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No. 965 $1500-

The Virginia Life Insurance Company Richmond 19th January 1864

This Policy of Insurance witnesseth: That the Virginia Life Insurance Company, in consideration of the sum of Eighty Six Dollars and Twenty give cents, to them in hand paid by J. R. Gates of ______ and of the annual premium of ______ Dollars ____ cents, to be paid on or before the ____ day of ______ in every year during the continuance of this Policy

Do assure the Life of Stephen a slave in Beaver Pit of Oliver Hill Coal Co., in the County of Chesterfield State of Virginia in the amount of Fifteen Hundred Dollars, from this day at noon, unto the Nineteenth day of January one thousand eight hundred and sixty five at noon,

And the said Company do hereby promise and agree to and with the said assured, his executors, administrators and assigns, well and truly to pay, or cause to be paid, the said sum insured, to the said assured his executors, administrators or assigns, within sixty days after due notice and proof to the death of the said slave Stephen.

Provided always, and it is hereby declared to be the true intent and meaning of this Policy, and the same is accepted by the assured upon these express conditions, that in the case the said slave Stephen shall, without the consent of this Company previously obtained and endorsed upon this Policy, pass beyond the limits of the State of Virginia or in case the assured shall have already any other insurance on the slave hereby insured, and not notified to this Company, and mentioned in or endorsed upon this Policy, or shall hereafter effect any other insurance upon the said slave without the consent of this Company first obtained and endorsed upon this Policy, or in case the said slave shall commit suicide, or shall die by means of any invasion, insurrection, riot or civil commotion, or of any military or usurped power, or by the hands of justice, or in case the party in whose name and for whose benefit this Policy is issued, his assigns shall be indemnified for the loss of said slave, by a common carrier or otherwise, this Policy shall be voice, null, and of no effect.

And it is also understood and agreed, to be the true intent and meaning of this Policy, that if the declaration made by the said R. R. Gates and bearing date the 19th day of January 1864, and upon the faith of which this agreement is made, shall be found in any respect untrue, then in such case this Policy is not assignable, unless by consent of the Virginia Life Insurance Company, manifested in writing. This insurance may be continued for such further term as shall be agreed on, the premium therefor being paid and endorsed on the Policy, or a receipt being given for the same.

In witness whereof, The Virginia Life Insurance Company have caused these presents to be sealed with their seal and signed by their President and Secretary, this 19th day of January in the year of our Lord one thousand eight hundred and sixth four