American Life Insurance and Trust Company (Incorporated April 9, 1850.) [Right margin of the page] No. 3704 Premium $16.20 Sum Insured $900 This policy of insurance witnesseth: the the American Life Insurance and Trust Company, in consideration of the payment of sixteen dollars and twenty cents, and of the further premium of sixteen dollars and twenty cents to be paid annually, hereafter, to wit: on the twenty third day of April in each and every year, always in advance, during the continuance of this Policy do assure the life of William slave of M. F. Vaiden of [blank] county of Charles City state of Virginia in the sum of nine hundred dollars for the term of five years from the date hereof. And the said company do hereby promise and agree, well and truly to pay or cause to be paid, the said sum insures, to M. F. Vaiden his executors, and administrators, within ninety days after due notice and satisfactory proof of the death of the said slave William. Provided always, and it is hereby declared to be the true intent and meaning of this Policy, and the same is accepted by the insured upon these express conditions; that in the case the said slave William shall without the consent of this Company, previously obtained and endorsed upon this Policy, die upon the Seas, or pass beyond the settled limits of the United States, or go to any locality South of the State, in which he or she now lives or pass to, or West of the Rocky Mountains, or enter into any military or naval service whatsoever, or be employed as an Engineer or Fireman in running a Locomotive or Steam Engine or as an Officer, or Brakeman upon a Rail Road, or as an Officer, Hand, or Servant on any Steam or other Vessel, or Raft, or as a Miner, or hand in any Coal or other Mine, or in the manufacture or transportation of gunpowder, or in case he or shall become so far intemperate as to impair his or her health, or induce delirium tremens, or shall die by his or her hand, whether sane or insane, or in consequence of a duel, or by a foreign invasion, or by an insurrection, or by the neglect, abuse or maltreatment of his or her owner, or any one to whom he or shall be entrusted, or shall be laboring under any chronic disease at the time of issuing this Policy, or shall be forced, permitted or entreated by his or her owner, or by the agent of the owner, to engage in any in any combat causing his or he death, or shall abscond or be kidnapped, or shall be engaged in any more hazardous occupation or employment that that mentioned in the proposals,or in any case of any previous insurance on the life of said slave, or of any subsequent insurance without the written consent of this Company, then this Policy shall be void, null, and of no effect.
And it is hereby Declared and Agreed, That if the Proposals, Answers and Declarations made by the said M F Vaiden and bearing the date the 23rd day of April 1858 upon the full faith of which this Policy is issued, shall be found to be fraudulent or untrue in any respect, or that there is any misrepresentation or concealment in said proposals, answers or declarations, or in case the said M F Vaiden shall not pay the annual premiums as hereinbefore mentioned, on or before the several days specified and appointed for the payment of the same, This this Policy shall be void and of no effect; and the payment made shall be forfeited to the Company. And it is also Agreed, That this Policy is not assignable, unless by the consent of this Company in writing, and the Insurance hereby effected shall be subject to the several conditions and regulations printed on the back hereof, so far as the same can be applicable, in the same manner as if the same respectively were incorporated in this Policy. This Policy shall not be valid until the actual payment of the Premium has been made in cash and receipted for at the bottom of this Policy by Chas R Bricken M.D. Agent for Richmond. Inn Witness Whereof, the President of the said American Life Insurance and Trust Company, on behalf of the Board of Trustees, has hereunto subscribed his name, attested by the Secretary, and caused the common seal of said Company to be affixed, at the Office in Philadelphia, this Twenty third day of April Eighteen Hundred and fifty Eight. [???]illfin President Attest, Jno C Sims Secretary Received Richmond April 23rd 1858 Sixteen Dollars Twenty Cents it being the first above named premium. C.R. Bricken Agent