SUMMARY

This summary page has been provided for you so that you can quickly reference purchase cost and replacement cost for all the rooms. You can print this form and store for your records.

Room Purchase Cost Replacement Cost
Living Room _____________________ _____________________
Entrance Hallways _____________________ _____________________
Dinning Room _____________________ _____________________
Family Room _____________________ _____________________
Kitchen _____________________ _____________________
Basement / Shed / Garage _____________________ _____________________
Bathroom _____________________ _____________________
Bathroom No.2 _____________________ _____________________
Master Bedroom _____________________ _____________________
Bedroom No.2 _____________________ _____________________
Bedroom No.3 _____________________ _____________________
Miscellaneous _____________________ _____________________
TOTAL _______________________

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