Property Coverages
Pennsylvania
Name:
       Contact Person: 
Address:
City:
     State:     Zipcode: 
Phone:
      Fax: 
E-Mail Address:
Property Location:
Building Contents Stock & Merchandise Loss of Income Deductible
Value:  Value:  Value:  Value:  $ 
Replacement Cost:
Depreciated Value:		 Replacement Cost:
Depreciated Value:		 How long would it take you to get back in business after a loss? 

Building Information
Type of Occupancy                    Year Built: 
Construction: 
Ground Floor Square Footage
Second Floor Ground Footage
Basement Square Footage
Number of Stories:  Roof Type: 
List Types of Occupants: 
What's on the right side of building:
What's on the left side of building:
What's in the rear of building:
Burglar Alarm:
Fire Alarm:
Sprinklered:  Yes /  No

Ansul System:  Yes /  No
Mortgagee 1:
Name:
Address:
City:
 State:   Zipcode: 
Phone:
Fax:
Mortgagee 2:
Name:
Address:
City:
 State:   Zipcode: 
Phone:
Fax:

Building Updates
Heating System Updates:
 Year:    What was done? 
Plumbing Updates:
 Year:    What was done? 
Electrical Updates:
 Year:    What was done? 
Roof Updates:
 Year:    What was done? 

M c G R A T H   I N S U R A N C E   G R O U P

4170 William Penn Highway          Murrysville, PA. 15668-1890
(724) 327-8474             (FAX) (724) 327-7911
Toll Free: 1-800-977-2999             (FAX) 1-888-800-0034