Property Quote Form

Property Quote Form

Please complete the form below if you would like a quote on property insurance. Do a separate form for multiple locations.

Name:
Address Line 1:
Address Line 2:
Town/City:
Province:
Postal Code:
Phone number
Email Address:
Employer:
Date of birth (for discounts)
Have you had an insurance policy cancelled by a company for non-payment or any other reason in the past 3 years?
Expiry date of current policy
Continuous years of insurance
If no previous insurance explain reason
Any Non-Family Residents?
Type of Property Policy
Year Property was built
Fire Protection
Building Coverage amount
Outbuildings Coverage
Liability Limit required
Contents coverage required
Extra Jewelry
Extra Musical Instruments
Extra Fine Arts
Other, specify
Deductible required on policy
Primary source of heat
If oil heat, please enter oil tank age and location
Other sources of heat, select all that apply
Type of home construction
Style of Home
Sewer backup coverage
Do you have a home based business? If so please describe
Do you have a mortgage?
Any losses in the past 5 years? If so please describe

Protection