Quotation Request Form

Download our quotation form here or simply fill in the quotation form below and submit online.

Your Name (required)

Your Home Address (required)

Your Home Phone

Your Cell Phone

Your Email (required)

Subject

Date of Birth: (required)

Occupation

How many years continuously employed?

Do you have a mortgage?

Do you have an alarm system?

 Burglar Fire Sprinkler

If yes, is it monitored?
 Yes No

How long have you lived at this location?

Do you have a home-based business?

Is this a non-smoking household?

Current insurer and policy # with expiry date

Current building insurance limit and/or contents limit (if a condo or tenant policy)

How long have you had continuous property insurance?

What deductible do you have?

Have you had ANY claims or losses in the past 5 years?

Is earthquake insurance required?
 Yes No

Underwriting information required for your risk:

Year Built (required)

Is the house within 200 meters of a fire hydrant?
 Yes No

Is the house within 8 kilometers of a firehall?
 Yes No

How many floors?

Is there a basement?

If yes, is it finished?

If yes, is it
 Above ground Below ground 1/2 and 1/2

If no basement is it
 on a slab crawlspace

How many families?

Is there a suite?

How many kitchens?

Sq. footage of main floor?

What is exterior finish (wood, stucco, vinyl or other?)

Hot water tank age?

How many full bathrooms?

How many 1/2 bathrooms?

How many fireplaces?

Gas?

Wood?

Decks sq. feet?

type (wood, concrete or other?)

Is there a garage or carport?

If yes, is it attached, detached or built in and what size - 1 or 2 car?

Do you have a swimming pool?

If yes, is it concrete or vinyl?

In-ground or above?

What is the size of the pool?

Do you have a hot tub?

If yes what is the size?

Roof age and type (asphalt, wood, metal, clay tile or other?)

If replaced, what year?

Electrical Age and type (copper, aluminum or knob and tube?)

Are there breakers or fuses?

Is it 60, 100 or 200 amp service?

Type of heating - electric or gas furnace?

If furnace, age?

Do you have your furnace serviced annually?

Plumbing age and type (copper, plastic or cast?)

Is there a woodstove?

Comments

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