom compensation is paid in the business or trade carried on by the assured at the locations mentioned and described in this schedule, including regular time and overtime, and all allowances, whether paid in cash, or board, or store certificates, or merchandise, or credits, or in any other way, including the compensation, of whatever kind, paid to pieceworkers, also the wages or other compensation paid to drivers when there is no concurrent teams policy, and including the salaries or other compensation of president, vice-president, secretary, treasurer, clerks and office men, except as follows: 5. The operations carried on are those usual to the work described above. 6. No wrecking or demolition is done, except as follows: 7. No explosives are used, except as follows: 8. The assured does not operate a railroad in connection with the work designated in the schedule, except as follows: 9. No power is used, except as follows: 10. No chemicals are used, except as follows: II. No part of the work is sub-contracted, directly or indirectly, except as follows: 12. The estimated compensation excludes payments to sub-contractors, except as follows: 13. No employee is allowed to ride on any elevator or hoisting device which is not operated by a person riding thereon. 14. The following insurances are now carried: Employer's liability, $ ; name of company, Public liability, $ ; name of company, Workmen's collective, $ ; name of company, Elevator, $ ; name of company, Teams, $ 15. Valid insurance in amounts not less than stated above will be carried during the period of this policy. 16. No company has canceled or refused to issue hability, elevator or boiler insurance to the assured during the past three years, except as follows: 17. No company has insured this risk during the past two years, except as follows: 18. The entire compensation earned by all employees during the year ending December 31, last, was $ premium for this policy is $

Boiler, $ ; name of company,
; name of company,

19. The minimum

The insurance to begin on the

day of

19 at noon, and to expire on the , 19 , at noon, standard time, at the place where the policy is countersigned.

day of

Dated

dollars ($

) es

The hereinafter called "the company," in consideration of timated premium and the statements hereinafter set forth in the schedule of statements, which statements the assured makes and warrants to be true by the acceptance of this policy, except the statements concerning the number of employees and their compensation, which are estimated does hereby agree to indemnify , of State of

, county of months, beginning on

190, noon, standard

, hereinafter called the assured, for a period of the day of , 190, noon, and ending on the day of time at the place where this policy has been countersigned : Against loss from the liability imposed by law upon the assured for damages on account of bodily injuries or death, accidentally suffered while this policy is in force, by any person or persons not employed by the assured while at or about the work of the assured described in the schedule, during the prosecution of the said work at the place or places described in the schedule, subject to the following conditions:

CONDITIONS.

A. The company's liability for loss from an accident resulting in bodily injuries to or in the death of one person is limited to dollars ($ ), and, subject to the same limit for each person, the company's total liability for loss from any one accident resulting in bodily injuries to or in the death of more than any one person is limited to dollars ($ ).

B. This policy does not cover loss from liability for injuries or death-(1) Caused by any person unless his compensation is included in the estimate set forth in the schedule (provided that this exclusion shall not apply to loss from liability for injuries or death caused by the assured himself if an individual, nor if a firm by any member thereof, nor if a corporation by its president, vice-president, secretary or treasurer, provided such officer is not managing or superintending the work); (2) Caused by any child employed by the assured contrary to law or any child employed under fourteen (14) years of age where no statute restricts the age of employment; (3) Caused by any convict employed by the assured; (4) Suffered while in or on any elevator or any hoisting device or while entering upon or alighting from any elevator or any hoisting device: (5) Caused by any draught or driving animal or vehicle or any person in charge thereof; (6) Suffered otherwise than during the immediate doing of the work of construction. This policy does not cover loss from liability for injuries or death occasioned by reason of the failure of the assured to observe any statute affecting the safety of persons; nor for injuries occasioned by reason of the failure of the assured to observe any local ordinance of which he has knowledge.

C. Upon the occurrence of an accident the assured shall give immediate written notice thereof, with the fullest information obtainable at the time, to the company's home office or to the agent who has countersigned this policy. If a claim is made on account of such accident the assured shall give like notice with full particulars. The assured shall at all times render to the company all co-operation and assistance in his power.

D. If thereafter any suit is brought against the assured to enforce a claim for damages on account of an accident covered by this policy, the assured shall immediately forward to the company's home office every summons or other process as soon as the same shall be served on him, and the company will, at its own cost, defend such suit in the name and on behalf of the assured unless the company shall elect to settle the same or to pay the assured the indemnity provided for in condition A hereof.

E. The assured shall not voluntarily assume any liability, nor shall the assured, without the written consent of the company previously given, incur any expense or settle any claim, except at his own cost, or interfere in any negotiation for settlement or in any legal proceeding; except that the assured may provide at the time of the accident such immediate surgical relief as is imperative. Whenever requested by the company, the assured shall aid in securing information and evidence and the attendance of witnesses and in effecting settlements and in prosecuting appeals.

F. No action shall lie against the company to recover for any loss under this policy unless it shall be brought by the assured for loss actually sustained and paid in money by the assured in satisfaction of a judgment after trial of the issue, nor unless such action is brought within ninety (90) days after final judgment against the assured has been so paid and satisfied. The company does not prejudice by this condition any defenses against such action that it may be entitled to make under this policy.

I. If the business of the assured is placed in the hands of a receiver, assignee or trustee, whether by the voluntary act of the assured or otherwise, the policy shall immediately terminate, but such termination shall not affect the liability of the company as to any accidents theretofore occurring. If the assured is a corporation, a change of title, or if a firm or individual a change of title or of ownership, shall in like manner terminate this policy unless such change is consented to by the company, by an endorsement hereon, signed by its president, vice-president or one of its secretaries.

J. The premium is based on the entire compensation whether for salaries, wages, piecework, overtime or allowances earned by the employees of the assured during the period of this policy; whenever employees are compensated, in whole or in part, by store certificates, board, merchandise, credit, or any other substitute for cash, the amount of compensation covered by such substitutes shall be included in the entire compensation on which the premium is based. If such entire compensation exceeds the sum set forth in the schedule, the assured shall immediately pay the company the additional premium earned; if such compensation is less than the sum set forth in the schedule, the company will return the unearned premium, when determined; but the company shall receive or retain not less than dollars ($ ), it being agreed that this sum shall be the minimum earned premium.

K. This policy may be canceled by the company at any time by written notice, served on or sent by registered letter to the assured at the address given herein, stating when the cancellation shall be effective, It may be canceled by the assured by like notice to the company. If canceled by the company, the company shall be entitled to the earned premium, pro rata, when determined. If canceled by the assured, unless the assured has retired from business, the company shall receive or retain the customary short-rate premium. (In either case the earned premium shall be computed on the compensation for the year as indicated by the actual compensation earned by the employees of the assured during the time the policy has been in force.) In any case the company shall receive or retain the minimum earned premium stated in condition J. The company's check mailed to the address of the assured as given herein shall be a sufficient tender, but no return premium shall be payable until a statement of the actual compensation earned by the employees of the assured during the period the policy was in force shall have been furnished to the company by the assured.

L. Any of the company's authorized inspectors shall have the right and opportunity, whenever the company so desires, to inspect the plant, works, machinery and appliances of the assured; and the company or any of its inspectors may suspend this insurance, so far as any boiler is concerned, because of any defect or dangerous condition found in the same. Notice of such suspension and the reason therefor and of the reinstatement of the insurance must be in writing.

M. Any of the company's authorized auditors shall have the right and opportunity, whenever the company so desires, to examine the books and records of the assured as respects compensation earned by employees of the assured, and the assured shall render reasonable assistance; but the company waives no right by failing to make such examination. The assured shall, whenever the company so requests, furnish the company with a written statement of the amount of compensation earned by his employees during any part of the period of the policy, and at the end of the period of the policy the assured shall furnish the company with such statement covering the full period of the policy. The rendering of any estimate or statement or any settlement shall not bar the examination herein provided for nor the company's right to additional premiums.

N. No erasure or change appearing on the face of this policy as originally printed and no change or waiver of any of its terms or conditions or statements shall be valid unless endorsed hereon and signed by the president, vice-president or one of the secretaries of the company. Notice to or knowledge by any agent or any other person shall not be held to waive any of the terms, conditions or statements hereof.

O. No person shall be deemed an agent of the company unless such person is authorized in writing as such agent by the president, vice-president or one of the secretaries of the company.

SCHEDULE.

1. Name of assured 2. Address of assured (state street, town, county and State where head office is located), 3. The assured is (state whether individual, co-partnership, corporation, receiver or other trustee), 4. The place or places where work is to be carried on, the kind of work carried on at each such place, the estimated number of employees and the estimated compensation of employees at each such place are as follows:

Kind of Work.

Place Where Work
is to be Done.

Estimated Estimated Premium
Average Compensation
Rate per
Number of for Period of $100 of Com-
Employees. Policy. pensation.

Estimated Amount of Premium.

including regular time and overtime, and all allowances, whether paid in cash, or board, or store certificates, or merchandise, or credits, or in any other way, including the compensation, of whatever kind, paid to pieceworkers, and including the salaries or other compensation of president, vice-president, secretary, treasurer, clerks and office men, excepting as follows: Drivers

12. The estimated 13. The following insurBoiler, $ Name of comName of company, Name of company,

5. The operations carried on are those usual to the kind of work described herein. 6. No wrecking or demolition is done except as follows: 7. No explosives are used, except as follows: 8. The assured does not operate a railroad in connection with the work designated in the schedule, except as follows: 9. No power is used, except as follows: 10. No chemicals are used, except as follows: 11. No part of the work is sub-contracted, directly or indirectly, except as follows: compensation excludes the payments to sub contractors, except as follows: ances are now carried: Employers liability, $ Name of company, pany, Public liability, $ Name of company, Workmens collective, $ Name of company, insurance in amounts not less than stated above will be carried during the period of this policy. 15. No company has canceled or refused to issue liability or boiler insurance to the assured during the past three years, except as follows: 16. No company has insured this risk during the past two years, except as follows: 17. The entire compensation earned by all the employees during the year ending December 31, last, was $ 18. The minimum premium for this policy is $

Elevator, $
Teams, $

The insurance to begin on the day of 19, at noon, and to expire on the 19, at noon, standard time, at the place where the policy is countersigned,

14. Valid

day of

Dated,

TEAMS LIABILITY POLICY.

dollars ($

The hereinafter called "The Company," in consideration of estimated premium and the statements hereinafter set forth in the Schedule of Statements, which statements the assured makes and warrants to be true by the acceptance of this policy, except the statement concerning the number of drivers and their compensation, which are estimated, does hereby agree to indemnify

State

, County of of , hereinafter called the assured, for a period of months, beginning on the day of 190, noon, and ending on the day of , 190 , noon, standard time at the place where this policy has been countersigned, Against loss from the liability imposed by law upon the assured for damages on account of bodily injuries or death, accidentally suffered while this policy is in force, by any person or persons, by means of the draught or driving animals or vehicles for which a charge is made in the premium, and the use thereof as hereinafter set forth, while in charge of the assured or the assured's employees, subject to the following conditions:

CONDITIONS.

B. This policy does not cover loss from liability for injuries or death caused by: (1) Loading or unloading of vehicles, unless an endorsement is attached hereto providing for the same; (2) Any draught or driving animal or vehicle driven by any person under the age of (16) years.

C. Upon the occurrence of an accident the assured shall give immediate written notice thereof, with the fullest information obtainable at the time, to the company's home office or to the agent who has countersigned this policy. If a claim is made on account of such accident the assured shall give like notice thereof with full particulars. The assured shall at all times render to the company all co-operation and assistance in his power.

D. If thereafter any suit is brought against the assured to enforce a claim for damages on account of an accident covered by this policy, the assured shall immediately forward to the company's home office every summons or other process as soon as the same shall have been served on him, and the company will, at its own cost, defend such suit in the name and on behalf of the assured unless the company shall elect to settle the same or to pay the assured the indemnity provided for in condition A hereof.

F. No action shall lie against the company to recover for any loss under this policy unless it shall be brought by the assured for loss actually sustained and paid in money by the assured in satisfaction of a judgment after trial of the issue; nor unless such action is brought within ninety (90) days after final judgment against the assured has been so paid and satisfied. The company does not prejudice by this condition any defenses against such action that it may be entitled to make under this policy.

I. If the business of the assured is placed in the hands of a receiver, assignee or trustee, whether by the voluntary act of the assured or otherwise, this policy shall immediately terminate, but such termination shall not affect the liability of the company as to any accidents theretofore occurring. If the assured is a corporation, a change of title, or if a firm or individual a change of title or ownership, shall in like manner terminate this policy, unless such change is consented to by the company, by an endorsement hereon, signed by its president, vice-president or one of its secretaries.

J. The premium is based upon the entire compensation earned by the drivers of the assured during the period of this policy. If the assured himself drive any draught or driving animal or vehicle there shall be included therefor in the compensation a sum equivalent to the average compensation of a driver of a team covered hereunder. Whenever employees are compensated, in whole or in part, by store certificates, board, merchandise, credits or any other substitute for cash, the amount of compensation covered by such substitutes shall be included in the compensation. If such compensation exceeds the sum set forth in the schedule, the assured shall immediately pay the company the additional premium earned. If such compensation is less than the sum set forth in the schedule, the company will return the unearned premium, when determined; but the company shall receive or retain not less than dollars ($), it being agreed that this sum shall be the minimum earned premium.

K. This policy may be canceled by the company at any time by written notice served on or sent by registered letter to the assured at the address given herein, stating when the cancellation shall be effective. It may be canceled by the assured by like notice to the company. If canceled by the company, the company shall be entitled to the earned premium pro rata, when determined. If cancelled by the assured, unless the assured has retired from business, the company shall receive or retain the customary short-rate premium. In either case the earned premium shall be computed on the compensation for the year as indicated by the actual compensation earned by the drivers of the assured during the time the policy shall have been in force. The company's check mailed to the address of the assured as given herein shall be a sufficient tender, but no return premium shall be payable until a statement of the actual compensation earned by the employees of the assured during the period the policy was in force shall have been furnished to the company by the assured.

L. Any of the company's authorized auditors or inspectors shall have the right and opportunity, whenever the company so desires, to examine the books and records and to inspect the premises and all draught or driving animals and vehicles owned or used by the assured for the purpose of ascertaining the compensation earned by the drivers of the assured, and the assured shall render reasonable assistance; but the company waives no right by failing to make such examination. The assured shall, whenever requested, furnish the company with a written statement of the amount of compensation earned by its drivers during any part of the period of the policy, and at the end of the period of the policy the assured shall furnish the company with such statement covering the full period of the policy. The rendering of any estimate or statement or any settlement shall not bar the examination herein provided for nor the company's right to additional premiums.

M. No erasure or change appearing on the face of this policy as originally printed and no change or waiver of any of its terms or conditions or statements shall be valid unless endorsed hereon and signed by the president, the vice-president or one of the secretaries of the company. Notice to or knowledge by any agent or any other person shall not be held to waive any of the terms, conditions, or statements hereof.

N. No person shall be deemed an agent of the company unless such person is authorized in writing as such agent by the president, the vice-president, or one of the secretaries of the company.

SCHEDULE.

1. Name of assured, 2. Address of assured (state street, town, county and State where head office is located). 3. The vehicles are used at the following places only: 4. The assured is (state whether individual, co-partnership, corporation, receiver, or other trustee). 5. The trade or business is 6. The number of vehicles owned by the assured, driven single, is: 7. The number of vehicles owned by the assured, driven double, is: 8. The number of draught or driving animals owned by the assured is 9. The number of drivers employed by the assured is 10. The average compensation to each driver, weekly, is $ II. The kind of work for which the vehicles are used is 12. The assured does no driving himself, except as follows: 13. The vehicles are used exclusively in the business of the assured, except as follows: 14. No unusual type of vehicle is used to assured's knowledgs, except as follows: 15. No vicious draught or driving animal is used so far as the assured knows or is informed. 16. No driver under sixteen (16) years is or will be employed. 17. There is no exceptional hazard involved, such as transportation of explosives, except as follows: 18. The estimated entire compensation for the term of this policy is $ 19. The actual amount of compensation paid to all drivers during the last calendar year (ended December 31, 190 ), was $ 20. No company has canceled or refused to issue teams insurance to the assured during the past three years, except as follows: 21. No company has insured the risk during the past two years, except as follows: 22. The number and description of all vehicles covered by this policy, the places where used and the premium rate for each driver, is as follows:

23. The minimum premium for this policy is $

This risk commences at noon, standard time at the place where the policy is countersigned, 190. Dated 190. Broker or agent,

day of

Resident manager or general agent,

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The Insurance Year Book: Life and miscellaneous, Issue 32