Insurance Artwork - Excel

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					              HOUSEHOLD INVENTORY - INSURANCE PURPOSES
Why you should complete a household inventory:
1. It can be difficult to remember what possessions you have and an approximate value of each item. when
they suffer a loss, due to fire, theft or other unfortunate event.
2. Completing an inventory will assist us in determining your policy provides adequate limits.

Tips for completing this household inventory:
1. Bring this inventory moving methodically from room to room in your home. It may be helpful to bring a
camera, video camera or audiocassette recorder along to assist in capturing the details of your items.
2. Remember to include items stored in closets, cabinets, drawers, or garage and the home exterior.

What to do when you have completed the household inventory:
1. Stored in a safety deposit box b} Complete this form and email it back to us c} stored it off site
2. Remember to update this inventory periodically. { Once every 3 years } .

                                                Living Room
      Item             Qty               Description        Where/When                 Purchase Price
                                                             Acquired
Floor Cover                                                                 $                                  -
Window Cover                                                                $                                  -
Light Fixtures                                                              $                                  -
Couch                                                                       $                                  -
Chairs                                                                      $                                  -
Coffee Tables                                                               $                                  -
End Tables                                                                  $                                  -
Lamps                                                                       $                                  -
TV                                                                          $                                  -
VCR                                                                         $                                  -
Stereo                                                                      $                                  -
Dvd                                                                         $                                  -
Video Tapes                                                                 $                                  -
CD                                                                          $                                  -
Bookshelves                                                                 $                                  -
Books                                                                       $                                  -
Desk                                                                        $                                  -
Clocks                                                                      $                                  -
Mirrors                                                                     $                                  -
Pictures                                                                    $                                  -
Artwork                                                                     $                                  -
                                                                            $                                  -
                                                                            $                                  -
                                                                            $                                  -
                                                                            $                                  -
                                 Total                          Living Room $                              -
             HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                          Dining Room
           Item         Qty    Model/Serial #           Description   Purchase Price

Floor Cover                                                     $                          -
Window Cover                                                    $                          -
Light Fixtures                                                  $                          -
Table                                                           $                          -
Chairs                                                          $                          -
China Cabinet                                                   $                          -
China                                                           $                          -
Silverware                                                      $                          -
Crystal                                                         $                          -
Tablecloths                                                     $                          -
Artwork                                                         $                          -
Liquor Cabinet                                                  $                          -
Liquor (wine)                                                   $                          -
                                                                $                          -
                                                                $                          -
                                                                $                          -
                              Total                Dinning Room $                      -
                                      Family Room / Den
      Item        Qty            Model/Serial #    Description        Purchase Price
Floor                                                           $                          -
Window                                                          $                          -
Light Fixtures                                                  $                          -
Couch                                                           $                          -
Chairs                                                          $                          -
Coffee Tables                                                   $                          -
End Tables                                                      $                          -
Lamps                                                           $                          -
Bookshelves                                                     $                          -
Books                                                           $                          -
TV                                                              $                          -
VCR                                                             $                          -
Stereo                                                          $                          -
CDs / Dvd                                                       $                          -
Videos                                                          $                          -
Video Games                                                     $                          -
Desk                                                            $                          -
Toys / Games                                                    $                          -
Pool Table                                                      $                          -
                                                                $                          -
                                                                $                          -
                                                                $                          -
                                                                $                          -
                                                                $                          -
                              Total                Familty Room $                      -
              HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                       All Halls and Front Foyer
            Item         Qty    Model/Serial #         Description          Purchase Price

Floor Cover                                                             $                        -
Window Cover                                                            $                        -
Light Fixtures                                                          $                        -
Credenza                                                                $                        -
Bench                                                                   $                        -
Tables                                                                  $                        -
Lamps                                                                   $                        -
Art                                                                     $                        -
Mirror                                                                  $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                                                                        $                        -
                               Total                   All Halls /Foyer $                    -

                                Total All Bathrooms Combined
     Item          Qty            Model/Serial #       Description          Purchase Price

Floor Cover                                                           $                          -
Window Cover                                                          $                          -
Light Fixtures                                                        $                          -
Medicine                                                              $                          -
Towels                                                                $                          -
Scale                                                                 $                          -
Small Appl.                                                           $                          -
Arts                                                                  $                          -
Mirrors                                                               $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                                                                      $                          -
                               Total                    All Bathrooms $                      -
             HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                      Kitchen
      Item       Qty      Model/Serial #        Description        Purchase Price
Floor                                                          $                        -
Window                                                         $                        -
Light Fixtures                                                 $                        -
Table / Chairs                                                 $                        -
Counter Stools                                                 $                        -
Fridge                                                         $                        -
Stove                                                          $                        -
Dishwasher                                                     $                        -
Microwave                                                      $                        -
Freezer                                                        $                        -
Coffeemaker                                                    $                        -
Toaster Oven                                                   $                        -
Small Appl.                                                    $                        -
Pots & Pans                                                    $                        -
Dinnerware                                                     $                        -
Cutlery                                                        $                        -
Other Utensils                                                 $                        -
Artwork                                                        $                        -
Cookbooks                                                      $                        -
                                                               $                        -
                                                               $                        -
                                                               $                        -
                                                               $                        -
                                                               $                        -
                       Total                      Main Kitchen $                    -
                                    Basement
      Item       Qty      Model/Serial #        Description        Purchase Price
Floor Cover                                                  $                          -
Window Cover                                                 $                          -
Light Fixtures                                               $                          -
Washing                                                      $                          -
Dryer                                                        $                          -
Workbench                                                    $                          -
Power Tools                                                  $                          -
Other Tools                                                  $                          -
Exercise Eq.                                                 $                          -
Sports Eq.                                                   $                          -
Luggage                                                      $                          -
Sewing Mach.                                                 $                          -
Christmas Dec                                                $                          -
Vacuum                                                       $                          -
                                                             $                          -
                                                             $                          -
                                                             $                          -
                       Total                        Basement $                      -
             HOUSEHOLD INVENTORY - INSURANCE PURPOSES

                               Garage / Outside Shed
      Item       Qty      Model/Serial #     Description       Purchase Price
Bicycles                                                   $                        -
Sports Eq.                                                 $                        -
Lawnmower                                                  $                        -
Snowblower                                                 $                        -
Vacuum                                                     $                        -
Garden Tools                                               $                        -
Lawn Furniture                                             $                        -
BBQ                                                        $                        -
Exercise Eq.                                               $                        -
Bicycles                                                   $                        -
Sports Eq.                                                 $                        -
Christmas Dec                                              $                        -
                                                           $                        -
                                                           $                        -
                                                           $                        -
                       Total                 Garage / Shed $                    -

                                   Bedroom One
      Item       Qty      Model/Serial #     Description       Purchase Price
Floor Cover                                               $                         -
Window Cover                                              $                         -
Light Fixtures                                            $                         -
Bed                                                       $                         -
Mattress                                                  $                         -
Bed Clothes                                               $                         -
Pillows                                                   $                         -
Dressers                                                  $                         -
Armoire                                                   $                         -
Night Tables                                              $                         -
Desk                                                      $                         -
Shelves                                                   $                         -
Shelf Contents                                            $                         -
Artwork                                                   $                         -
Lamps                                                     $                         -
Radio                                                     $                         -
Chairs                                                    $                         -
Telephone                                                 $                         -
Cosmetics                                                 $                         -
                                                          $                         -
                                                          $                         -
                                                          $                         -
                                                          $                         -
                       Total                  Bedroom One $                     -
             HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                  Bedroom Two
      Item       Qty      Model/Serial #   Description       Purchase Price
Floor Cover                                             $                         -
Window Cover                                            $                         -
Light Fixtures                                          $                         -
Bed                                                     $                         -
Mattress                                                $                         -
Bed Sheets                                              $                         -
Pillows                                                 $                         -
Dressers                                                $                         -
Night Tables                                            $                         -
Desk                                                    $                         -
Shelves                                                 $                         -
Shelf Contents                                          $                         -
Artwork                                                 $                         -
Lamps                                                   $                         -
Radio                                                   $                         -
Chairs                                                  $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                       Total                Bedroom Two $                     -
                                 Bedroom Three
      Item       Qty      Model/Serial #   Description       Purchase Price
Floor Cover                                              $                        -
Window Cover                                             $                        -
Light Fixtures                                           $                        -
Bed                                                      $                        -
Mattress                                                 $                        -
Bed Sheets                                               $                        -
Pillows                                                  $                        -
Dressers                                                 $                        -
Night Tables                                             $                        -
Desk                                                     $                        -
Shelves                                                  $                        -
Shelf Contents                                           $                        -
Artwork                                                  $                        -
Lamps                                                    $                        -
Radio                                                    $                        -
Chairs                                                   $                        -
                                                         $                        -
                                                         $                        -
                                                         $                        -
                                                         $                        -
                       Total               Bedroom Three $                    -
             HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                 Bedroom Four
      Item       Qty      Model/Serial #   Description       Purchase Price
Floor Cover                                              $                        -
Window Cover                                             $                        -
Light Fixtures                                           $                        -
Bed                                                      $                        -
Mattress                                                 $                        -
Bed Sheets                                               $                        -
Pillows                                                  $                        -
Dressers                                                 $                        -
Night Tables                                             $                        -
Desk                                                     $                        -
Shelves                                                  $                        -
Shelf Contents                                           $                        -
Artwork                                                  $                        -
Lamps                                                    $                        -
Radio                                                    $                        -
Chairs                                                   $                        -
                                                         $                        -
                                                         $                        -
                       Total               Bedroom Three $                    -

                                  Other Rooms
      Item       Qty      Model/Serial #   Description       Purchase Price
Floor Cover                                             $                         -
Window Cover                                            $                         -
Light Fixtures                                          $                         -
Hobby                                                   $                         -
Cameras                                                 $                         -
Collections                                             $                         -
Jewellery                                               $                         -
Computers                                               $                         -
Toys                                                    $                         -
Piano                                                   $                         -
Guitar                                                  $                         -
Other Music                                             $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                                                        $                         -
                       Total                Other Rooms $                     -
            HOUSEHOLD INVENTORY - INSURANCE PURPOSES
                                           Clothing

       Item      Person One   Person Two        Person Three   Total per Line Item
Coats            $            $                 $              $                     -
Jackets          $            $                 $              $                     -
Sweaters         $            $                 $              $                     -
Dress Shirts     $            $                 $              $                     -
Blouses          $            $                 $              $                     -
Dresses          $            $                 $              $                     -
Skirts           $            $                 $              $                     -
Dress Pants      $            $                 $              $                     -
Casual Pants     $            $                 $              $                     -
Jeans            $            $                 $              $                     -
Casual Shirts    $            $                 $              $                     -
Shorts           $            $                 $              $                     -
Suits            $            $                 $              $                     -
Ties / Scarves   $            $                 $              $                     -
Undergarments    $            $                 $              $                     -
Shoes            $            $                 $              $                     -
Boots            $            $                 $              $                     -
Raingear         $            $                 $              $                     -
Swimwear         $            $                 $              $                     -
Jewellery        $            $                 $              $                     -
Watches          $            $                 $              $                     -
Hats             $            $                 $              $                     -
Gloves           $            $                 $              $                     -
Belts            $            $                 $              $                     -
Accessories      $            $                 $              $                     -
Wedding Dress $               $                 $              $                     -
Formal Attire $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
              $               $                 $              $                     -
                              Total             Clothing       $                     -
            HOUSEHOLD INVENTORY - INSURANCE PURPOSES


                                   Grand Total Calculation

                             Rooms                                              Total Value
                          Living Room                                 $                       -
                          Dining Room                                 $                       -
                          Family Room                                 $                       -
                           Hall / Foyer                               $                       -
                         All Bathrooms                                $                       -
                             Kitchen                                  $                       -
                            Basement                                  $                       -
                         Garage / Shed                                $                       -
                          Bedroom One                                 $                       -
                         Bedroom Two                                  $                       -
                         Bedroom Three                                $                       -
                         Bedroom Four                                 $                       -
                          Other Rooms                                 $                       -
                            Clothing                                  $                       -
                           Grand Total                                $                       -

           Client Name :
          Client Address :
          Date Completed :


1. Keep a copy of this for your records at a location other than your home.
2. Email - info@sutherlandinsurance.com, fax 519-822-0698 or mail back to us.

* Be advised that the amount declared on your insurance contract for contents is arbitrary
* and if you complete this form and find that your contents limit is not adequate please
* contact us immediately.

				
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