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chemicals are used, except as follows: ... ΙΟ. No explosives are used, except as follows: II. No stamping of sheet or other metal is done

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by power presses, except as follows: ... (state number of power presses, if any) .. 12. The estimated pay-roll includes the wages of all executive officers, office men, piece-workers employed in the factories or shops, and all other employees, except as follows: ... 13. The employees whose wages are included in the following list do not make alterations or additions to buildings or plant. They make no repairs, except as follows: . . 14. The following similar insurance is carried: Boiler, $. ... Name of Employer's liability $ ... Name of company. . . . EleName of company 15. The insurances described

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vator, $

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in paragraph 14 cover the period for which this policy is written except as follows:

16. The estimated average number of employees in each class or occupation and the estimated average annual wages in each description or class are given in the following list:

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17. The total expenditure for wages for the last calendar year, ended December 31, 190..., was $... 18. The estimated expenditure for wages for the term of this policy is $... The premium rate is... cents for each $100 of wages. The minimum premium is $...

SURGEON'S CLAUSE

In consideration of an additional premium of $..., being at the rate of $..., for every one hundred dollars ($100) of wages paid to the employees, this policy, subject to all its agreements and conditions, is hereby extended so that the company will, at its own cost and expense, furnish to the injured employee, through its own surgeon, such medical attendance as may be considered by such surgeon necessary to the treatment of any injuries covered hereby.

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GENERAL EXPOSURE CLAUSE

In consideration of an additional premium of $..., being at the rate of $... for every one hundred dollars ($100) of wages paid to employees, this policy, subject to all its benefits, agreements, and conditions, is hereby extended to cover accidents to the employees of the assured insured hereunder, occurring at any time or place during the continuance of this policy. Dated. . . ., 190... Countersigned . . .

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APPENDIX F

FORM OF AGREEMENT FOR LARGE FIRMS1

ARTICLES OF ASSOCIATION

ARTICLE I
NAME

The undersigned, employees of the United Traction and Electric Company, or of companies owned, operated, or controlled by it, hereby form an association under the name of the United Traction Employees Mutual Aid Association.

ARTICLE II
OBJECT

The object of this Association is to afford aid and relief to sick and disabled members and to the widows and children of deceased members.

ARTICLE III
MEMBERS

Membership in this Association shall be limited to employees of the following companies, namely: The United Traction and Electric Company, The Rhode Island Company and companies owned, operated, or controlled by them, or either of them.

BY-LAWS

ARTICLE I

MEMBERSHIP

SECTION 1. Every employee of the United Traction and Electric Company, or of any company owned, operated or controlled by it, and every employee of the Rhode Island Company who is engaged in its street railway business who shall make the weekly contributions hereinafter required, shall be a member of this Association so long as he remains such employee, or is in receipt of a pension from any of said companies, or of benefits from this Association. Provided, however, that neither elective officers of said companies nor temporary laborers on construction work shall be members.

This form was drawn up under the direction of the actuary, Mr. M. M. Dawson. It is not recommended for employers of a small force of wage earners.

SEC. 2. No certificate of membership shall be required, but proof of the fact that any person was, at a given date, eligible to membership, as provided in sec. 1, and had duly made all the contributions required by these By-Laws, shall be evidence that such person was, on that date, a member of this Association and entitled to benefits as hereinafter provided.

ARTICLE II

BOARD OF TRUSTEES

SECTION I. The management of this Association shall be vested in a Board of Trustees, which shall consist of seven persons. Until the first day of January, A. D. 1903, this board shall be composed of four persons to be elected by the directors of the United Traction and Electric Company and of the following members of this Association, viz.: George S. Apley, Frederick T. Nicholas, and Charles Young. From and after the first day of January, A. D. 1903, said board shall consist of four persons to be elected by the Directors of the United Traction and Electric Company before the first day of January of each year, and three persons to be chosen from their own number by the members of the Association in the following manner, viz.: Each member whose name is on a pay-roll shall give in his ballot to the paymaster at the time of payment of his wages next before December 25 in each year. Members whose names are not on a pay-roll shall send in their ballots, with their names indorsed thereon, to the chairman of the Board of Trustees. The paymaster shall also turn in all ballots received by him to the chairman of the board. The votes shall be counted by the board or under its supervision, at a meeting to be held for the purpose not later than December 30th; and the three members having the largest number of votes shall be declared elected.

SEC. 2. From and after the first day of January, (A. D. 1903, the Board of Trustees shall hold their offices for the period of one year, beginning on the first day of January next succeeding the date on which they were chosen. Any vacancies in the number of the trustees chosen by the Directors of the United Traction and Electric Company may be filled by the remaining trustees chosen by said directors. And any vacancies in the number of the trustees chosen by the members of the Association may be filled by the remaining trustees chosen by said members.

SEC. 3. The Board of Trustees shall meet at two o'clock P. M. on the first Thursday of each month at the office of the Union Railroad Company in the City of Providence; provided, that the board may

change the time and place of such meeting, giving at least three days' notice of such change to each trustee. Special meetings may be called by the chairman and shall be called by the secretary upon request in writing of a majority of the board. At least three days' notice of such special meeting shall be given to each trustee. All notices shall be signed by the secretary, and shall be mailed, postpaid, to the several trustees at their addresses as last given to the secretary.

SEC. 4. Four trustees shall constitute a quorum for the transaction of business. When at any meeting a less number than a quorum is present, they may adjourn the meeting, giving at least three days' notice of the time and place of such adjourned meeting to the absent trustees.

SEC. 5. The Board of Trustees shall in the month of January in every year cause an audit and examination of the Association's accounts and condition to be made by a competent actuary who shall not be a member of said board, and shall issue a printed report for circulation among the members setting forth the receipts and disbursements for the previous year and the assets and liabilities on December 31st thereof, and such other facts as they may deem advisable concerning the transactions and condition of the Association.

ARTICLE III

OFFICERS AND THEIR DUTIES

SECTION 1. The Board of Trustees shall, at their first regular meeting after their election, proceed to organize by the election of a chairman, a treasurer, a secretary, and such other officers as they may deem necessary. All officers shall hold their offices during the pleasure of the board.

SEC. 2. It shall be the duty of the chairman to preside at all meetings.

SEC. 3. It shall be the duty of the secretary to keep a correct record of the proceedings of all meetings; to keep a correct account of the receipts and disbursements of the Association and to report the same to the Board of Trustees when required; and to give all notices required by the By-Laws.

SEC. 4. It shall be the duty of the treasurer to receive and hold the funds of the Association, depositing the same in a bank or banks approved by the Board of Trustees, and disbursing moneys only upon the joint order of the chairman and secretary. It shall be required to give bond, approved by the board, in the sum of five thousand dollars for the faithful performance of his duties.

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