Flood Insurance  for Pennsylvania

Building Replacement Value	Building Insured Value	Number of Floors One Floor Two Floors Three or More Floors Split Level Manufactured/Mobile Home	Building Deductible $ $ 1,000 $ 2,000 $ 3,000 $ 4,000 $ 5,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 50,000	Contents Amount Location of Contents: Not applicable Basement/Enclosure/Crawl Space and above Lowest Floor Only above basement Lowest Floor above Ground Level & Higher Above Ground Level More than One Full Floor	Contents Deductible $ $ 1,000 $ 2,000 $ 3,000 $ 4,000 $ 5,000 $ 10,000 $ 15,000 $ 20,000 $ 25,000 $ 50,000
Foundation Slab on Grade Basement Below Grade Crawl Space Split Level Slab on Grade Elevated without Enclosure Elevated with Enclosure Walkout Basement Above Grade Crawl Space Split-Level Basement

Occupancy

Single Family Dwelling

2-4 Family Dwelling

Other Residential

Commercial

Is the building in the course of construction?	Yes	No
Is the building over water?	Not over waterPartially over waterEntirely over water
Is this your primary/principal address?	Yes	No
Number of Units in building?	Units:
Building Use	Main HomeMain BuildingDetached Guest HouseDetached GarageAgricultural BuildingWarehousePoolhouse, Clubhouse, Other Recreational BuildingTool or Storage ShedOther
Building Purpose	100% Residential 100% Commercial (No Residential use) Mixed Use (Residential & Commercial Percentage of Residential Use: %
Condo Form of Ownership:   Condo Description: Not a condo High Rise Low Rise Residential Condo Unit Non-Residential Condo Unit	Yes	No
Business Property? A Business Property is a Non-residential building that produces income, or a building designed as office or retail space, or for wholesale, hospitality or similar uses.	Yes	No
Additions & Extensions Coverage: The NFIP insures additions and extensions attached to and in contact with the building by means of a rigid exterior wall, a solid load-bearing wall, a stairway, an elevated walkway, or a roof. At the insured's option, additions and extensions connected by any of these methods may be separately insured. Additions and extensions attached to and in contact with the building by means of a common interior wall that is not a solid load-bearing wall are considered part of the building and cannot be separately insured.	Building does not have additions or extensions Coverage is for main building and additions and extensions Coverage does not include additions and extensions Coverage is for additions and extensions only
Severe Repetitive Loss Property:	Yes	No
Rental Property:	Yes	No
Is the insured the tenant (if rental property)?	Yes	No
Machinery or Equipment servicing the building located in the Basement?	Yes	No

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