Automobile Policy . Number ---------

The X. Y. Company Of

(Hereinafter called the Company)

In consideration of the premium and the representations of the Assured hereinafter set forth and made a part of this contract hereby agrees to indemnify the person, firm or corporation named in the Schedule, hereinafter called the Assured,

Against loss from the liability imposed by law upon the Assured for damages on account of bodily injuries, including death, accidentally suffered by any person or persons not employed by the assured, by reason of the ownership, maintenance or use of any automobile enumerated in the Schedule, for the purposes hereinafter described, during the period hereinafter stated or any continuance thereof by renewal.

A. If the use specified is Private and Pleasure, it shall include ordinary business purposes except the carriage of passengers for a consideration express or implied, or demonstrating, or testing, or the transportation of materials or merchandise. If the specified use is Commercial, meaning an automobile used for transportation of materials or merchandise, it shall include the loading and unloading of materials or merchandise carried on the automobile.

B. This policy shall not apply to injuries sustained while any automobile is let out for hire; is driven in any race or competitive speed test, or by any person under the age affixed by law or under the age of sixteen in any event; outside the confines of the United States, Canada or Mexico; nor shall this Policy apply to any Workmen's Compensation Agreement, Act, Plan or Law.

C. In addition to the limits stated the Company will, at its own expense, investigate, defend or settle in the name of and in behalf of the Assured, any claims, demands or suits on account of injuries, including suits alleging injuries and demanding damages, although the claims, demands or suits are wholly groundless, fraudulent or false, and will pay all costs taxed against the Assured and all interest accruing on such portion of a judgment as shall not be in excess of the Company's limit of liability as herein expressed, rendered on account of any claim covered hereunder.

D. Upon the occurence of an accident, or notice of any claim, the Assured shall give immediate written notice thereof to the Company or its duly authorized Agent. If suit is brought, the summons or other process shall be immediately forwarded to the Company. The Assured shall, when requested, aid in effecting settlements, securing evidence, the attendance of witnesses, and in prosecuting appeals. The Assured shall not, except at his own cost, incur any expense, assume any liability, or interfere in any negotiation or legal proceeding without the written consent of the Company previously given, except that the Assured may provide, at the Company's expense at the time of any accident covered hereunder, such immediate surgical relief as may be necessary.

E. No assignment of interest under this Policy shall bind the Company unless its consent shall be endorsed hereon.

F. If the Assured carries a Policy with any other Insurer covering concurrently a claim covered hereunder, he shall not recover from this Company a larger portion of any such claim than the sum hereby insured bears to the whole amount of all valid and collectible insurance.

G. The Company shall be subrogated in case of any payment under this Policy to the extent of such payment to the Assured's rights of recovery thereof against others.

H. This Policy may be cancelled at any time by either of the parties hereto upon written notice to the other party stating when thereafter cancellation shall be effective and the date of cancellation shall then be the end of the Policy Period. If such cancellation is at the Company's request, the Assured shall be given five days' written notice of same and the earned premium shall be computed and adjusted pro rata. If at the Assured's request, the earned premium shall be computed and adjusted at short rates in accordance with the table printed hereon. Notice of cancellation mailed to the address of the Assured herein given shall be sufficient notice and the check of the Company -similarly mailed a sufficient tender of any unearned premium.

I. No provision of this Policy shall be waived or altered except by Rider attached, signed by an Officer of the Company.

J. The Company's liability for the indemnity provided herein is limited to the amounts and as expressed in the Schedule, which limits shall apply to each automobile covered hereunder.

K. The statements in the Schedule hereinafter contained are represented by the Assured to be true. This Policy is issued in consideration of such representations, the provision of the policy respecting its premium and the payment of the premium in such Schedule expressed.

In witness whereof, etc.

E. F., Secretary. C. D., President,

By G. H., Authorized Agent.

CLAUSES HEREIN LISTED ARE ATTACHED TO POLICY AND COVERAGE EXTENDED ONLY AS PREMIUM CHARGE IS MADE IN SCHEDULE AND THE ENDORSEMENT COUNTERSIGNED BY AN AUTHORIZED AGENT OF THE COMPANY $1000.00 Property Damage - (Covering Damage to Property of Others)

No. 1. In consideration of an additional premium of --------Dollars ($--------) and subject to all its terms and conditions, this Policy also agrees to indemnify the Assured against loss or expense arising from claims upon the Assured for damage to or destruction of property of every description (except property of the Assured, or in charge of the Assured, or any of the Assured's employes or carried in or upon any automobile covered by this Policy), arising from an accident occuring while this endorsement is in force.

In consideration of the premium at which this Policy is written, it is understood and agreed that the Company's liability under this Policy is limited to the value of the property damaged or destroyed at the time of its damage or destruction, or the cost of its suitable repair or replacement.