HomeMy WebLinkAbout1976LI'' �
�,ONDONaMUT(/A�
ire �zt�txrartce CA.
OF CANADA.
a.. nm�aw .neou.�rr:�emer.+�Ama
pumminy
C ...... 'o,�
...___°... __: P.O.
11 WI.,. wLere the pagit to hcnsrign l 1tolomi oti he rollo"'19 d"Ae O n,d ontl 1611 '151 cont' wn In -1 11 r,lioy. A
Inloton a t P"[6Y1m Y 1 o lf" I'l.' .gndn rete ten ', t1 It IfIeiollY a 1 .. a to Al tele o6 Ot...mn. Fenhy
*loom, oen W ulownoe a 1p itying to Jq So ... MY.
,4or `!>nhle xecmneD. hereby traf, asstgn, andsid over unto
.. . and asngros all __..
right, title and lnterase in ibis Policy of Insurance, and all ben fede and advantage to be dermad
from the same being in eonsulauer'on of ._... ......
W91p6ess... hand this day f....... e8..
In Presence of
. I h'e 4111 Ill o, nu. tmnsmvua.om hm E11n fn m1 rml e, mentiol mo ., oma, 1ne tl
m to ho p,w. ( "Y' vnlm thdllmmmm, le ((on ml
Rlem,o—Pmr'<n(, Re mum lv..mwou wkh ebn.e w,nrra.
` is 'govDmz Mit Will ,I i r e I its itrnn cc Tompanit oCftGimbahereby consent that
the enteron of _......... iia the wilhim heathy, be
aaegno i to.. subject, nevertheless, to all the eanddwns
therm» coniabmd.
Loudon,..... e8
.therreag.. _.
SURRR.NDER,
'do She lCuabou 10oal Jae $nBurance (Lompanp of Qtmaba.
Having alienated and sold oul ail __.. _ rig7u, title and interest, ex and to the
... insured by the within Poly to .. ...
9 of the _. of .__(address) P.O.
N
— kereky surreMer the saixe, and request that the Pols'' y he rnruelted.
'� Grain ander .. ... hand. this... _... day of S
I ratify the fads of the above atie„anon m kl
roam mo,ding to vry wrn kno:utedt,
I
� 1
NUMBER
LI
- qr
1
LI tMas ;'illcu c
r.eezie4 DO rNSURE_.
oo/rh Ter».,h:p f
Ly fire or Itteitau+g to the m
Ilt W0
ESTABLISHED/N/l >_ a TAL ONLY EOM/NLON/NNHLAL.
for and in omeAd aeo» fa
aq{� BOLuas.
LNiElp Comm"
OF CANADA.
----y---A&ooaarY, ay said co 9aity
In t& tt&.C-oounlyf ��–�;�-/ and P lof Onanq ngaiue lo: orderSgee
�Ilollare. th f Il .,Pop toy r eut:
✓I�–. nI "jL /Bate'
Italy
-_–. N • � –. �J/– uuc►rr..as— I–¢^..�/7+►.ac---. /O O /.
® / s1 ,gyp
.' tea/ a-4- T I .�a�e of y loll
..� s na /.GJ 1 oE.; earn we. a�o,g t�h..moh
he e.1/ /W ..e., m. tj/• .�6
the A4 krt6 le u, n., A VPVhmm, m otn w hand / /.� .• Sam ban �(
,211111 the tar emWmucv M he ...... lmana do P..ttea.ln{aee Juan Weald All i4.Gm rn.. ,tea... JI al
10,111 11 dotage, e.Ien
k, An .1alt An nod it .1tol 11111helej. IIIIIIALLAS.n..h eat e. Ily Elyfaij 1. the beyearbod penalty be_ FlIt'lo, 1.0fibir., hoddepholponedat d1olag lha thall IIEI r Tana I...,,.,e.or.
anm.leal c,arding 1. 1111 "We ade w,YXl mthe III the ..nf Abul fallen aua to tohall .'6 p. babled,11ou Said nrhen. ,N oo,d.whe wArl,, ornF lrye I.rnu bu wmnx 31111.
e,
,r•r th. pont of l.,
It - 'Aq L llk1t 11111May 31 Lowell¢¢ 1' eald 31 111 Lot the tnn. anot not 1 ,arm nmea h,m, uW r JulA n Al 1 f...
A.Lm' a n. 3�ea rheAenr nu. ' tow }�w -n me aprr..np�a' If Hot ter e, ,eat., meat .,,..a.n. nm.num..�dmta me
IS he .,be' near fano e.. bnN to t e.pL' a a n. eat me pv,n6maa m apl eaen nw nNer.tie Vmmm tom '
Ma'
Ell Mitu[ee Whayof 1YI yrI W vWny wnv M1u ayeleficy. Leddo Aorv.be nss .mtet.S"ease tle awe aW affol da a.pv.¢ fall pl neat of tk ISI or L"ILAT I' me bell A omau.. the
J/. Iw__ALX if beer of �d_—
STATU70RI CONDITIONb
.._.._,.I- jl:b;Aa -1 41 LI at .e,., ntcrea, herl, le, . LI tal,l (,.AI noodarboolett dAlarano, ,man.0.
Ioe.11t Schnee
SIP., , LL, I—Aly fitood 11 111. .1 1. . I. de,ey LALat ..I IN Voloa. A aby a LI Are ral late .all. I he I.., Ut totI�j L L I
has ...ey old. w.,.�, wad. ..as.00l. a<t
Le. ..rraue or LeI at LeaAeoa,b.v..aAtAlab.,.t...nt..,,al „.a..
all I., fabor Rm
III ok
I be Ile, for 11hat.olea; al .111 All
otr. B. Iw...
ITCLAIAAA�nftaodl
ho
d .1len. '� ......a Mtn tort. ...lat _,. Ilejaet
' —N. oldef. 4 'Ile Sale, .4hul le fee at to el At N elite ` 11. At eatee y the (Ill 11 It I
F t
d party
w..wm
I Lee Ill
a.�:ava'"..�.
�-.-- ...-_ ooLtoL 11 •
VARIATIONS IN CONDITIONS.
This Policy Is issued on the above statutory Conditions,with the following variations and additions
These variations and additions are, by wine of the Ontario statute in that behalf, in force so far as by the Court or Judge before whom a question is tried
relating thereto, they shall be held to be just and reasonable to be exacted by the Company;