Document YGEMmYL5pm4KE83nw4XrQGeyk

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METROPOLITAN LIFE INSURANCE COMPANY Croup Polity No____?JZ^'beariuc dare 1UIBZSTOS - HAHBATTaJi, me. tereby amended as follows: ___and injuring the Employee! of Effective Harsh 1, 1956 aa to laploveea at Kanheix, Penneylv*ala eetivelv at rork oa that date and each Ihpleyee* eaplovad subsequent to tut data, effective on the date of his return to active' work aa to any aueh Eapioyet not actively at work on March 1, 1956, and effective March 1, 1956 as to all other Employees, by substituting for tba Schedule of Insurance and Esployaa,> Kudus Contributions, aa aaerded, in Soetlea 6 on Page 2a of said Croup Poliey, the following; '&u Inploytea ef a elass or nit specified la Schedule A hereof, ezeept such tapleytea at Hecnah, Wisconsin Ufa Insurance $4,000.09 Accidental and Health Insurance (Weekly Benefit)* $28.09 Baploysaa st Baensh, Vlaecnaln 3,030.99 28.09 Bepleyees at Manhsla, Pennsylvaala with weekly earnings (aa datemined by the Eapleyer] ef: $50.0} or acre less than $50.00 teployess of General asbestos and Rubber Division 3,009.99 3,090.09 2,009.99 35.09 31-50 20.00 All other &pleyeas 2,000.99 28.00 *86 Aeeident and Health Insurance Is provldsd hereunder for any toployees employed la Dev Jersey. Any Baplcyee explored in Hew fork State who dose sot sake written request for Life Insurance horounaer shall bo Insured heraader for Accident tad Health Insurance only. The aaeuat ef Ufa Insurance as to any Zbplovee of (i) Manhattan lubber Division, (11) Vsbaah Division, or (ill) Sonersl Asbvrtos end Bobber Division retired oa or subsequent to (1) October 15, 1951, but prior to the data specified in the next following santaaea, (11) September 22, 1952, or (ill) January 2, 1953, rsspectlvsly, shall be $1,090.90. for the Manhattan Subbsr Division, tha Mount of Ufa Inauronoo aa to (1) Salaried bployeee, other than Duplcrreea on tba Mala Office Payroll, and Bepleyees eubjset to the Bargaining Agreement between Manhattan Rubber Worker* Independant Onion, Inc., (11) Deployeel vbo are nonbers ef Manhattan lodge 1679, Zntonatloaal Association of Machinists, and (ill) Mala Office Payroll tpleyesa retired on or subsequent te (1) October 28, 1955, (U) Heveaber 25, 1955, or (111) January 1, 1956, respectively, shall be 501 of the aasuht ItlllAe9C HltM I*. 37 1 ( t PLAINTIFF'S EXHIBIT a L .: ' r rV--`STs-*'*' AHHliralura b Mr made.' ^ Mmo?oirriii lots msmuirc^jo:IMPART (or a Croup Policy os*eria the elirihk tettora (* bdowi of ^ Main address ol Eiuployei- ib. __ niEJLXo* ciiiji tkc ixrunruu Natare of businessSisuhnun dp Tsui "Essrurrsa"--The tcm "Employees." as used harem. (ball be deemed la include--BO lx-------- -nd_jaUl*t_airJl*isn_RX_ina,,a5-.iaijrj_________________ Iucthutt--AH preseat Employees who have completed____________ macthe cI coatmaeus service than be tlifible tor bauaoct on the data of cue of the Policy. All ether presentand new Employees shall be eHfible far iasurtace upon the complelioo of ,, .Arte--..... - .months of coatlauous service. SCHEDULE OP SEMTm AX1> EMrtOYTET COWTJtlStmOHS 0-- -- -----------------TM _iisiniLrjil^at>iir,s.s_*_Av.tekrf__u.i viiun |.^S^WTS^io==Si^^ Bipmimi' Cwmmmi S rae*. pry Isplojrsss UKUtlvu. *rt;n :soo 1000 kort 1 it,JO i ! 13.JO !............................... .. . m m J,20..eoll/ --------------- for*n*n 1 S**utl*** loon I * in.nn j .. Of . duly 1, 10J 3 1000 [ . ............ n>lovo not ctWtir wt #i>r< <rn jcetuai df ltfcn3j i lnjiar|r k*xetn; tn to^lfey** *bo dOBilun) *n thJ *rfr*.lv* dut* ____U_rsiry.d_nl.u_0f_.v.l.V;.9Mrr,, of thic ool ley, eft* liu jr xl ____U.W 0_8..U.tJJ.tJiW '.*.1.51-1.>.s.... ri..luVSi oX_Jua.e. si .ltdT,jolley .i .. .1 04b*<; hsurlaj or policy lOSl-lii! baurlrt! dots.of Audiat 11. ... dot* of. Soeesfcer si, IBii. 9*6 on the dty 1 tc tne as aunt! for shies basil iaaursd msi such eollcloa |t . n...vfb.,4<ur.,0Btf, KkM..eBaf.. agi-jniU,.frt .iUjc.raUjamA aac1 il rat am n,,j 1 * i1 hrtrin- dute of 3e;oelr .1 . Iful .ns -lit..- itti-H te-rlar oi.t of ,lu r rt 11. 153C. onlOi ure to 1- one ell.,- Il.B.*rsX* 1_AiaflAOfi. -lUKSMJOkJiZ_________ ?ft-. I I >- ) 31V ! '. ; j , 1 It ia understood and ogre*'ll that. u Life Iimrtaaee is applied For, tba Employee'* contribution (or tueh insurance shall not eggtd-_fl i j- ^ 1 -...... ~pcr.......... ii c.lL. .. . . per $1,000 of Life laser 'ixr. It is understood end eenxd that if Temrorm^r Disability Tonranee is applied (or, the benefits win begta oc the ---------eighth-------- day of disability end wQl eeciiirue (or e period of disability notmoriing----------i^lglnan....------------ weeks, for any one disability, end ehell_<_U_w__*i_M__U_T__r _X_X_j *.- payable on account o( disability (rem injury or occupational disease arising oat of, or fai the course uf, any employment (or ware nr profit, except .1^1..i wr.-.r^ij^e;^..A ACklCd.JklL~^...... mv-fcr.iuy-nc u. .ctout of at-iaHii-.. iy,a?j^rA-M' *1''i'; Lr;-'-1-- * -r ' : - - -fy **r`i.*i :tr 3a* *Tw Intirmnce herein applied for ia not to replace, aor is it in to, any Croup Coverage or Wholesale tosuruae now or previously in (oree in this or oay other Company on any persona eligible (or this insurance, except: Name of Insurance Company____ __..................................................................................................... --............---....... .. Coverage^..Li ............Date of discontinuance.......................................... .......... ................................'. h is agreed that d the r.mpU.ys are tn eomribuic w*ward the initial cost, the roliey will aot bccranc effective until at least 7S per cent. o( all eligible Empiwycce have made written application lor insurance ibcreuadcr, but in no oaoe shall the Policy. if iaued, be effective prior to Use...........................day af-------------- Jluly._.......... .......... toll. Premiums will be paid.____^ It Is orreed that nereteary particulan concerning Kuiptoyccs tn be insured immetlately or ia tho future, and Employee wheat mauraace ia to be changed nr discontinued. suafl be (umiahed monthly to the Insurance Company on forms provided by it. Dated oy^atauic__ . ------ .^.sa^rAr://- i 0.4lff;w. mi- * tlu,_______ iiil r f*T *t___ Juna. .19.13 sr* rtmm Iti