HUD 5460 Insurance Information

Public Housing Capital Fund Program

HUD 5460 burden statement and accessibility compliance corrected 2 26 2020

Public Housing Capital Fund Program

OMB: 2577-0157

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Insurance Information

U.S. Department of Housing
and Urban Development
Office of Public and Indian Housing

OMB Approval No. 2577-0157 (exp. 3/31/2020)

Project Name

Project Number

Project Location

No. of Dwelling Units

Name & Title of Person submitting this information

Date

1. Fire and Extended Coverage

C. Classify all buildings according to both the arrangement of stories and the

A. Describe items listed below by thickness & material used in construction.
1. Exterior Walls:

Non-bearing

Load bearing
Thickness:

2. Interior Partitions: Thickness:

number of dwelling units. Enter in column 1 the number of buildings of each of
these types. Mark those without basements "X", mark those with group
heating plants in basement "H", mark those with a sprinkler system installed
"S". In column 2 enter for each type of building listed in column 1 the number
of units under each story level. In column 3 enter the number of units between
fire walls for each type of building, such as (2-4-2).

Material:
Material:

Number of
Buildings

□
3. Walls Between Units: Thickness: Material:

No. of Units in Building Under Story
Level Specified
(2)

(1)
1 Story

a. Are firewalls built
from the ground?
□□ Yes □□ No

Number of
Units Between
Fire Walls
(3)

2 Story

3 Story

4 Story

b. Are they built to the
c.Number of inches
underside of roof sheathing?
above the roof:
□ Yes □ No

d. Describe openings, if any:

4. Top Ceiling:

Thickness:

Material:

Thickness

Material

5. Flooring System:
a. First Floor :

b. Second Floor : Thickness

Material

c. Third Floor :

Thickness

Material

d. Fourth Floor :

Thickness

Material

D. Computation of Insurable Value (See instructions on back)
6. Roof:

□
□

□ Pitched

a. Framing:

Flat

Thickness

Material

1. Architect's Fees (include 30% of fees)

$

2. Structures and Equipment

$

3. Total of 1 and 2

$

b. Sheathing:

Thickness

Material

Deduct the following:

□
c. Covering:

Thickness

Material

4. Entire cost of footing excavations and foundations
(cost below level of ground, or if basement, estimated
cost below lowest basement floor)
$
5. Underground Work in Buildings

B. Information for Rating Purposes

a. 25% of cost of plumbing rough-in $
b. 10% of cost of electrical rough-in $

1. Give greatest distance of any
project building from a fire hydrant:

6. Underground Work outside of Buildings 10% cost of
heating if central plant is involved
$

2. Describe city fire department
□ Part paid & part volunteer
□ Volunteer
Full Time

2. Boiler Insurance
A. Type of Heating (check ” one)

□

Central Heating
Plant

□

B. Type of Boiler (check ” one)

Group Heating
Plants

F. Type of Fuel (check ” one)
Coal

Gas

Oil

□

Space
Heaters

□□✔

Hot Water

✔

C. No. of Boilers

Total Deductions

$

1/

$

Insurable Value

D. Pressure

Steam

G. Approximate value of heating plant (building and equipment). If system is composed of group
LPG

heating plants, give approximate value of largest plant. If plant is located in basement of building,
include value of dwelling area above plant which would be subject to damage by an explosion.

E. Sq. Ft. of heating Surface
per Bolier

$

1/ The insurable value for the first term can be accurately computed upon completion of a project. For subsequent renewals the Field Office will provide assistance in
determining the current insurable value. Instructions for computation of Insurable Value are on the back of this form.

Previous editions are obsolete

form HUD-5460 (1/2014)

Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. HUD may not conduct or sponsor,
and an applicant is not required to respond to a collection of information unless it displays a currently valid OMB control number.
The Annual Contributions Contract (ACC) between HUD and a Public Housing Agency (PHA) or Indian Housing Authority (IHA) requires the PHA or IHA to
insure their property for an amount sufficient to protect against financial loss. PHAs/IHAs complete the Form HUD-5460 only when a new project is constructed.
It is used to establish an insurable value at the time the project is built. The amount of insurance can then be increased each year as inflation and increased cost
s of construction create an upward trend on insurable values. Responses to the collection of information are voluntary. The information requested does not lend
itself to confidentiality.

Instructions for Computation of Insurable Value (Block 1-D)
1. Architect's Fee (include 30% of fees). From latest Contract
Award Budget, form HUD-52484, Account Classification
1480, column (f).
2. Structures and Equipment. Total the following items:
(a) From form HUD-52396,
(attached to Contract Award Budget):
Dwelling Structures, Account 1480;

Deductions
4. From form HUD-51000, Schedule of Amounts for Contract
Payments: Add applicable items of footings and foundations.
5. a. 25% of plumbing rough-in only. Do not include any cost of
fixtures, etc.
b. 10% of cost of electrical rough-in. Do not include any cost of
fixtures, etc.

Dwelling Equipment, Account 1480;
Nondwelling Structures, Account 1480;

6. 10% of cost of heating if central plant is provided.

Nondwelling Equipment, Account 1480.
(b) From Contract Award Budget, Column 5:
Dwelling Equipment - Non-expendable, Account 1480
;Nondwelling Equipment, Account 1480
(c) From Change Order Record Card:
Changes charged to Dwelling and Nondwelling Units.
3. Total of 1 and 2

Previous editions are obsolete

form HUD-5460 (1/2014)


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File TitleMicrosoft Word - HUD 5460.docx
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File Modified2020-04-14
File Created2018-08-22

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