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Insurance Brokers Association of Canada
BATHROOM 1 VERANDA OR PATIO
Article Replacement Cost Article Replacement Cost
Curtains Chair(s)
Floor Mats Dining Set
Bric-A-Brac Sofa
Electric Appliances (hair
dryer, shaver, etc.)
Glider
Other: Table(s)
Outdoor Cooking
Equipment
Barbecue
Other:
BATHROOM 2
Curtains
Floor Mats
Bric-A-Brac
Other:
TOTAL
$
TOTAL
$
OTHER ROOMS OTHER ROOMS
Article Replacement Cost Article Replacement Cost
TOTAL $ TOTAL $
