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Home My WebLink AboutCreate a B&W TIFF image file_1THIS POLICY IS ISSUED ON THE CO-OPERATIVE PLAN �O---2331------------------------ 400.-------------- Cl;4r Jfittrmer�' Mutual 3UbrMU14t!J .��snritt#iun X1 Utz ftzt�zi4l, +tamzf� and of the statements and representations contained in the application and survey for this policy and of the observance by the insured of the by-laws endorsed on the back; hereof, and of the payment of $------------------------------- Membership Fee, Six a n d 6 100 Dollars by the insured, to -wit : $ - - - -- ------ -- -•Policy Fee, ? ---------------------- -------------------------------------------------------- $------------------------------- Survey Fee, $ ------------------------------- Percentage, DoesInsure --------------------- �e r t -- n_- ------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------for the term of ------------rhre Thre-e ------------------------------- from the ------------------------ -- th--------------------------------------day of ............... --Fe1 ruary ------------------- 192-0--------, at noon, to the ---------------------------- =1-th-------------------------------------day of -----------------`-�e'� �,u` �V--------------------192-S--------, at noon, against all direct loss or damage by fire, except as hereinafter provided, To an amount not exceedingS-- verl ty --f out r�unc�re d ------------------- Dollars -------•-------------------- ------------------------------------------------------------------- , to the following described property while located and contained as described herein, and not elsewhere, to -wit: $.20.0.0..On Dwelling House and Attachments $........ On Household Furniture, Printed Books, Pictures, Silver and Plate, Provisions and Nearing Apparel on Premises ,$ ........ On Piano $ ........ On Organ ........ On Phonograph and Records ........ On Private Garage $ 2 50Q *.On Barn No. 1 s .. 5n.o .. On Barn No. 2 ........ On Barn No. 3 ........ On Barn No. 4 $........ On Hog House $ ........ On Hen Hozrse ........ On Corn Barn or Granary ..6,cj, ... On Produce on Premises . - 0Q .. On Farming Utensils, Carriages, Sleighs, Robes Ha nes Automob1 es mif�jnk machine etc. On Horses On. Cattle Pm ..60Q .. On Registered Cattle ........ On Sheep ........ On Fowls ........ On Swine ... 4QQ ton .. S,:Uo. J.4. x .30............... . ........On ................................. Total 13., SITUATE on. and contained in the prcmises owned a2ul occupied by the insured in the Town of o r Or -----------------_Semnron� us ---------------•----- - -- - --- Cnutzty of ------------------- 3---------- -------State of New York and as described in the written application for thisinsurance, which is hereby made a part of this policy. New York Standard Co=Operative Lightning Clause This policy shall cover any direct loss or damage caused by Lightning (meaning thereby the commonly accepted use of the term Lightning, and in no case to include loss or damage by cyclone, tornado or wind -storm), not exceeding the sum insured, nor the interest of the insured in the property, and subject in all other respects to the terms and conditions of this policy; provided, however, if there shall be any other insurance on said property, this company shall be liable only pro rota with such other insurance for any direct loss by Lightning, whether such other insurance be against direct loss by Lightning or not. Live Stock insured by this policy is covered against death only directly caused by Lightning (meaning thereby the use of the term Lightning as above stated), in said barns or while at large on owner's premises or elsewhere within the territorial limits of this company. This Policy is made and accepted subject to the foregoing stipulations and conditions, and to the following stipulations and conditions printed on back hereof, which are hereby specially referred to and made a part of this Policy, together with such other provisions, agreements, or conditions as may be endorsed hereon or added hereto; and no officer, agent or other representative of this Company shall have power to waive any provision or condition of this Policy except such as by the terms of this Policy may be the subject of agreement endorsed hereon or added hereto; and as to such provisions and conditions no officer, agent, or representative shall have such power or be deemed or held to have waived such provisions or conditions unless such waiver, if any, shall be written upon or attached hereto, nor shall any privilege or permission affecting the insurance under this Policy exist or be claimed by the insured unless so written or attached. .PROVISIONS REQUIRED BY LAW TO BE STATED IN THIS POLICY. —The acceptance of this policy by the insured shall bind the insured to pay all assessments which may lawfully be levied thereon. ,Jtt 30ffitros Wmd, this company has caused these presents to be signed by its President and Secretary this-------1,21- --day o ---, 19-25-- ---- .,, -- - -- -- - - =� - -_Secretary.-----------------A----------- --- -----------=�- ------President. ready for instant use shall be kept within fifteen daylight only, and when the stove and engine is feet of the same. There shall also be near at not in use. No artificial light shall be permitted hand a ladder of sufficient length to reach from in the room when the reservoir is being filled and the ground to the roof of the exposed buildings. no gasoline except that contained in said reservoir Sec. 27. This Association requires of its mem- shall be kept within the building and not more bers strict conformity to the following regula- than five gallons to be kept in a tight and en- tions, viz: To give true answers to the questions tirely closed metallic can, free from leak. Incu- embraced in their form of application; to adjust bators, brooders and kerosene engines may be all stoves and pipes so as not to come in close permitted by seeing that the lamps or engines are contact with wood or any combustible matter; properly cleaned, trimmed and used where there stove -pipes in passing through walls or ceilings is no combustible matter to ignite; alllamps and to be secured by means of earthen, metal or engines to be filled by daylight. Tank heaters stone tubes or otherwise kept from close contact may'be used by taking proper precautions in re - with wood; and in case any pipe shall enter the gard to draft and using coal only, and seeing chimney in an attic or garret they shall be well that the smoke pipe has a proper spark arrester. secured by wire fastenings. In all cases they Permission is given for the use of kerosene, gas - must enter a good substantial chimney by a oline, acetylene, gas and electricity for heating thimble. or be firmly cemented therein. Wooden and lighting and in all cases the equipment must fireboards must be lined with brick. stone or be properly installed and protected. metal to the heigbt of eighteen inches. Ashes, Sec. 29. Wearing apparel, farm utensils, car - if kept in contact with wood, roust not be kept , riages, etc., are insured and covered while on the less than thirty feet from any insured building. premises located and described in the application No smoking shall be allowed in barns and out- or elsewhere within the territorial limits of the buildings, and in case of loss or damage or es- association when in actual use by the assured. posure thereto it shall be the duty of each mem- This Association may issue permits to store per- ber to use his best exertions to preserve insured sonal property on premises other than those de - property. scribed in the application. Threshing machines, Sec. 28. Consent is given to use a gasoline stove , hay presses. ensilage cutters and similar machiu- or gasoline engine, the reservoir to be filled by ery may be insured only in separate policies and The interest of covered by this Policy is hereby assigned to iur terms of one year only. Automobiles may be insured as farm utensils, etc., and will be covered on the owner's premises or elsewhere within the territorial limits of this Company when in actual use by the assured. Consent is hereby given to store automobiles in buildings insured in this Association. Consent is also given to store auto- mobiles insured in this Association in any garage within the territorial limits of this Association for a period of forty-eight continuous hours for ordinary storage or for seven days for repairs. In case of loss, insurance on automobiles will be subject to an adjustment according to deprecia- tion, age and market value of the car. Sec. 30. If in any respect any of these By- I.aws shall prove to be inconsistent with any existing law of the State, or with any law of the State hereinafter enacted, then, and in every such case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated as amended accordingly; they may also be amended by a two-thirds vote of the Directors at any annual meeting, or at a special meeting called and noticed for that purpose by written or print- ed notice mailed to each Director, postage pre- paid, not less than ten days before the date set for such special meeting, all of said amendments to be subject to the written approval of the Su- perintendent of Insurance. Assignment of. Interest by Insured subject to the consent of The Farriers' Mutual Indemnity Association of Cayuga County. __-_as owner of property ............................................................................................................ ......................... Dated z9 (Signature of the Insured) NOTE —To secure Mortgagees, if desired, the Policy should be made payable on its face to such Mortgagee, as follows: Loss, if any, payable to Jno Doe, Mortgagee. Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the interest of ------------------------- covered by this Policy be assignees' to, Dated.- --- _ 19 as owner of the property _______________________Secretary �+ 1�,Cd CV A O a ; Z 00 r 0 ii. i 0 IY Q Q N It LO w a i U Con (dro djCIS i 1 r 'Tl o P=Cd cis I W �' ii � t% : i �• 0 THIS POLICY IS ISSUED ON THE CO-OPERATIVE PLAN No.-------------------- 2.65-71- -1�-.------------------- 'Farmers.vnld'iFarmers' Mutual Indemnity Association of Cayuga County ift Consideration of the Stipulatlolzs hereiit itarrted a ad of the statements and representations contained in the application and survey for this policy and of the observance by the insured of the by-laws endorsed on the back hereof, and of the payment of ................................ Tt'70 _..a:T1Ci.. 00 /1(�O-•---------._.Dollars by the insured, to wit: { $----------2. 00------------------Percentage s Does Insure ------•----•------ e_or 'e___ ' ,_... T1 L11'i---------------------------------------------------------------------------------------------------------- ------------- ............... ----------------------------------------------------------------------------------..-.-----------------------for the term of --------------- Thr a e----------------------------------years from the--------------------------- -5: �1........_......_...----.......------------.day of-----..-----------e?-t Ulil-b e-----------------------._-_192- ------ at noon, to the----------------------------------------------------------------------------- day of-------------_Se-fit embe r_-193---------pty--------- at noon, _, against all direct loss or damage by fire, except as hereinafter provided, unc rea -- .......... •------------- otla/,s, to the following described property while located and contained as described herein, and not elsewhere, to wit: Cc c;..... On Dwelling House and Attachments $ . p. ; ... On Household Furniture, Printed Books, Pictures, Silver and Plate, Provisions and Wearing Apparel on Premises $ ........ On Piano $ .. ?-4:0 ... On Organ $.1.7.5 , .. On Phonograph and Records $. lL0... On Private Garage $ ........ On Barn No.1 $........ On Barn No. 2 $ ........ On Barn No. 3 $........ On Barn No. 4 $........ On Hog House $ ........ On Hen House $ ........ On Corn Barn or Granary $ ........ On Produce on Premises $ ........ On Farming Utensils, Carriages, Sleighs, Robes, Harness and Automobiles $ ........ On Horses $ ........ On Cattle $ ........ On Registered Cattle $........ On Sheep $ ........ On Fowls $ ........ On Swine $ lkg9 $........On ................................. $.lip.•. Total ALL SITUATE on and contained in the premises owned o d occupied by the insured in the Town of or --------------------Q cke-------------------•------------------..._......-- -----County of --------_Camt�a..--------------------------------------State of New York, and as described in the written application for this insurance, which is hereby made a part of this policy. New York Standard Co -Operative Lightning Clause This policy shall cover any direct loss or damage caused by Lightning (meaning thereby the commonly accepted use of the term Lightning, and in no case to include loss or damage by cyclone, tornado or wind -storm), not exceeding the sum insured, nor the interest of the insured in the property, and subject in all other respects to the terms and conditions of this policy; provided, however, if there shall be any other insurance on said property, this company shall be liable only pro rata with such other insurance for any direct loss by Lightning, whether such other insurance be a ainst direct loss by Lightning or not. Live Stock insured by this policy is covered agarnsf death only d irectly caused by Lightning (meaning thereby the use of the term Lightning as above stated), in said barns or while at large on owners premises or elsewhere within the territorial limits of this company. This policy is made and accepted subject to the foregoing stipulations and conditions, and to the following stipulations and conditions printed on back hereof, which are hereby specially referred to and made a part of this Policy, together with such other, provisions, agreements, or conditions as may be endorsed hereon or added hereto; and no officer, agent or other representative of this Company shall have power to waive any provision or condition of this Policy except such as by the terms of this Policy may be the subject of agreement endorsed hereon or added hereto; and as to such provisions and conditions no officer, agent, or representative shall have such power or be deemed or held to have waived such provisions or conditions unless such waiver, if any, shall be written upon or attached hereto, nor shall any privilege or permission affecting the insurance under this Policy exist or be claimed by the insured unless so written or attached. PROVISIONS REQUIRED BY LAW TO BE STATED IN THIS POLICY. —The acceptance of this, policy by the insured shall bind the insured to pay all assessments which may lawfully be levied thereon. At 35ittmos 04jerriatthis company has caused these presents to be signed by its President and Secretary th S e nt edo e r •------------ 19---L--9- •-- this..----.--:..._. ....._..day o...........:..................................... ------------------------------------------------------------------Secretary.-------•---------- - ---- ------ ---- - - --_--_--President. See. 27. This Association requires of its mem- bers strict conformity to the following regula- tions, viz: To give true answers to the questions embraced in their form of application ; to adjust all stoves and pipes so as not to come in close contact with wood or any combustible matter; stove -pipes in passing through walls or ceilings to be secured by means of earthen, metal or stone tubes or otherwise kept from close contact with wood; • and in case any pipe shall enter the chimney in -an attic or garret they shall be well secured by wire fastenings. In all cases they must enter a good substantial chimney by a thimble, or be firmly cemented therein. Wooden firebo4rds must be lined with brick, stone or metal to the height of eighteen inches. Ashes, If kept in contact with wood, must not be kept less than thirty feet from any insured building. No smoking shall be allowed in barns and out- buildings, and in case of loss or damage or ex- posure thereto it shall be the duty of each mem- ber to use his best exertions to preserve insured property. This entire policy shall be void if a building herein described, whether intended for occupancy by owner or tenant be or become va- cant or unoccupied and so remain for a period exceeding thirty days unless otherwise provided by agreement endorsed hereon or added hereto. Sec. 28. Consent is given to use -a gasoline stove or gasoline engine, the reservoir to be filled by daylight only, and when the stove and engine is not in use. No artificial light shall be permitted in the room when the reservoir is being filled and no gasoline except that contained in said reservoir shall be kept within the building and not more than five gallons to be kept in a tight and en- tirely closed metallic can, free from leak. Incu- bators, brooders and kerosene engines may be permitted by seeing that the lamps or engines are properly cleaned, trimmed and used where there is no combustible matter to Ignite; all lamps and engines to be filled by daylight. Tank heaters may be used by taking proper precautions in re- gard to draft and using coal only, and seeing that the smoke pipe has a proper spark arrester. Permission is given for the use of kerosene, gas- oline, acetylene, gas and electricity for heating and lighting and in all cases the equipment must be properly installed and protected. Sec. 29. Wearing apparel, farm utensils, car- riages, etc., are insured and covered while on the premises located and described in the application or elsewhere within the territorial limits of the Association when in actual use by the assured. This Association may .issue permits to store per- sonal property on premises other than those de- scribed in the application. Threshing machines, hay presses, ensilage cutters and similar machin- ery may be insured only in separate policies and for terms of one year only. Automobiles may be Insured as farm utensils, etc., and will be covered on the owner's premises or elsewhere within the territorial limits of this Company when in actual use by the assured. Consent is hereby given to store automobiles in buildings insured in this Association. Consent is also given to store auto- mobiles insured in this Association in any garage within the territorial limits of this Association for a period of forty-eight continuous hours for ordinary storage or for seven days for repairs. In case of loss, insurance on automobiles will be subject to an adjustment according to deprecia- tion, age and market value of the car. Sec. 30. If in any respect any of these By - Laws shall prove to be inconsistent with any existing law of the State, or with any law of the State hereinafter enacted, then, and in every such case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated as amended accordingly ; they may also be amended by it two-thirds vote of the Directors at any annual meeting, or at a special meeting called and noticed for that purpose by written or printed notice mailed to each Director, postage prepaid, not less than ten days before the date set for such special meeting, all of said amendments to be: subject to the written approval of the Superin- tendent of Insurance. t of Interest by Insured Theinterest of ---------------------------------------------------------------------------------------------------------------as owiter of property coveredby this Policy is hereby ass --------------------------------------- -------------------------------------------------------------------------------------- subject to the consent of The Farmers utual Indemnity Association of Cayuga County. Dated.---------------------------------------------------------------------------19 ------------------------------------------------------------------------------------------------------------- (Signature of the Insured) Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the _ as owner o the property interest of ----------------------------------------------------------------------------------------------------------------------------------------------- - p �' y coveredby this Policy be assigned to--------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- Secretary v Dated---------------------------------------------------------------------------19 ° Q :2i O 4 dr C\J RS H Q A—& 0 w d O .W VI �� VJ 0 1. M 0 ;N L O O ""✓ ' a Co L~� V{ (f) bib �''t �s h w Q� M N Cd O OWN Cd Z; 0 E4 ,� =� c J 09 A R `°` Cd Cd ° �a r—! b tip; a �sq V101 4*-4 aG y J cc w i •.. �O E w G p THIS POLICY IS ISSUED ON THE CO-OPERATIVE PLAN No - ---------- 22"g. 6 4 ------------ The Farmers' Mutual Indemnity Association of Cayuga County it Ooasideratioiz of the Stipulatioizs liereia gained aad of the statements and representations contained in the application and survey for this policy and of the observance by the insured of the by-laws endorsed on the back hereof, and of the payment of ---------------------------------T?- �---and .--�n �10�-----------Dollars by the insured, to wit. ------------------ �_ - ---------------------- {$ Percentage, } Does Insure ---------------13:_V-i--.D-t---- 01aIr k ---------------- -------------------------------------------------------------------------------------------------------------for the term of ........... Th.r-e-e....................................... years )ril from the----------------------, S-t----------------------------------------------------day of ............ ...............--......-�� --------------------- IV21---------., at noon, tothe---------------------------- � -�---------------------------------------------------day of-----------.�1 -1 --11------3.3--------------------IY2l..---...._, at noon, against all direct loss or damage by fire, except as hereinafter provided, o an amount not exeeedcny►----------- Tl=.e e---Hucl-r_eC.L-- 1.�.t.y----------------------------------------------------------0o`lars, to the following described property while located and contained as described herein, and not elsewhere, to wit: $..... On Dwelling House and Attachments . Of $ n On Household Furniture, Printed Books, Pictures, Silver and Plate, Provisions and Wearing Apparel on Premises $ ........ On Piano $ ........ On Organ $ ........ On Phonograph and Records $ ........ On Private Garage $ ........ On Barn No.1 $ ........ On Barn No. 2 $ ........ On Barn No. 3 $ ........ On Barn No. 4 $ ........ On Hog House $ ........ On Hen House $ ........ On Corn Barn or Granary $ ........ On Produce on Premises $ ........ On Farming Utensils, Carriages, Sleighs, Robes, Harness and Automobiles $ ........ On Horses $ ........ On Cattle $ ........ On Registered Cattle $ ........ On Sheep $........ On Fowls $ ........ On Swine $........ On ................................. $........ On ................................. $ .3 .Q 1 .. Total ALL SITUATE on and contained in the premises owned ord occupied by the insured in the Town of -------------=t-T-LOYl-----------------------------------------------------------County of--T ora►king------------------...--------------------State of New York, , and as described in the written application for this insurance, which is hereby made a part of this policy. New York Standard Co -Operative Lightning Clause This policy shall cover any direct loss or damage caused by Lightning (meaning thereby the commonly accepted use of the term Lightning, and in no case to include loss or damage by cyclone, tornado or wind -storm), not exceeding the sum insured, nor the interest of the insured in the property, and subject in all other respects to the terms and conditions of this policy; provided, however, if there shall be any other insurance on said property, this company shall be liable only pro rata with such other insurance for any direct loss by Lightning, whether such other insurance be against direct loss by Lightning or not. Live Stock insured by this policy is covered against death only directly caused by Lightning (meaning thereby the use of the term Lightning as above stated), in said barns or while at large on owner's premises or elsewhere within the territorial limits of this company. This Policy is made and accepted subject to the foregoing stipulations and conditions, and to the following; stipulations and conditions printed on back hereof, which are hereby specially referred to and made a part of this Policy, together with such other provisions, agreements, or conditions as may be endorsed hereon or added hereto; and no officer, agent or other representative of this Company shall have power to waive any provision or condition of this Policy except such as by the terms of this Policy may be the subject of agreement endorsed hereon or added hereto; and ,as to such provisions and conditions no officer, agent, or representative shall have such power or be deemed or held to have waived such provisions or conditions unless such waiver, if any, shall be written upon or attached hereto, nor shall any privilege or permission affecting the insurance under this Policy exist or be claimed by the insured unless so written or attached. PROVISIONS REQUIRED BY LAW TO BE STATED IN THIS POLICY. —The acceptance of this policy by the insured shall bind the insured to pay all assessments which may lawfully be levied thereon. 3n IfUnros IR4errof, this company has caused these presents to be signed by its President and Secretary this---- .-- -----day o f -- n r i-- -- -- - -------------------------- 19--- 3 v .- _W. .. -- - ---- ------ - ...Secretary. -------------------- --- - -- .... . . ..'resident. See. 27. This Association requires of its mem- bers strict conformity to the following regula- tions. viz: To give true answers to the questions embraced in their form of application; to adjust all stoves and pipes so as not to come in close contact with wood or any combustible matter; stove -pipes in passing through walls or ceilings to be secured by means of earthen, metal or stone tubes or otherwise kept from close contact with wood; and in case any pipe shall enter the chimney in an attic or garret they shall be well secured by wire fastenings. In all cases they must enter a good substantial chimney by a thimble, or be firmly cemented therein. Wooden fireboards must be lined with brick, stone or metal to the height of eighteen inches. Ashes, if kept in contact with wood, must not be kept less than thirty feet from any insured building. No smoking shall be allowed in barns and out- buildings, and in case of loss or damage or ex- posure thereto it shall be the duty of each mem- ber to use his best exertions to preserve insured property. This entire policy shall be void if a building herein described, whether intended for occupancy by owner or tenant be or become va- cant or unoccupied and so remain for a period exceeding thirty days unless otherwise provided by agreement endorsed hereon or added hereto. Sec. 28. Consent is given to use a gasoline stove or gasoline engine, the reservoir to be filled by daylight only, and when the stove and engine is not in use. No artificial light shall be permitted in the room when the reservoir is being filled and no gasoline except that contained in said reservoir shall be kept within the building and not more than five gallons to be kept in a tight and en- tirely closed metallic can, free from leak. Incu- bators, brooders and kerosene engines may be permitted by seeing that the lamps or engines are properly cleaned, trimmed and used where there is no combustible matter to ignite; all lamps and engines to be filled by daylight. Tank heaters may be used by taking proper precautions in re- gard to draft and using coal only, and seeing that the smoke pipe has a proper spark arrester. Permission is given for the use of kerosene, gas- oline, acetylene, gas and electricity for heating and lighting and in all cases the equipment must be properly installed and protected. Sec. 29. Wearing apparel, farm utensils, car- riages, etc., are insured and covered while on the premises located and described in the application or elsewhere within the territorial limits of the Association when in actual use by the assured. This Association may issue permits to store per- sonal property on premises other than those de- scribed in the application. Threshing machines, hay presses, ensilage cutters and similar machin- Assignment of Interest by Insured ery may be insured only in separate policies and for terms of one year only. Automobiles mgy be insured as farm utensils, etc., and will be covered on the owner's premises or elsewhere within the territorial limits of this Company when in actual use by the assured. Consent is hereby given to store automobiles in buildings insured in this Association. Consent is also given to store auto- mobiles insured in this Association in any garage within the territorial limits of this Association for a period of forty-eight continuous hours for ordinary storage or for seven days for repairs. In case of loss, insurance on automobiles will be subject to an adjustment according to deprecia- tion, age and market value of the car. Sec. 30. If in any respect any of these By - Laws shall prove to be inconsistent with any existing law of the State, or with any law of the State hereinafter enacted, then, and in every such case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated as amended accordingly; they may also be amended by a two-thirds vote of the Directors at any annual meeting, or at a special meeting called and noticed for that purpose by written or printed notice mailed to each Director, postage prepaid, not less than ten days before the date set for such special meeting, all of said amendments to be subject to the written approval of the Superin- tendent of Insurance. The interest of ------------------------------------------------------------------_as owner of property ----------------------------------------------------------- covered by this Policy is hereby assigned to---------------------------------------- ---------------------------------------------------------------------------------------. subject to the consent of The Farmers' Mutual Indemnity Association of Cayuga County. Dated---------------------------------------------------------------------------- 19 ------------------------------------------------------------------------------------------------------------- (Signature of the Insured) Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the Interest of -------------------------------------------------------------------------------------------------------- - -------------------------------------- as owner of the property coveredby this Policy be assigned to-------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------- r------------------------------------------------- Secretary Dated---------------------------------------------------------------------------19 >, 14 ar a c ; �+ a, Z V �: 4: iCd '+--� •r-1; ppile o --4; p..,; o -«� O •v a� tom' bar4r\ o•� a 4-j ceI -�-a _o � V O O N' boo z Cz cn p U � 0 a 0 0 a� � b � C �° r.. cz � a v � Cd W 0 .(J) •4 .a v 0 v � THIS POLICY IS ISSUED ON THE CO-OPERATIVE PLAN No. 2iota $-iQ-O- o- THE FARMERS' MUTUAL. INDEMNITY ASSOCIATION OF CAYUGA COUNTY 04/1, ff-1/Z , f-tv"'.c-c/i/vt +Va4+1 eb and of the statements and representations contained in the application and surrey for this policy acid of the observance by the insured of the by-laws endorsed on the back hereof, and of the payment of f$------------------------------- Membership Fee; Two - 0 0 / 10 0--------------------- t o wit $ ------Policy Fee, _Dollars by the insured, < } ------------------------------- ' ,.$------------------------------- Survey Fee, $ ------------------------------- Percentage, DoesInsure.---- .......... --------- ----------- -- -- J -- - ©mZ -- ns o---------------------------------------------------------------........ ----...... -............ ____for the term o f ___...__th ___ three ___________________years from the ............................... 2i�#t------•--•---------------- ---- of -------- Qct-0-ber-------------------------- =-192-1----------, at noon, tothe ----------------------------------- -26t,h---------- -------------------- day of .... bier---------------------------192A---------- , at noon, against all direct loss or damage by fire, except as hereinafter provided, To an amount not exceeding ---------Owe ... thousand ------------------------------------------------------------------------------------ Dollars, to the f ollowing described property while located and contained as described herein, and not e waItere, to irit ........On D«-elling House and Attachments ........On Household Furniture, Printed Books, Pictures, Silver and Plate, Provisions and Wearinb Apparel on Premises $ ........ On Piano $........ On Organ $........ On ................................. $........ On ................................. $ ........ On Barn No. 1 $........ On Barn No. 2 $........ On Barn No. 3 $........ On Barn No. 4 $........ On Hog House $ ........ On Hen House ........ On Corn Barn or Granary .. 000 , On Produce on Premises ........ On Farmino, Utensils, Carriages, Sleighs, Robes, Harness and Automobiles on premises (See Section 29 of By -Laws.) ........ On Horses ........On Cattle ...... On Registered Cattle ........ On Sheep . ...... .On Swine ........ On Fowls ........On .Qther. i-Ap.grQLp.ge. pQMJt-.ted ........ On .. Q Pmubrenti ly.'s .............. . ;,QQ.0. . Total ALL SITUATE on and contained in the premises owned and occupied by the insured in the Town of or or Groton -County of ----- Tompkins -----------•------------ State oNew York, --- ----------------------------------------- -- ----- and as described in the written application for this hisu ranee, which is hereby made a part of this 1-tolicy. New York Standard Co=Operative Lightning Clause This policy shall cover any direct loss or damage caused by Lightning (meaning thereby the commonly accepted use of the term Lightning, and in no case to include lose or damage by cyclone, tornado or wind -storm), not exceeding the sum insured, nor the interest of the insured in the property, and subject in all other respects to the terms and conditions of this policy; provided, however, if there shall be any other insurance on said property, this company shall be liable only pro rats with such other insurance for any direct loss by Lightning, whether such other insurance be against direct loss lny Lightning or not. Live Stock insured by this policy is covered against death only directly caused by Lightning (meaning thereby the use of the term Lightning as above stated), in said barns or while at large on owner's premises or elsewhere within the territorial limits of this company. This Policy is made and accepted subject to the foregoing stipulations and conditions, and to the following stipulations and conditions printed on back hereof, which are hereby specially referred to and made a part of this Policy, together with such other provisions, agreements, or conditions as may be endorsed hereon or added hereto; and no officer, agent or other representative of this Company shall have power to waive any provision or condition of this Policy except such as by the terms of this Policy may be the subject of agreement endorsed hereon or added hereto; and as to such provisions and conditions no. officer, agent, or representative shall have such power or be deemed or held to have waived such provisions or conditions unless such waiver, if any, shall be written upon or attached hereto, nor shall any privilege or permission affecting the insurance under this Policy exist or be claimed by the insured unless so written or attached. PROVISIONS REQUIRED BY LAW TO BE STATED IN THIS POLICY. —The acceptance of this policy by the insured shall bind the insured to pay all asses;slllents NI-Iiicli may lawfully be levied thereon. 3n tfness W4rred, this company has caused these presents to be signed by its President and Secretary this ------- - ------ day of ----------------- Q c t obey .--92--1--------- r.rr-••-r,� ... wwwwwo............ .... .....,....... ....... ev...S61 etary. ,.\ ..... .. N.. 0 ..... 9 .......,: ........... .......... reawnt. ready for instant use shall be kept within fifteen feet of the same. There shall also be near at hand a ladder of sufficient length to reach from the ground to the roof of the exposed buildings. Sec. 27. This Association requires of its mem- bers strict conformity to the following regula- tions, via: To give true answers to the questions embraced in their form of application; to adjust all stoves and pipes so as not to come in close contact with wood or any combustible matter; stove -pipes in passing through walls or ceilings to be secured by means of earthen, metal or stone tubes or otherwise kept from close contact with wood; and in case any pipe shall enter the chimney in an attic or garret they shall be well secured by wire fastenings. In all cases they must enter a good substantial chimney by a thimble, or be firmly cemented therein. Wooden fireboards must be lined with brick, stone or metal to the height of eighteen inches. Ashes, if kept in contact with wood, must not be kept less, than thirty feet from any insured building. No smoking shall be allowed in barns and out- buildings, and in case of loss or damage or ex- posure thereto it shall be the duty of each mem- ber to use his best exertions to preserve insured property. Sec. 28. Consent is given to use a gasoline stove or gasoline engine, the reservoir to be filled by daylight only, and when the stove and engine is not in use. No artificial light shall be permitted in the room when the resrvoir is being filled and no gasoline except that contained in said resrvoir shall be kept within the building and not more than five gallons to be kept in a tight and en- tirely closed metallic can, free from leak. Incu- bators, brooders and kerosene engines may be permitted by seeing that the lamps or engines are properly cleaned, trimmed and used where there is no combustible matter to ignite; all lamps and engines to be filled by daylight. Tank heaters may be used by taking proper precautions in re- gard to draft and using coal only, and seeing that the smoke pipe has a proper spark arrester. Permission is given for the use of kerosene, gas- oline, acetylene, gas and electricity for heating and lighting and in all cases the equipment must be properly installed and protected. Sec. 29. Wearing apparel, farm utensils, car- riages, etc., are insured only while on the prem- ises located and described in the application. This is however extended to cover said personal property anywhere we could insure while the same is in actual use by the assured. Automo- biles may be insured as farm utensils, etc., and will be covered on the owner's premises or else- where within the territorial limits of this Com- pany when in actual use by the assured. Con- sent is hereby given to store automobiles in build- ings insured in this Association. Consent is also given to store automobiles insured in this As- sociation in any garage within the territorial limits of this Association for a period of forty- eight continuous hours for ordinary storage or for seven days for repairs. In case of loss, in- surance on automobiles will be subject to an adjustment according to depreciation, age and market value of the car. Sec. 30. If in any respect any of these By - Laws shall prove to be inconsistent with any existing law of the State, or with any law of the State hereinafter enacted, then, and in every such case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated as amended accordingly; they may also be amended by a two-thirds vote of the Directors at any annual meeting, or at a special meeting called and noticed for that purpose by written or print- ed notice mailed to each Director, postage pre- paid, not less than ten days before the date set for such special meeting, all of said amendments to be subject to the written approval of the Su- perintendent of Insurance. Assignment of Interest by Insured The interest of-----------------------------------------------------.--------------------------------------------------.as owner of property ---------------------- ------------------------------------ coveredby this policy is hereby assigned to ----------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------- subject to the consent of The Farmers' Mutual Indemnity Association of Cayuga County. Dated --------------------- 19 ............................................................ ................................................................................... (Signature of the Insured) NOTE —To secure Mortgagees, if desired, the Policy should be made payable on its face to such Mortgagee, as follows: Loss, if any, payable to Jno Doe, Mortgagee. Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the interestof--------------------------------------------------------------------------------------------------- -------------------------------- as oulner of the property covered by this Policy be assigned to ------------------------------------------ --------_-_-------____.____-_. ---------------------------------------- ----- - Secretary Dated------------------------------------------------ •------------------ 19 � 0 m O u CIO O cd O ''d q cd t� ...Cd Q±; o: �s '� q O w O IJ o are �► bl •.�0 �G N b O o 0 a �; oa ! .� � A a b ,.4 p Q)' U, R4 b0 k " i�0 4 s� 01 0: m `d `� a o V `", O ° ° _a 41 ,� V 0 ° td ; \ + �► �� THIS POLICY IS ISSUED ON THE CO-OPERATIVE PLAN No. --- 2_4�3_73 -------------------- $ --3900-- ---------------------------------- L74r armrrs' �utixttl t 9 .�s�nritt�inrr of �itt�ugtt C�uixn#� ,�, 40ve/41, atio+u /Vtame/6 and of the statements and representations contained in the application and observance by the insured of the by-laws endorsed on the backsurvey for this policy and o f 1 hereof, and of the payment of $------------------------------- Membership Fed --•------------------------------•--------• Seven --80 /100------Dollars -- ------------------- ---- b y the insured, to wit: < $ -Policy Fee, $ -------------------------------Survey Fee, Does Insure ------- ----------- Delbert $ -------------------------------- Percentage, -------------------------------------------------------------------------- -----------------•-----------------------------•----------------- the term o f ----------------------------------for ........ ter e �-------------------------------- yea fromthe ----•--------•---------------•-------•-------14th ................ da o Sept ember y f---------------------------------------------------192--3----------, at no( tothe ...................... -............... •-- ......... 14-th----------------day of ......... geptember----------------------- 192-- --------- at noc against all direct loss or damage by fire, except as herein -after provided, To an amount not exceedingThirty nine hundred -------------........ -............ �------.-------------------------------------------------------------------•------------ Dollar to the following described property while located and contained as describ ed herein, and not elsewhere , $ . l2 00. , On Dwelling House and Attachments $ • • 40 0.. On Household Furniture, Printed. Books, Pictures, Silver and Plate, Provisions and Wearing Apparel on Premises $........ On Piano $ ........ On Organ $ ........ On Phonograph and Records ........On ... . . . ..... ... .. ......... $ • 1.2 00.. On B am No. 1 .... . $........ On -Barn No. 2 • ....... On Barn No. 3 ........ OnBarn No. 4 • ....... On Hog House • ........ On Hen House $ .. ..... On Corn Barn or Granary 3 • 00 , , On Produce on Premises • • 81Q .. On Farming Utensils, Carriages, Sleighs, Robes, Harness and Automobiles $........ On Horses on either place $........ On Cattle $ ........ On Registered Cattle $ ........ On Sheep $ ........ On Swine $ ........ On Fowls $........ On ........................... .. $........ On ................................. $ .39 DO .. Total ALI, SITUATE- on and contained in the premises owned and occupied by the insured in the Town of ------------------------ ------Sera-proniu ------------------------ County f -------Pay- jaj !................................ °State o f New Yorlc, and as described in the written application for this insurance, which is hereby made a art o this � p f s holic. New York Standard Co=Operative Lightning Clause This policy shall cover any direct loss or damage caused by Lightning (meaning thereby the commonly aoccepted use of the term Lightning, and in no case to include loss or damage by cyclone, tornado or wind -storm), not exceeding the sum insured, nor the interest of the insured in the property, and subject in all other respects to the terms and conditions of this policy; provided, however, shall be any other insurance on said property, this company shall be liable only pro rats with such other insurance for anif there y direct loss by Lightning, whether such other insurance be against direct loss by Lightning or not. Live Stock insured by this policy is cove -red against death only directly caused by Lightning (meaning thereby the use of the term Lightning as above stated), in said barns or while at large on owners premises or elsewhere within the territorial limits of this company. y This Policy is made and accepted subject to the foregoing stipulations and conditions, and to the following Stipulations -and conditions on back hereof, which are hereby specially referred to and made a part of this Policy, together with such h other provisions, geements or conditions as may be endorsed hereon or added hereto; and no officer, agent or other representative of this Company shall have power to waive any provision or condition of this Policy except such as by the terms of this Policy may be the subject of agreement endorsed hereon or added hereto; and as to such provisions and conditions no officer, agent, or representative shall have such power or be deemed or held to have waived such provisions or conditions unless such waiver, if any, shall be written upon or attached hereto, nor shall an privilege or permission affecting the insurance under this Policy exist or be claimed by the insured unless so written or attached. y PROVISIONS REQUIRED BY LAW TO BE STATED IN XHIS POLICY. —The acceptance of this Policy b th insured shall bind the insured to pay all assessments which may lawfully be levied thereon. p y y e 3tt Nifttros 04rrrof, this company has caused these presents to be signed by its President and Se cretary this --------- h----- day of ........ September---------- 19�_ 3 --------------� ... -- -- - ----------------•----- ----- President. l :c•eady for instant use shall be kept within fifteen feet of the same. There shall also be near at hand a ladder of sufficient length to reach from the ground to the roof of the exposed buildings. Sec. 2 This Association requires of its mem- x)ers strict conformity to the following regula- tions, viz: To give true answers to the questiops embraced in their form of application; to adjust all stoves and pipes so as not to come in close contact with wood or any combustible matter; stove -pipes in passing through walls or ceilings to be secured by means of earthen, metal or stone tubes or otherwise kept from close contact with wood; and in case any pipe shall enter the chimney in an attic or garret they shall be well `secured by wire fastenings. In all cases they 'must enter a good substantial chimney by a thimble. or be firmly cemented therein. Wooden fireboards must be lined with brick, stone or metal to the height of eighteen inches. Ashes, if kept in contact with wood, must not be kept Mess than thirty feet from any insured building. No smoking shall be allowed in barns and out- buildings, and in case of loss or damage or ex- posure thereto it shall be the duty of each mem- ber to use his best exertions to preserve insured property. Sec. 28. Consent is given to use a gasoline stove or gasoline engine, the reservoir to be filled by daylight only, and when the stove and engine is not in use. No artificial light shall be permitted in the room when the reservoir is being filled and no gasoline except that contained in said reservoir shall be kept within the building and not more than five gallons to be kept in a tight and en- tirely closed metallic can, free from leak. Incu- bators, brooders and kerosene engines may be permitted by seeing that the lamps or engines are properly cleaned, trimmed and used where there is no combustible matter to ignite; all lamps and engines to be filled by daylight. Tank heaters may be used by taking proper precautions in re- gard to draft and using coal only, and seeing that the smoke pipe has a proper spark arrester. Permission is given for the use of kerosene, gas- oline, acetylene, gas and electricity for heating and lighting and in all cases the equipment must be properly installed and protected. Sec. 29. Wearing apparel, farm utensils, car- riages, etc., are insured and covered while on the premises located and described in the application or elsewhere within the territorial limits of the association when in actual use by the assured. This Association may issue permits to store per- sonal property on premises other than those de- scribed in the application. Threshing machines, hay presses, ensilage cutters and similar machin- ery may be insured only in separate policies and for terms of one year only. Automobiles may be insured as farm utensils, etc., and will be covered on the owner's premises or elsewhere within the territorial limits of this Company when in actual use by the assured. Consent is hereby given to store automobiles in buildings insured in this Association. Consent is also given to store auto- mobiles insured in this Association in any garage within the territorial limits of this Association for a period of forty-eight continuous hours for ordinary storage or for seven days for repairs. In case of loss, insurance on automobiles will be subject to an adjustment according to deprecia- tion, age and market value of the car. Sec. 30. If in any respect any of these By - Laws shall prove to be inconsistent with any existing law of the State, or with any law of the State hereinafter enacted, then, and in every such case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated as amended accordingly; they may also be amended by a two-thirds vote of the Directors at any annual meeting, or at a special meeting called and noticed for that purpose by written or print- ed notice mailed to each Director, postage pre- paid, not less than ten days before the date set for such special meeting, all of said amendments to be subject to the written approval of the Su- perintendent of Insurance. Assignment of Interest by Insured The interest of ---------- as owner of property covered by this Policy is hereby assigned to __------------------------- _-_ subject to the consent of The Farmers' Mutual Indemnity Association of Cayuga County. ___ __ _ ___ _ _ _............................................................................................. .. .. -... . . . Dated-------------------------------------------------------------------,------- 19 (Signature of the Insured) NOTE —To secure Mortgagees, if desired, the Policy should be made payable on its face to such Mortgagee, as follows: Loss, if any, payable to Jno Doe, Mortgagee. Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the interest of as owner of the property covered by this Policy be assigned to Dated------------------------------------------------------------------- --19 1 . / 1 1 , V 1 1 1 1 1 z nCA 1 1 1 1 1 1 Cn 1 1 1 1 , VCAQ •>. Cd cad �D 1 1 , 1 1 1 o o--� CCi; •f--t. W 0 04 1 ^� a) � t, / C4; O C�2 �i./ ci; Cd b,p A 0 ^ (U ?�1 Vl 1 �; 0 VA/, 1 V 1. 1 1 1 1 1 1 ,4 W Ca y.., 14)Cd V ------------ __-Secretary o Cd o a P-b a O Q p O ab� cd p a � � o � 0 Cd o Cd bo 1-4p O •Z o �� U b ~ U � .� A a141 COS, THIS POLICY IS "SSUED ON THE CO-OPERATIVE PLAN NO ------------ 11 ---24368.... .. $.__ CI;4r yariner�' wit#uttl �ni�r�ltatitJ Alilijarlattall of Lttgugtt C�llizntq and of the statements and representations contained in the application and survey for this policy and of the observance by the insured of the by-laws endorsed on the back hereof, and of the payment of $------------------------------- membership Fee, Two and 40/100 .......... .................... Dollars by the insured, to-4vit: 4 $ -------Policy Fee, '$------------------------------- Survey Fee, $ - ------ Percentage, DoesInsure ........ Mar.v_1xL..&__Sad j4� .--0.G1--Qr-------------------------------------------------------------------------------------------------------- .................... -... ---------•-•---------------- •---------------------------------------- _---for the term of .......... T}•-------------------------------- years from the ...................... 1L t%h&................................ - ...... day . of .............. AijZ ,#�-------------------_----19N�-6--------, at noon, tothe ................ -......... J.5.th--------•------------------------------- day of.-- ........... Augu�&--------------------------192--8--------, at noon, against all direct loss or damage by fire, except as hereinafter provided, To an amount not exceeding ............. TWejatty_-f_Qux'--- Jiundx►ad---------------------------------------------------------------- Dollars, to the following described property while located and contained as described herein,and not elsewhere, to -wit: $ . 1.30 0.. On Dwelling House and Attachments $ ........ On Household Furniture, Printed Books, Pictures, Silver and Plate, Provisions and wearing Apparel on Premises ........ On Piano $ ........ On Organ $ ........ On Phonograph and Records $ ........ On Private Garage ........ On Corn Barn or Granary ........ On Produce on Premises ........On Farming Utensils, Carriages, Sle.ig1is, Robes, Harness and Automobiles $ ........ On Horses $ ........ On Cattle 8 ........ On Registered Cattle �. ! �n .ril1PP71 New York Standard Mortgage Clause Loss or damage, if any, under this Policy, shall be payable to ..........Sc'�,rah . k1unt................... . ............. mortgagee [or trustee], as interest may appear, and this insurance, as to the interest of the mortgagee [or trustee] only therein, shall not be invalidated by any neglect of the mortgagor or owner of the within described property nor by any foreclosure or other proceedings or notice of sale relating to the property, nor by any change in the title or ownership of the property, nor by the occupation of the premises for purposes more hazardous than are per- mitted by this policy; provided, that in case the mortgagor or owner shall neglect to pay any premium due under this policy, the mortgagee [or trustee] shall, on demand, pay the same. Provided, also, that the mortgagee [or trustee] shall notify this Company of any change of ownership or occupancy or of increase of hazard which shall come to the knowledge of said mortgagee [or trustee], and unless permitted by this policy, it shall be noted thereon and the mortgagee [or trustee] shall, on demand, pay the premium for such in- cr-- ased hazard for the term of the use thereof; otherwise this policy shall be null and void. This Company reserves the right to cancel this policy at any time as provided by its terms, but in such case this policy shall continue in force for the benefit only of the mortgagee [or trustee] for ten days after notice to the mort- gagee [or trustee] of such cancellation and shall then cease, and this Company shall have the right, on like notice, to cancel this agreement. Whenever this Company shall pay the mortgagee [or trustee] any sum for loss or damage under this policy and shall claim that, as to the mortgagor or owner, no liability therefor existed, this Company shall, to the extent of such payment, be thereupon be legally abrogated to all the rights of the party to whom such payment shall be made, under all securities held as collateral to the mortgage debt, or may, at its option, pay to the mortgagee [or trustee] the whole principal due or to grow due on the mortgage with interest, and shall thereupon receive a full assignment and trans- fer of the mortgage and of all such other securities; but no subrogation shall impair the right of the mortgagee [or trustee] to recover the full amount of. .. - br ..... claim. Daled, ...Augu at 1511-1 .... 19 2 6 Altached to and form7ncrpai-i of Policy No.. 24,313.6 . Issued by 7 he Farmers' lllidual Indemn7iy Assocz'lion of Ca y2tga Cortuiy. ... .. .......... i<-` i .`• is � _, ready for instant use shall be kept within fifteen feet of the same. There shall also be near at exceeding thirty- days unless otherwise provided by agreement endorsed hereon added hereto, hay presses, ensilage cutters and similar machiu- hand a ladder of sufficient length to reach from the ground to the roof of the exposed buildings. or Sec. 28. Consent is given to use a gasoline stove ery may be insured only in separate policies and for terms of one year only. Automobiles may be Sec. 27. This Association requires of its mem- bers or gasoline engine, the reservoir to be filled by daylight only, and when the stove and engine is insured as farm utensils, etc., and will be covered on the owner's premises or strict conformity to the following regula- tions, viz: To give true answers to the questions not in use. No artificial light shall be permitted in the room when the reservoir is being filled and elsewhere within the territorial limits of this Company when in actual use by the embraced In their form of application; to adjust all stoves and pipes so as not to come in close no gasoline except that contained in said reservoir shall be kept within the building and not more assured. Consent is hereby given to store automobiles in buildings insured in this Association. contact with wood or any combustible matter; stove -pipes in passing through walls or ceilings than five gallons to be kept in a tight and en- tirely closed metallic can, free from Incu- Consent is also given to store auto. mobiles insured In this Association in any garage to be secured by means of earthen, metal or stone tubes or otherwise kept from close contact leak. bators, brooders and kerosene engines may be permitted by seeing that the lamps or engines within the territorial limits of this Association for a period of forty-eight continuous hours for with wood; and in case any pipe shall enter the chimney in an attic or garret they shall be well are properly cleaned, trimmed and used where there is no combustible matter to ignite; alllamps ordinary storage or for seven days for repairs, In case of loss, insurance on automobiles will be secured by wire fastenings. In all cases they must enter a good substantial chimney by a and engines to be filled by daylight. Tank heaters may be used by taking proper in subject to an adjustment according to deprecia- tion. age and market value of the car. thimble, or be firmly cemented therein, wooden fireboards must be lined with brick• stone or precautions re- gard to draft and using coal only, and seeing that the smoke pipe has a proper spark Sec. 30. If in any respect any of these By - Laws shall prove to be inconsistent with any m$ ak .to the height of eighteen inches. Ashes, @p�'-in contact with wood, must not be kept arrester. Permission is given for the use of kerosene, gas- existing law of the State, or with any law of the State hereinafter enacted, then, and in every such less than thirty feet from any insured building. No ossnokirtg shall be allowed in barns and out- olive, acetylene, gas and electricity for heating and lighting and in all cases the equipment must be properly installed and protected. case, the Laws of the State shall take the place of such By -Laws and such By -Laws shall be treated buildings, ltnd in case of loss or damage or ex- posure thereto it shall be the duty of each mem- Sec. 29. wearing apparel, farm utensils, car- riages, etc., are insured and covered as amended accordingly; they may also be amended by a two-thirds vote of the Directors at ber to use his best exertions to preserve insured property. This entire policy shall be void if a while on the premises located and described in the application or elsewhere within the territorial limits the any annual meeting, or at a special meeting callers and noticed for that purpose by written or print. building herein described, whether intended for occupancy by owner or tenant be or become va- of association when in actual use by the assured. This Association may issue permits to store ed notice mailed to each Director, postage pre - paid, not less than ten days before the date set for cant or un-occupied and so remain for a period per- sonal property on premises other than those de- such special meeting, all of said amendments to be subject to the written approval of the Su scribed in the application. Threshing machines, - - perintendent of Insurance. Assignment of Interest by Insure. The interest of as owner of property :covered by this Policy is hereby assigned to ___________________________ -------------------------------------------------------------------------------------------- --------------- subject to the consent of The Farmers' Mutual Indemnity Association of Cayuga County. -------------------------------------------------------------------- ate---------------------------------------------------------------- ---------------------•------------------------------.19 (Signature of the Insured) NOTE —To secure Mortgagees, if desired, the Policy should be made payable on its face to such Mortgagee, as follows: Loss, if any, payable to Jno Doe, Mortgagee, as his interest may appear. Consent by Company to Assignment of Interest The Farmers' Mutual Indemnity Association of Cayuga County hereby consents that the interest o- f as owner of the property covered by this Policy be assigned to Dated------------------------------------------------ ----------------------19 --- -----------------------.....------ �-------------• - - ------------------------- - ---- - --- ----- Secretary O n r � 0)Cd ' t a i O �� 1 i co J-+ 4 0 C4 0 cd =;4, C-) w ' �Y11y/ 0 v � ' ' ,9 4J p ram` •r•� :; ZV � �� e ! Cl�, R W v O r •+ t11; H O 0 4J V ` � O; 0 ' ro '� ' r ; a-, cd ) O cd r•? , its ar.• •S — dully a �� .. JO.- 82 dafw 83 the air n 84 expenses-•u-_ 85 This ecjc- 86 requirement, & , 87 not become paa'y' 6-, 88 have been received 89 This company,,, 90 toss by and expense V'remc 91 ance, whether valid or not, a 92 insurance under this policy rt 93 or condition written hereon •r 4 If this company- shall c �i; 95 ipa.l, this company shall, on, ter, t,- POEM" ca >; 'i r—" Cd C • n•�y > 1 •+J O .., (� ( OC C4 0 �--� O _ V rCd - Cd Cd � w � �.. 4-4 O ram.. `� V W �e W 96 insured for the loss resultin th It) I .r l f . - �: No slut action on ,S:a.: ,:,:;.•' , t.:.:•-. ,.....;•.{:•, ` this r �%' .; ;� .:'�?x�,}• .:fir ::::.::';:;:.::.::::.:. 98 after full compliance h r rettL,�� ,r r_ .:�lw � < ! . • C(•% Eb ..'r,''' r'�F%'•�:+;: e••Y•s�• ^''fi�C '' ... •;+';;;:•:;:•:;�;':':;;``a;r 9 after the fire. a 98t 0 o he •ever in ibis policy the. ty ' 101 :.and whereve� ie word "loss" eer ` '' ` � �11' t d 1 Q � �,. 102 0 . c,ars it � • l�••be deemed to r f Di��:-: .. . .Y I •�� K...::....:...:..... 10<3 Tills company is a, co-operat'ive\ t.,,� Q f gC �'1. 104 to organization, membership, policie l ^ the ge d,,2 , 105 pu " - 7is policy, as the same may b :f ''� rl ne• a 1 pl 106 cc ' ., }�r inconsistent with the pro �7 � i. ..� The aid 1 107 >4 tabove set forth shall control. fry '�.•,., 4ti'. � �eat} Application of - - - ..Town of Groton Tompkins County, N. Y., for Insurance against Fire or Lightning by the Dryden and Groton Fire Insurance Co. Made under and in conformity with its Articles of Association and By -Laws For the sum of $ ------------- ---------------- ----------_for the term of ____-_.___ ................. ..years from the ______day of_______.__ %? L_�--_----192 �! at 12 o'clock, m., on property as follows, to -wit: V Amount Amount J Portable Gasoline Engine---------------- $ -------------------- D`Y elli�:g House ---------------------------- $--�------�- -- ' enement House $ Milking Machine -------------------------------- $ -------------------- Household Furniture and Cloth- Heating Plant __________________________________ $-_-_____-_--___-_.__ ing, Fuel and Family Stores-__- $____________________ LightingPlant ---------------------------------- $ -------------------- Piano $-------------------- ------------------------- -------------------- Water System ----------------------------------- -------------------- Mechanical Players and Records $ ---------------- Hay, Grain, Ensilage and Farm Barr. and Attachments__________________ $-,l_./-- - // ry - .- Produce -------------------------------------------- $-------------- Barn No. 2 and Attachments_..__.___ $____ --------------- Horses, Mules and Colts.--------------- $------------------- Carriage House ---------------------------------- $ -------------------- Coins and other Live Stock.--------- $-------------------- �� - ..-_ Farming Utensils, Wagons, �Y -- -- -- t - ------------ Sleighs, I-Iarziess---------------------------- -------------------- Silo--------------------_-------------------------------- $ -1� Pure Bred Registered Cattle---------- $ -------------------- HenHouse ------------------------------------------ $ ----- ` . Kure Bred Registered Swine ---------- $_____ Hen House No. 2----_---------------------- --------------- ----- Pure Bred Registered Sheep ---------- $-------------------- Hen House No. 3 ------------------------------ ------------- ------- ---------------------------------------------------------------- - HogHouse -------------------------------------------- $ ------- FarmShop -------------------------------------------- $ ------ douse--------------------- $. Family Garage_____________ $ Farm Tractor-------------------------------------- $- Amount Insured -------------------- $ -------------------- Farm Trucks---------------------------------------- $ -------------------- In case of loss on buildings pay first to ------------ TractionEngine ---------------------------------------------------- ------------------------------------------------------------------------------------------ Grain Separator -------------------------------- $ -------------------- as h------------ interests may appear. Fees, $2.00; plus percentage, $------------------------- Total to pays $------------------------- N CONSIDERATION of the insurance warranted on the property named, I, the owner, do hereby bind myself and my heirs, executors, administrators and assigns to meet all requirements put upon me by the Dryden and Groton Co-operative Fire Insurance Company, in the way of assessments to meet losses that may occur, to conform to all the rules and regulations of the Association, and bear my just proportion of the expenses of managing the affairs of the Dryden and Groton Co-operative Fire Insurance Company. If said real estate is or becomes encuml erect, then in case of loss pay to an rtgagee as his or their interests may appear. 00, -- -- - - - PI No......................... Dryden and Groton Co -Operative Fire Insurance Co. APPLICATION OF Taken by Approved Insuredfor .............................................. . ...... years Ending.......................................................... 192 ------ Amount Insured, Membership fee .............................................. $1.00 0 Surveyfee ........................................................ $1.00 Percentage I- ----- 0 191- �- ........................ P. 0. Describe the size, material and location of every building that is to be insured, and their distance from each other, and every other building or exposure within 100 feet. Report any encumbrance. SURVEY Dwelling House.!Z4A--0.'6 Wing No. I _.` .. C3 ---- 0 ------ x-./.s ........... Wing No. 2 X Tenement House X Wing X Earn No. ---------- ........ X --- Wing ----- X.................... ----------- X--Z-�----------- Wing X Silo ------ ---------------- X -------------------- House- 12 .. ......... T4R'f- House.... Granary or Corn House.-. 2 Hen House No. ............ Hen House No. 2 X Hen House No. 3 X Hog House.._... Farm Shop---- e-� ..... X. Family Garage ---- -------------------------------------------------------------- X .................... -------------------------------------------------------------- X .................... -------------------------------------------------------------- X .................... ATTACH THIS SLIP TO POLICY SEND ORSEMENT SLIP Farffi'#'ers' Mutual Indemnity Association of Cayuga County rh ................................ :..........SOLICITOR On Dwelling House and Attachments ..................... On Household Furniture, Etc .................. ............... On Barn No. I ..................................................... (, . .. ..... . OnProduce ........................................................... ............ On Farm Utensils, Carriages, Sleighs, Autos, Etc ....................... On Horses, $ ............... On Cattle, $.K-o ...... ............ 40 fir .4 TOTAL----- 41 A . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . ......... ............ .................. Polio' No ......... 1-4 454 ............. ....... . ... ................ . Date of Policy .... .................. . . . . ........ .............. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of Entry.. ...... .............. ...... . ....................... ........... ............ ............................... ........ ... ......... ...... Cancelled................................................ . ..... .................................... ...... I ................................ .. ..... .................... Return Premium $ ............... Premium $ ............... Fee $ ............... TOTAL $ .......... ............................. ................................................................................... .................... ................................ ........................................................... x"xalw ATTACH THIS SLIP TO POLICY On Dwelling House and Attachments ................... ENDORSEMkN-S T LIP H Farmers' Mutual Indemnity Association of Cayuga County NAM#..#,/ ............................ ................ ......................SOLICITOR Policy No ......... Date of Policy ............. ..................... 192 ...... III ) .. Date of Entry. ........192.. Cancelled................................................192...... I Return Premium $ . . . . . . . . . . . . . . . i Premium $ ............... Fee $ ............... ,rOTAL $ .......... ... usehold Furniture, Etc ................................ OnBarn No. I ................................................. OnProduce ............................................. ............ On Farm Utensils, Carriages, Sleighs, Autos, Etc... On Horses, $ ............... On Cattle, $ . .. ....... On..... ..................................... ... ..................... TOTAL........ .......................................... .............. . . . . . . . . . . .. .................. ............ . . . . . . . . . . . . . . . . . . . . . . . . .......... . ..... ........ . . .............. ............. ....... ..... .... . . . . . . . . . . . . . . . . ..... ................. ........... ......... ................. ............. ........ I ATTACH THIS SLIP TO POLICY ENDORSEMENT SLIP Farmers' Mutual Indemnity Association of Cayuga County NAME. . . ............ ................. ...................... 1� ... ............... .....................SOLICITOR , 11 /, Z -/ " PolicyNo..,.,:� ... ............................. Date of Policy . ......... Date of Entry .. . . ............... / ......... Cancelled ................................................ 19.2d ...... Return Premium Premium $ ............... Fee - % - - $ ............... On Dwelling House and Attachments ..................... ................. On Household Furniture, Etc .................. ............... ................ OnBarn No. I ...................................................... OnProduce ........................................................... On Farm Utensils, Carriages, Sleighs, Autos, Etc..... On Horses, $ ............... On Cattle, $ .. ............ .................. On..... ..................................... ... ........... ......... . . .... .......................... ...... TOTAL ........ ....................... ............... ..... ...... &-*---'-1`0 ................................................ ........................ TOTAL $ .......... ... 1 "x*/Wt-,V On Dwelling House and Attachments........... ................... ................. vENDODQEMENT SLIP On Household Furniture, Provisions and Wearing Ap are .................. )n Barn No. I ............................................. ......... .................. R farmersMutual inaemnit essoGlatlon iI ofCayuga County Oil Pv�jduco ............................ ....... ....... ....................... .................. On Farm L,Tteimils, Carriages, Sleighs, Etc ... .................... .................. sOn Cattle, ... .................Oil Horse , ......................... ..... ........... .............. NAME !oil ............ ........ ..................................................... . ............................SOLICITOR ToTAL ................ — — ------- -- . Policy No ..... ......... .............. 2 ........ .............. ..... ........... ........................................ ...... ......... Date of Polio Af 10 -,-/ ... ... ............... w$6.Date of Entry.'*..._ ......-w.191. .................... ..... Caneelled............................................ ................................................................................. ........................................ ........ .... ........................ .. lReturnPremium ............... ................................................................. ................ Premium$ ............... .................... .......................... .................... ..................................................... Fee ToTA 1. $ ............... ATTACH THIS SLIP TO POLICY .,Oh Dwelling House and Attachments .................... ... ENDORSEMENTSLIP j On Household Furniture, Etc .................................................. �0 � io QO � QO � 1 On Barn No. 1 ........................................................1... Farmers' Mutual Indemnity Association I On Produce........ • • • • • .. • .. • • - ................. of Cayuga County On Farm Utensils, Carriages, S)eighs, Autos, Etc..... On Horses, $ ............... On Cattle, $ .. ............ .................. 4 NAME On..... ..................................... ... ........................ ................ SOLICITOR I T .. ..... .... ...... ........... ........... ** ........................................ ....... ........................ . ............. .............. Poliev No. ........................ Date of Poliev ............... .. ..................... 192 ...... . .............. ................. .. ....................... ........................ ........................... Date of Entry ....... 10 ......... .......... ............ ................. ............. ........ ... .......... ...... . Cancelled................................................ 192 ...... ..... ................. . ................................... ..... .................... ..... .................................... ....... Return Premium $ ............... ............................................................... Premium $ ............... Fee............. TOTAL $ ............... t�9ra, "Nazw t� ATTACH THIS SLIP TO POLICY, ...... ................. On Dwelling House and Attachments ............... ENDORSEMENTSLIP On Household Furniture, Etc ................................ ................. /On Barpr o. I ..................................................... .................. Farmers' Mutual Indemnity Association On Produce ........................................................... .................. of Cayuga County On Farm Utensils, Carriages, Sleighs, Autos, Etc..... .................. On Horses, ... On Cattle, $ .. ............ .................. OR ..... ..... ............ A� .................. rv. On..... ........ .. ......... le —M-01 I . ..................................... ...... ....... .............. SOLICITOR TOTAL.....0 .................. ... of................................. ............. ................. I ...... & ......... e ............. Policy No ........... ........ ................................ ............................................................................... Date of Policy ......................192...... ......... ...................... ........................ ............................ ................................ .. ...... 19 Date, of Entry../, ..... Cancelled...... ...................................192........... ................. ........... ............ .... .......................... ........ .... .......... ...... ..... .................................... ....... ................................... ..... ........... Return Premium $ ............... Premium ............... .................. ........................................................... Fee $ .............. TOTAL $ ............... 0 4 ATTACH THIS SLIP TO POLICY ENDORSEMENT SLIP vvovvo©v Farmers' Mutual Indemnity Association of Cayuga County NAAF: . ............ ..................................... ..................... SOLICITOR On Dwelling House and Attachments ..................... i I On Household Furniture, Etc ................................ OnBarn No. 1.................................................... On Produce....................................................... I On Farm Utensils, Carriages, Sleighs, Autos, Etc..... On Horses, $............... On Cattle, $.............. On.................................................................. TOTAL................................. PolicyNo..... ...... .�.� ... oZ .................. .. ......... .... ........ Date of Policy ... .................192...... ... . �� .. ........... ... .. .... ..... ........... . Dateof Entry... O ... 6.......19W . .. i........................................................................................................... . i Cancelled......................... .....................192.................................................. ................. .... ........ ....... Return Premium - $.............. .......................................................................................................... I Premium- - $............... i.............................................................................................................. i Fee- - - - $ .............. .......................................................................................... ................. •rOTAI. - $............... j �i7G�xa � c an 6, ecxe cc-�•'z� i IATTACH THIS SLIP TO POLICY On Dwelling House and Attachments .............. I#NDORSEMENT SLIP j On Household Furniture, Etc... ............................ .................. t! OnBarn No. 1..................................................... ................. Farmers' Mutual Indemnity Association j On Produce............. .................................... ..... .............. ' of Cayuga County On Farm Utensils, Carriages, Sleighs, Etc. do --- j On Horses, $............... On Cattle, $................................ NAME.............. ......... ....... .. A .. .. ........ .............. i On....................... ........... I ................. ............ ..... ..................................... SOLICITOR .Y TOTAL.....................................................I••••.............. Cs�' V .. j .... .. ..... (3w.... �..... f . ....................................... ............ *- Date of Poz ... ......69..........191. ................................................................................................................. Dateof E'. .....191................................................................................................................... Cancelle.....1.........................191��'e................................................................................................................ ReturPremium - $ ............. i .................................................... ................................................... I Premium - - $............... .......... ............................................ :..... ................................................ i Fee- - $............. .. .............................................................................................................. . TOTAL - ............... I e XJ� GG��I2 CJ . CC�I/G�l2Q c / �C�IcB�GG�c?� ATTACH THIS SLIP TO POLICY NDO S � EMENT SLIP "� vvvvvvvvv Farmers' Mutual Indemnity Association of Cayuga County NAME... ,, ......::.. �.....: ..... _..... ..... .............. ............ .........`�.:` . «........................ SOLICITOR C TOR )n Dwelling House and Attachments.......... ............................ i )n Household Furniture, Etc................................ ............... • . j i )n Barn No. 1................................................. ................. )n Produce ........................... .......................... ................. In Farm Utensils, Carriages, Sleighs, Etc.............. ................. n Horses, $............... On Cattle, $............ ................. .I. in.......................................................................I................. TOTAL............................... ...................... ................. Policy No....i......... ......................... :...:............:.. _r �• ' . ...:..:...�.......:.........::..:...... _ _ .... �.......`.......................... Date of Policy.../ ,' 1 .,` ....... ................191... ' .....:.. ...,. ..............:1.... ....: _ '� ° r Date of Entry �` ..::4 .....:. ..° e ........... , ,......�... .... .... .... ...............+�' Cancelled............................... .... ........191...... ...........:...:: .. , ,� � � ' :.'.... ° .....:............................ ReturnPremium - $ ............. .................................................... ............... ....... ........................... Premium............... I i ................................................... . .......................... .— ........ Fee - - ( SR � V ......... TOTAL ...... .............................. --- .................... ........................... l.�c/G��'d. C�J . tC�C/Gi0'L�Q� c.✓��C�Ic��GL�X ;'On Dwelling House and Attachments ................... ENDORSEMENT SLIP ........... ................. On Household Furniture, Provisions and Wearing Apparel ........... I ...... Farmers" Mutual IndemnItU fIssoGlatlon II'On Barn No. I .................. ............................. .............. .................. of Cayuga County. On Prodtie( ......................................... .. ............... .. . .............. On Farm I.Ttensils, Carriages, Sleighs, Etc........ On Horses, .................... On Cattle, $ .............. . ................................. NAME 11011 ............ ................ .................. .............. lk4r .....................SOLICITOR TOTAL........................................................... ......... ........ If/ e Policy No-..,6_,� �,......'7 k_ . . ....... ..... ........................ Consent is hereby -given to transfer personal property Date of Policy.....,.., ......... 191 to premises of.....,"t ........................... ................... Date of Entry..19 1 "J ................ Town of...-. ......... ........... ............... Cancelled............................................. Return Premium........ ...... ............................. ........................ .......................... .... ....... .............. _ ........... . Premium Fee ToTAT. i- ............................................... .................. ......................... .... ........................ $ ............... .......... ......... .. ...................... $ ............... ............. ......... ............ ...... ........ ......... ..... ....................... Polio this day assigned to Forbert C. Corbet and C.C.E"l-iza Corbeto Loss if anv on buildirigcs- payablv le to Fed TTI,. 1,ijes 1, mortj,,-agec. as Ilis interest. niay a-i-)pear* L Attached to and forming a part of Policy No. r)C)58[� Indemnity Association of Cayuga County, N. Y. L)4ted Jur. e 2 n(` 19 2 3 0 ATTACH THIS SLIP TO POLICY ENDORSEMENT SLIP Farmers'Mufual ndeninity Association of Cayuga County NAME....... ................ .. ................................ ..... ............ .. V .. ...............SOLICITOR . ....................................... . PolievNil.,.... ..... .................. Date of Poliev 191 Date of E, ntry....o, ... ...... 1".................... Cancelled................................................ 192 ...... Return Premium $ ............... preillitim $ --------------- Fee $ _ ............ TOTAL, $ 1 ......... ... issued by the Farmers' Mutual Secretary On Dwelling House and Attachments............ I ........ ........ On Household Furniture, Etc ................................ i ................. . Olt" On Barn No. 1'17. ............ OnProduce ........................................................... .................. On Farm Utensils, Carriages, Sleighs, Autos, Etc.....i .................. . I On Horses, .$ ....... On Cattle, $. . ............ .................. On..... ........................ . ....................... .............. J TOTAL... -t,4 .. . ......... v ........................ N .......................... .................... ...... I ......................... ........... I ....................... I ....................... .4 ATTACH THIS SLIP TO POLICY ENDORSEMENT SLIP Farmers' Mutual Indemnity Association of Cayuga County NAME ....r .:................ :::............................ Al .............. �,.r:' :�::,�.d:: f ...: ................SOLICITOR PolicyNo........., .... ...- :........................ Date of Policy .. ...... � .................. 44 1 Date of Entry. .. :............ t... ...193.4.:. Cancelled...............................................192..... . I Return Premium - $............... i jPremium , - - $............... Fee- - - - $............... TOTAL - $.......... ... I On Dwelling House and Attachments ..................... .•.••••..•..•••••• i OnHousehold Furniture, - Etc .................. ......4....... ................. OnBarn No. 1.................................................... .................. i i OnProduce........................................................ ................. On Farm Utensils, Carriages, Sleighs, Autos, Etc..... .................. i On Horses, $............... On Cattle, $.. ............ .................. i On................................................................... ................ TOTAL...................................................... ................. I I 0000 "° �.� .... .... ..............rr ;',°": ...... `' '"'� :", r "� . ............... .. ........ . .�z K. axa�� eXJC . �i'lJa��Q, c7�-cxe��za ATTACH THIS SLIP TO POLICY On Dwelling House and Attachments ..................... ............••••• ENDORSEMENT' SLIP On Household Furniture, Etc ................................ ................. v'_V J// 000©oo®Q On Barn No. 1.................................................... ................ Farmers' Mutual Indemnity Association On Produce........ ... .... .. • • • .. i ................................. of Cayuga County On Farm Utensils, Carriages, Sleighs, Etc ......................... ...... ------------- -- On Horses, $............... On Cattle, $.............. ................ NAME_ ... �:� " ..... .........r'.! . .... ........... . .......................................`.°.... "'+t' ..............SOLICITOR TOTAi;......... ........................ I................................. !....:..�'.............. Policy No ................. .....191 Date of Policy... t, ... • . • • • • -• ,............................................................ ......................... ........................ Date of Entry ...........:...... ....., ....191.... ',d �I %"{ I ..... ................. ............ ........ ... .......... ...... 4 Cancelled...............................................l.l.. - . �...................................................................................................... Return Premium $..... .... .............:......................................................... Premium Fee - - - TOTAL I ATTACH THIS SLIP TO POLICY ENDORSEMENT SLIP �.�. Farmers' Mutual Indemnity Association of Cayuga County NAME.. ' .' ::tp:: ..::...�' ."'.r.' . ........................ '`.� .SOLICITOR Polio No...... .............. / ................. I Date of Policy. "�r.:r' :. f'.......191'`... Date of Entry..... ........... ...... ... F 19` /.... Cancelled ...............................................19?.... . Return Premium - $•••••••••••••• Premium - - - Fee - - - - $............... $............... 11 TOTA1, - $.......... e�i✓ u�c�•GG� eX1� . �i�Ua�'L�Q, c/ �Cxe�ax2� On Dwelling House and Attachments ..................... .................. j I On Household Furniture, Etc ............................... ................, OnBarn No. 1.................................................... ................. OnProduce............................................................... ... ...... On Farm Utensils, Carriages, Sleighs, Autos, Etc............✓.~... On Horses, $... On Cattle, i.............. ... On..... ..................................... ... .....� .....� .. ................ TOTA&'.`°.Y::-�. ... �,'.,. .............. ........ ...................... ........ .. .. ........ ....... ..... .. .................. i -::? ..�:`:?................... ''! '.':'........................................ 0 ATTACH THIS SLIP TO POLICY ' On Dwelling House and Attachments. . ' ENDORSEMENTSLIP i On Household Furniture, Etc ............................... i ................. iOn Barn No. 1.................................................... ........... Farmers' Mutual Indemnity Association iOn Produce ........................................... ............. . ................. of Cayuga County On Farm utensils, Carriages, S)eighs, Autos, Etc.....!. ,or �'" / On Horses, $............... On Cattle, $............. ................ NAME....... ............. On ..... ..................................... ... ... .............. ....�................ "" ti t yP•" A%'. �'6 ... ' .. .. . , . ................... SOLICITOR Tom. :............w :.. , . d................ . i ......................................................................................... ............ Policy No. ....-.e'............ I Date of Policy ..................................192...... j ...................... I Dateof Entry. y',.,. .. . . . ............ .1 2 . ............................................................ ,............................................. . 1yCancelled ............................... �y.........................._...... I........... ................. .... ........ ........ ................... ................ i ReturhPremium- $......................................................................................................................... - - - .............................................................................................................. Premium $ ............... Fee.............. I ........................................................................................................... TOTAL, - $............... .; xa�� Cana, �7�ce�ax/ems i ATTACH THIS SLIP TO POLICY I On Dwelling House and Attachments ..................... ................. ENDORSEMENT SLIP I On Household Furniture, Etc ... ..... ...........................i ........... ��/j'/ O ^�. f�' �d `•d x-..Rr°'7.Iv �.�+„";; ``a..•�+.r^'.s..r'�L•Y: ! On Barn No. 1 ... ...... .... ...+.✓........ Farmers' Mutual Indemnity Association ! y ", ( On 1 Produce........................................................ I ................. •1• of Cayuga COC1rity I i On Farm Utensils, Carriages, S)eighs, Autos, Etc.....! ............ . . . . . . On Horses, $............... On Cattle, $.............. ................. 16TA1VIE ........ .........'''�.r'.'............ �� O ❑ t.... .......... ... ..... ................ allp ........................... ....................... SOLICITOR TOTAL.... .! a, :a.. Policy j ..... `.".................. t Date of Policy ....... ;,F. ...... ..................... 192 ...... Date of Entry . ,,,.��:`........al..s'...........19'. Cancelled ....:.................... ..................... 192-- , i Return Premium - $............... i Premium - - - $............... Fee - - - - $ .............. ,TOTAL - �............... �I I ATTAOi-1 THIS SLIP TO POLICY On Dwelling House and Attachments ................. ................: IIIENDORSEMENT SLIP On Household Furniture OnBarn No. 1..................................... ...... .................. Farmers' Mutual Indemnity Association OnProduce....................................................... ................. of Cayuga County On Farm Utensils, - s e, Carr�ag� .0 , Sleighs, Etc .............. .......... -- -- On Horses, $............... On Cattle, $............. ................. NAME...... ..................... ................... .............. ................ On................................................................. .......................................................:.............SOLICITOR TOTAL................................................. Policy No ....................... ............................. '" ........:.`. ` = .::'..i: f .s. :�:. .�:.. ` ...........................................�.... .:,:.... ...... 1 Dateof Policy ..................... .............191...... ....... ......................:....................................... ..... .......................... 1 Date of Entry ............................ ........... 191....... ...... .......... ........................ .................... ........... Cancelled...............................................191........... ...... ,......................... - ....................................... ........ ... ReturnPremium - $.................... .............. ........... 4......... ....... ................................... Premium- - - $....................................................................................... i................................... Fee- - - - I .................. ..................................... i TOTAL - $ ........ G