Fillable RELIGIOUS ORGANIZATION INVENTORY SURVEY (Philadelphia Insurance Companies)

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RELIGIOUS ORGANIZATION INVENTORY SURVEY (Philadelphia Insurance Companies)

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RELIGIOUS ORGANIZATION – INVENTORY SURVEY
Applicant Name:
CATEGORY
VALUE
FURNITURE
Sanctuary chairs (excluding attached pews)
$
Unattached blackboards
$
Unattached carpeting and rugs
$
Unattached chairs, desks, and tables
$
Unattached cupboards and cabinets
$
OWNED MUSICAL INSTRUMENTS
Free-standing organ/ keyboards
$
Pianos
$
Bells/ free-standing chimes
$
ELECTRONICS
Calculators
$
Overhead projectors and screens
$
Radios and televisions
$
Radio broadcasting equipment
$
Sound and video recording equipment
$
Stereo equipment
$
Tapes, records, and compact discs
$
OFFICE EQUIPMENT
Computers (entire system including hardware, software, etc.)
$
Major phone system
$
Printers and photocopy machines
$
Telephones and fax machines
$
Maps and globes
$
Files and filing cabinets
$
OUTDOOR EQUIPMENT
Lawn and snow equipment
$
Sports equipment
KITCHEN
Carts and trays
$
Coffee makers, mixers, and toasters
$
Dishes and silverware
$
Pots and pans
$
Pressure cookers
$
FURNISHINGS
Altar furnishings
$
Artwork
$
Bible
$
Books
$
$
Religious Organization
Inventory Survey
Page 1 of 2
© 2018 Philadelphia Consolidated Holding Corp.
11/2018
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CATEGORY VALUE
FURNISHINGS (continued)
Choir music
$
Choir robes and vestments
$
Christmas decorations
$
Communion service items
$
Draperies
$
Gas/ electric fireplaces/ space heaters
$
Hymnals
$
Indoor plants
$
Lamps
$
ITEMS OF PRECIOUS METALS (GOLD, SILVER, ETC.)
Communion set of gold or silver
$
Statuary/ icons
$
OTHER TOOLS AND EQUIPMENT
Unattached gymnasium and playground equipment
$
Paint supplies and ladders
$
Mops and brooms
$
Cleaning compounds and waxes
$
OTHER VALUABLES
$
$
$
$
$
This inventory survey is offered to assist in establishing adequate property values for insurance purposes. It is not
offered as legal, accounting, or professional advice. It is intended as a guide that you can use together with others at
your disposal to establish values you wish to insure. Because this relies on information provided by the insurance
purchaser, no representation is made with respect to accuracy, adequacy, or suitability of the values established.
Philadelphia Insurance Companies will not assume any liability by reason of this information; the values determined using
it, or the insurance buying decisions made as a result. You should review with your insurance agent/ broker in
determining the property values you wish to insure.
COMPLETION OF THIS INVENTORY SURVEY DOES NOT GUARANTEE ACCEPTANCE OR AGREEMENT OF ANY
TERMS OR CONDITIONS.
SIGNATURE SECTION
NAME (Please Print/Type) TITLE
(Must be signed by the President, Chairman, CEO or
Executive Director)
____________________________________________________
SIGNATURE DATE
SECTION TO BE COMPLETED BY THE PRODUCER/ BROKER/ AGENT
PRODUCER AGENCY
(If this is a Florida Risk, Producer means Florida Licensed Agent)
PRODUCER LICENSE NUMBER
(If this a Florida Risk, Producer means Florida Licensed Agent)
ADDRESS (Street, City, State, Zip)
Religious Organization
Inventory Survey
Page 2 of 2
© 2018 Philadelphia Consolidated Holding Corp.
11/2018
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RELIGIOUS ORGANIZATION INVENTORY SURVEY (Philadelphia Insurance Companies)

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Completed 29 July 2020

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