Safety & Loss Prevention
Business Interruption Worksheet
| 1. | Gross Sales | $__________ | |
| 2. |
Adjustments to gross sales (includes
discounts given, returns and allowances, bad debts, freight). |
$__________ |
|
| 3. | Net Sales (1 minus 2) | $__________ | |
| 4. |
Other income that would be lost
if operations were interrupted (includes rents, interest, service fees). |
$__________ |
|
| 5. | Total revenues (3 plus 4) | $__________ | |
| 6. | Merchandise or materials consumed | ||
| a. Purchases during the year | $__________ | ||
| b. Change in inventory | |||
| Beginning inventory | $__________ | ||
| Ending inventory | $__________ | ||
| Change (beginning
minus ending) |
$__________ |
||
| c. Total (a plus b) | $__________ | ||
| 7. | Gross earnings (5 minus 6c) | $__________ | |
| 8. |
Discontinuing expenses (includes payroll that
would not continue, rent, heat, light, delivery and cartage, advertising, maintenance cost). |
$__________ |
|
| 9. |
Gross Earnings After Discontinued Expenses (7 minus 8) |
$__________ |
Adjust Gross Earnings After Discontinued Expenses For Period of Interruption Expected
Insurance Needed
| 1 year: | Line 9 * 1.00 | = | $__________ |
| 9 months: | Line 9 * .75 | = | $__________ |
| 6 months: | Line 9 * .5 | = | $__________ |