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Insurance Brokers Association of Canada
FAMILY REC ROOM DINING ROOM
Article Replacement Cost Article Replacement Cost
Chair(s)
Table
Curtains, Drapes
Chair(s)
Chesterfield
China Cabinet
Table(s)
Buffet
Lamp(s)
Serving Table
Rug(s), Carpet(s)
Rug(s), Carpet(s)
Desk
Curtains, Drapes
Brick-A-Brac
Electric Appliances
CDS, DVDs, Tapes
Other:
Other:
TOTAL
$
TOTAL
$
BEDROOMS 1 2 3 4
Article Replacement Cost
Chair(s)
Bed(s)
Bedding
Night Table
Dressing Table
Bench
Chest of Drawers
Mirror(s)
Rug(s)
Lamp(s)
Bric-A-Brac
Toilet Articles
Clock(s)
Curtains, Drapes
Other:
TOTAL
$ $ $ $
