HomeMy WebLinkAbout869"Fire Insurance Policy; 33.8 x 41 cm; Sarah J. Burk Papers
AC 93-872
6, 3, 6, 86
--THE--
Maple Leaf
FARMERS' MUTUAL
Fire Insurance Company.
POLICY NO. 5186
You are requested to read the Policy, to see that it is filled up according to your
intentions, if not, write to the Secretary to his P. O. address
Should any claim arise under this Policy, immediate notice thereof should be sent to the
Secretary.
NAME.
Mrs. Sarah J. Burke
Brougham, P.O.
Amount $ 2000 00/100
Premium Note $ 65 00/100
Expires on Mar. 16th, 1906
E. MUNDY, PRINTER, OSHAWA.
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"
ABSOLUTE ASSIGNMENT OF POLICY.
FOR VALUE RECEIVED hereby assign, transfer, and set over unto
Executors, Administrators, and Assigns, the foregoing Policy and all
right, title and
interest therein and thereto, and all benefits and advantages derivable therefrom.
As Witness hand and seal the day of AD. 190
Signed, Sealed and Delivered
In presence of [L. S.]
In consideration of 50c. Transfer Fee received, the consent of the Company is hereby
given to the Assignment of this Policy to
subject to all the conditions of and affecting the same.
..................................................................Secretary.
ASSIGNMENT AS SECURITY.
FOR VALUE RECEIVED hereby assign, transfer and set over unto
Executors, Administrators, and Assigns, the foregoing Policy and all
, title and
interest therein and thereto, and all benefits and advantages derivable therefrom.
This assignment, however, is made for securing payment of a mortgage dated the day of A.D. 190
for the sum of $ and interest, as
Mortgagor to the said
Assignee as Mortgagee, upon satisfaction whereof this assignment to be void, and
upon notice to the within named Company
to be reinstated in all rights under the said Policy.
As Witness hand and seal the day of A.D. 190
Signed, Sealed and Deliver
in the presence of
In consideration of 50c. Transfer Fee received, the consent of the Company is hereby
given to the Assignment of this Policy to all the terms and conditions of and affecting
the same.
.............................................................................................................Secretary.
"
BY-LAWS NOS. 1, 2,3 AND 6 OF THE MAPLE LEAF FARMERS' MUTUAL FIRE INSURANCE CC
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MAPLE LEAF FARMERS' MUTUAL FIRE INSURANCE COMPANY. `
,t,
a, Iiiiiij
ESTABLISHED 'q'
IN
1895,
�mounG JnsvrecL �_� C D C _ `c � �r�mzurn /�j/1�°ote
By this Policy of insuranceconsideration of anundertaking� n 1 re \A for the 9 by the Maple Lead Farmers
Mutual Fru Insurance Company, f �,�i�. W1lJ._%� �a rv�J ,. pyo of the Townshipa the County of
r ka+3-h-V I PI ince of Ontario, (hereinafter called d the ns r d) who has become a member of the said Comany �. and�i consldergon of the
statement of the assured contained in Life application hereinafter mentioned, the wli ,f which statement the assured warrants to be true. (and if such statement be not
tine, either by reason of misrepre emanon or I , this Policy shall be null and void,) and which application shall form part of this Policy, and subject to the laws
hayi� reference wNiMFire Insurance Companno, ill force in the said Province, and the Stlmmry and other Conditions hereon endorsed, and to the By Laws of
this Company, Assurza the said enured ..... ......:.. 8: R.'.4........ ,. , . Leirs, executors, administrants, and assigns against loss or damage by fire or lightning or
by steam thresher, according to Rules and Continuous in B) Law NO. 3, to prnpeny h<reinuf er mentioned (the t mpany's liability for animals killed by lightning to
to be limited to animals killed On the property described herein and to the amount catenated ill condition endorsed hexin in By Law No. 5), to the amount and on the
prapeny following namely Z 4 y[ y zU
On Dwelling House L 2 x $ L sod attachments /bx 2L `+s ! A,f2_ v0�� �I<4.n^-e 0 00
On ordinary contents of Dwelling tl use while contained therein
On Piano or Ocean y y �rx7 s k , ticok Picture; and Paintings $
..place No. I
cveei
On
nMable No On arn No.OOwY"+IC p) -0 fr20 k 0°"tP'"o0u xo_�` lYti` / /��„
Off contents inside v-� P 9 86106. C0
On ordinary contents I ' ^ _ ,.� of -� ti P. f ��.. �0, �( ! ,. , cif -( m � e .
On ordinary contents I ndc — ...... _..
ffwnated an felt No'
1_W -a �. ate. � Y a To 1P f
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ar nepld Campyr binnLylw
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.Iwnev1,10h,nrnsd ulWne or t,,I,, not POl,rly wI sof n. a Econµ ill ary MnM1ia bum 0, face billions, In ,Sole a,ix, l.. y. Iw,ny, nun m pie'
1... L ' Frosident.
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,igned Of n,c w_._ td.. 111).i.._.act t. l_..,,.
esmaeri, it
CoLconclum,
STATDTORY CONDITIONS.
"ORDINARY CONTENTS
The term Ordinary Contents, applied to a Dwelling House, will cover Household Furniture,
Bedding, Sewing Machine, Wearing Apparel, China, Crockery, Glassware, Provisions,
Root Crop, Twenty Barrels of Apples, Wool, Dairy Products, the Tools in common use on
a farm, Robes and Saddlery, and nothing else, unless specially mentioned. As applied
to Outbuildings, it will cover Farm Produce generally, Live Stock, Farming Implements,
including Saddlery. (Not more than $60 allowed for any Horse, $30 for Horned or
Neat Cattle, or $6 for any other animal,) only one Binder and Mower—and that the
best on the place, (not Threshing Machines,) Vehicles and nothing else,
unless specially mentioned. Such property must be the bona fide property of the
Applicant.
SURRENDER.
To the Directors of the Maple Leaf Farmers’ Mutual Fire Insurance Company.
GENTLEMEN,--I hereby surrender all my right, title and interst in and to this Policy,
and request it may be cancelled.
Given under………hand this………….day of……………..A. D. 190
L283
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