01/01/1964- SERVICE AGREEMENT,*
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THIS AGREEMENT, made thisIIA
i.., f.......... day of tj;:.,X.......................... 19PL by and
between The Fidelity and Casualty Company of New York, a corporation of the State of New York
having -its principal place of business at 80 Maiden Lane, New York 38, New York hereinafter.called
theCompany S:h:Jfc,=..................................................................
(name)
!t~v .1 •l��.r„ :a7 s ��<,�l..J�.�.►:; ..
(1'osi OfEtcc A dress}�........................................................
an individual acting in the capacity of an independent contractor, herein called the Contractor.
WITNESSETH:
That the Company does hereby engage the Contractor to perform certain services as independent
Contractor as follows:
To service insurance vending machines located ... .Y....'e.4reT.. �F .h.T.uz aw, P. P. I.T..............
......................................................................................................................................................................................
Servicing shall consist of (a) removing coins and the Company's record copies of policies from such
machines and placing printed policy forms therein, all as often as may be required to insure the con-
tinuous operation of the machines; (b) promptly correcting paper jams and other minor malfunctions;
(c) promptly notifying the Company of serious malfunctions; (d) not later than the fifteenth day of each
month forwarding to the Comlrany's Travel Insurance Department, 141 Livingston Street, Brooklyn 1,
New York, express collect, the Company's record copies of policies sold in the machines during the
preceeding month; and (e) not later than the fifteenth day of each month, or more often if requested by
the Company, remitting by mail to the Company's Travel Insurance Department, 141 Livingston Street,
Brooklyn 1, New York, in the manner prescribed by the Company, the proceeds of all moneys deposited
in said machines since the previous remittance less only .........1.O.C•0...................
per month, vokielievw, is Lposager, as full compensation for the services performed hereunder.
Contractor agrees, if requested by the Company, to furnish the Company a surety bond guarantee-
ing the faithful performance of this agreement in such amount and in such form as required by the Company,
it being understood that the Company shall pay the premiums for such bond and renewals thereof.
This contract is not assignable by either party without the written consent of the other, but if
Contractor is temporarily unable to perform the work required hereunder, he shall at his own expense
and responsibility arrange for it to be done for him by others. In all such cases Contractor shall remain
liable to the Company for the safe transmittal to it of all money deposited in the machines and for the
proper disposition of blank policies, record copies of policies and other property entrusted to him. Such
other persons shall not become contractors with or employees of the Company and the Company shall
be under no obligation of any kind to them.
Contractor shall assume full responsibility for payment of, all Federal, state and local taxes or
contributions imposed or required under unemployment insurance, social security and income tax laws,
with respect to Contractor and all other persons engaged in performance of the contract.
Either party may terminate this contract at any time by giving written notice thereof to the other
stating when such cancellation shall be effective and the contract shall terminate at that time. Such
notice to the Company shall be mailed to the Company's Travel Insurance Department, 141 Livingston
Street, Brooklyn 1, New York. Such notice to the Contractor shall be mailed to him at his address as
shown herein. Delivery of such written notice either by the Company or by the Contractor shall be
equivalent to mailing.
IN WITNESS WHEREOF the parties hereto have caused this contract to be executed as of the
above date, but this contract shall not be valid unless signed by an officer of the Company.
THE ID' .L lY AND CASUALTY COMPANY OF NEW YORK
•,I, 0-:�J'ZtJJb( VItcis::T
(/ (Title) j! /
—( ontrectot)
ATD 111 Printed In U.S.A.