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Valued Inventories
For Household Goods & Motor Vehicles

(Page 1 of 5)

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Your E-Mail Address (required):
Insured:
Origin City, Country:
Date:
Destination (Complete Address):
Moving By? Land Sea Air
IMPORTANT - Please read carefully the notes below:
(i) It is re-emphasized that the full replacement value of the goods at destination must be declared as the policy is subject to average and you will have to bear a proportionate part of any loss or damage to articles not insured for their full replacement value. Please remember that replacement value at destination may be more than in the country of origin.
(ii) Any item valued over $1,000 must be declared separately in the schedule and the value stated, e.g. antique table $1,600, piano $5,000. Items not declared will be deemed to have a value not greater than $1,000. These values will be aggregated with items valued under $1,000 to give the total value to be stated in the schedule. 
(A) ELECTRONIC COMPONENTS
Article No. of Items Value   Article No.
of
Items		 Value
Television(s)   Home Computer/PC
Software   Proj. Screen TV
Stereo Amplifier   Stereo Tuner
Cassette
Player/Recorder		   Video Camera
VHS Video Recorder/Player   CD Player
Turntable   Video Game Unit
Video Games Assorted   Record Albums
Pre-Recorded Tape Cassettes   Pre-Recorded Video Tapes
Blank Tapes - Cassettes   Compact Disks
Speakers   Clock Radio/Alarm
Washing Machine   Dryer
Refrigerator   Dishwasher
Cooker   Microwave
Food Processor  

You can rely on Reliable.
Other Electrical Items:
 
 
 
Electrical Items Total  $

Please make a note of the Electrical Items Total, click "Submit", and continue to the next page.

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Reliable Van & Storage Co., Inc.
550 Division Street, Elizabeth, New Jersey 07201 US
Phone 800.242.6102 or 908.352.5300  Fax 908.352.9833 Email info@reliablevan.com
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