The Company's liability under this indorsement for loss on account of any one accident is limited to One Thousand Dollars ($1,000.00).

The company, will, however, in addition thereto, at its own expense, defend in the name and on behalf of the Assured all suits brought to enforce such claims whether groundless or not.

The limit of the Company's liability as herein described shall apply to each of the automobiles covered by this Policy.

Nothing herein contained shall vary, alter or extend any condition or provision of the within Policy, except as hereinbefore stated.

American Bonding and Casualty Company.

Countersigned at --------, this -------- day of --------, 19-, by G. H., [Authorized Agent. ]

Collision "Damage Sustained" Clause - (Full Coverage)

No. 2. In consideration of an additional premium of -------- Dollars, this

Policy also covers, subject to its other conditions, damage to the automobile and (or) equipment herein described (each accident being deemed a separate claim), by being in accidental collision, during the period insured with any other automobile, vehicle or object, excluding (1) loss or damages to any tire due to puncture, cut, gash, blowout or other ordinary tire trouble, and excluding in any event loss or damage to any tire unless caused in an accidental collision which also causes other loss or damage to the insured automobile, (2) loss or damage while the automobile insured is being operated in any race or speed contest or while being operated by any person under the age of sixteen years or under the age limit fixed by law.

Excluding loss or damage caused directly or indirectly by fire.

It is hereby mutually understood and agreed; that:

In the event of damage to or the destruction of any automobile covered hereunder, the nature and extent of the damage requiring repair or replacement may be determined between the parties hereto, if possible; otherwise, by two appraisers, one to be chosen by the Assured, and one by the Company. The two appraisers so chosen, if they are not able to agree, may select a third, and the award in writing of any two of the appraisers shall determine the nature and extent of the damage requiring repair or replacement. The Company and the Assured shall pay the appraisers respectively selected by them, and shall bear equally the other expenses of the appraisal and of the third appraiser if one is selected. The Company may accomplish such repair or replacement so determined by such means as it may elect, and retain all salvage, or, at the option of the Company, pay in money the amount of the loss as fixed by the appraisers.

The Company shall have reasonable time and opportunity to examine any damaged automobile or its equipment covered hereunder before repairs are undertaken or physical evidence of the damage removed; but the Assured shall not be prejudiced hereunder by any act on his part or in his behalf undertaken for the protection of salvage of the damaged automobile or its equipment.

In the event of loss or damage to said automobile, whether such loss or damage is covered by the Policy or not, the liability of this Company for loss or damage resulting from collision in accordance with the terms of this endorsement shall be reduced by the amount of such loss or damage until re-pairs have been completed, but shall then attach for the full amount as originally written without additional premium.

Subject otherwise to all conditions, agreements and limitations of the policy as written, except as herein specifically provided.

American Bonding and Casualty Company,

A. B., President.

Countersigned at --------, this -------- day of --------, 19-, by G. H., [Authorized Agent.]

Additional Assured - Endorsement

Effective --------. Not valid unless countersigned by a duly authorized agent.

It is agreed - while any automobile covered by this policy is being used with the express or implied consent of the Assured named in the Policy or of an adult member of said named Assured's household who is not a chauffeur or domestic servant - that, any insurance granted by the Policy shall in addition to the said named Assured, inure to the benefit of any person riding in said automobile as well as to the benefit of any person, firm or corporation responsible for the operation of said automobile.

Subject otherwise to all conditions, agreements and limitations of the policy as written, except as herein specifically provided.

Attached to and forming part of Policy No. --------, issued by American

Bonding and Casualty Company to -------- of --------.

A. B., President.

Countersigned at -------- this -------- day of --------, 19-, by G. H., [Authorized Agent.]


By the acceptance of this Policy the Assured makes and represents to be true each of the following Statements, except such as are declared to be matters of estimate only.

Statement 1. Name of Assured: --------.

Statement 2. Address of Assured: -------- [street and number, city or town, county and state]. Statement 3. The Assured is: -------- [individual, co-partnership, corporation, trustee or estate].

Statement 4. The Assured's business or occupation is: --------.

Statement 5. The automobiles are principally used and kept in the location named in Statement 2, except as follows: --------.

Statement 6. The automobiles covered by this Policy, the purposes for which they are to be used, and the premium charge for same are as follows:


CAR No. 1

CAR No. 2

CAR No. 3

CAR No. 4

Trade Name of

Automobile .

Factory Number of Engine or motor

List Price


Horse power









Model of Car (Catalog No or letter)

Year of Model

Style of Body

Only Purpose for Which Automobiles are to be Used

Statement 7. None of the automobiles herein described are rented to others or used to carry passengers for a consideration, actual or implied, except as follows: --------.

Statement 8. No claims have been made for bodily injury or property damage caused .by any automobile driven by or for the Assured, except as follows: --------.

Statement 9. No company has refused to issue or renew, or has cancelled any automobile insurance of the applicant during the past three years, except as follows: --------.

Statement 10. The Policy Period shall be -------- months, beginning on the

-------- day of --------, 19-, at noon, and ending on the -------day of --------, 19-, at noon, Standard Time, as to both dates at the Assurer's address set forth in Statement 2.

Statement 11. The Company's Limit of Liability for one person injured shall be five thousand dollars ($5,000.00), and subject to that limit for each person the Company's total liability on account of any one accident injuring more than one person shall be limited to ten thousand dollars ($10,000.00).

Notice To Assured

This Policy extends coverage only for the following forms for which a premium is charged.


PREMIUM $...............

Property Damage

For $1,000 collision damage to property of others at par Clause No. 1. printed on Page No. 2


Collisioni (Full Coverage)

For collision damage sustained (Full coverage) at per Clause No. 2, printed on Page No. 2


Deductible Collision

End No.


Total Premiums


endorsement - right of action against company

No action shall be brought against the Company under or by reason of this Policy unless it shall be brought by and in the name of Assured for a loss, defined hereunder, after final judgment has been rendered in a suit, described hereunder, and within ninety days from the date of such judgment, to-wit: for loss that the Assured has actually sustained by the Assured's payment in money - (a) of a final judgment rendered after a trial in a suit against the Assured for damages; (b) of the expense (excluding any payment in settlement of a suit or judgment) incurred by the Assured in the defense of a suit against the Assured for damages. The Company does not prejudice by this condition any defense against such action that it may be entitled to make under this Policy.

---------, President.

See references under Sec. 3870.