Get A Quote - Homeowners Insurance

If you are a homeowner seeking insurance you are in the right place, please fill in the following form. If you are a tenant or own a condominium please apply using the tenant application form.

We know that you may not know all the answers at this time, if you do not know the answer you can move onto the next section and we will assist you answering the questions later.

Applicant Information

Additional Applicant Details

First Name

Middle Name(s)

Last Name

Date of Birth

Occupation

Years Experience

Add Additional Applicant

Remove Additional Applicant

Home Phone

Work Phone

Fax Number

Email Address

Mailing Address

Community

Postal Code

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Insurance History

Any Previous/Current Property Insurance

No Previous Current

Previous Current Insurer

Policy Number

Expiry Date

Years Insured

Any Losses or Claims

No Yes

Date of Loss

Paid Out

Type Of Loss / Description

Had any Insurer Cancelled, Declined or Refused to Renew or Issue Property Insurance to you?

No Yes

When

Please Explain Why

Address / Previous Address

Did you own or rent? Owned Rented

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Occupancy

Will this house be

Owner Occupied Rented Vacant

Value of Contents

Do you require rental income coverage? No Yes

Annual Rental Income

Provide details as to why vacant and advise on how long residence will be vacant or the date possibly rented or occupied

Do you own any Additional Residences that you Rent to Others?

No Yes

Which insurance company insures this location?

Is there any business in the home or being operated on your premises? No Yes

Please provide details

Is there a Day Care in the Home? No Yes

Total number of chilren

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General Property Information

Legal Description

Legal Community

Legal Territory

Type of home Single Family Detached Side x Side Duplex Bi - Tri Level Townhouse

Year Home Built

Number of Stories

Total Square Footage

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Foundation

Type of Foundation

Is There Crawl Space? No Yes

Is there a basement?

No Yes

Basement Size

Is the Basement Finished? No Yes

Percentage Finished

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Exterior

Additional Porch

Square Footage of Porch

Porch Enclosed Enclosed

Additional Exterior Wall Material

Wall Material

Wall Percentage

Roofing Material

Age of Roof

Balcony or Deck

No Yes

Construction Material

Size

Is there a garage?

No Yes

Garage Type Attached Detached

Garage Size Single Double Triple

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Interior

Additional Internal Wall Material

Material

Percentage

Additional Flooring Material

Material

Percentage

Are There Circuit Breakers?

No Yes

Circuit Breaker Ampage 60 100 200

Year Updated

Type of Plumbing

Year Updated

Number of Bathrooms

Half Bathrooms (2 Fixtures)

Full Bathrooms (3 or more Fixtures)

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Heating

Heating Type

Oil Electric Gas Wood Pallet Wood Stove Other

Is the Oil tank outside and above ground? No Yes

Age of tank

Is the Oil Tank CSA/ULC Approved? No Yes

Tank inspected annually? No Yes

Is there Radiant Floor heat? No Yes

Is there a fireplace? No Yes

Is there a wood stove? No Yes

Is the woodstove the primary heatsource? No Yes

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Extras

Is there an alarm? No Yes

Is the alarm monitored? No Yes

Is there a hot tub? No Yes

Is there central vacuuming? No Yes

Is there a wet bar? No Yes

Is there a skylight? No Yes

Is there an additional kitchen? No Yes

What size is the kitchen?

Is there an electric heat pump? No Yes

Is the house fire hydrant protected? No Yes

Are you within 8 miles of a responding fire hall? No Yes

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Legal Information

Effective Date of Coverage

Replacement value of home

Will there be a mortgage for this property? (Such as Bank or Housing Authority)

No Yes

Name

Address

Lawyer Firm Name

Lawyers Address

Work Phone

Fax Number

Attention To

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Get A Quote - Homeowners Insurance

Applicant Information

Additional Applicant Details

Insurance History

Any Previous/Current Property Insurance

Any Losses or Claims

Had any Insurer Cancelled, Declined or Refused to Renew or Issue Property Insurance to you?

Occupancy

Will this house be

Do you own any Additional Residences that you Rent to Others?

General Property Information

Foundation

Is there a basement?

Exterior

Additional Porch

Additional Exterior Wall Material

Roofing Material

Age of Roof

Balcony or Deck

Is there a garage?

Interior

Additional Internal Wall Material

Additional Flooring Material

Are There Circuit Breakers?

Number of Bathrooms

Heating

Heating Type

Extras

Legal Information

Will there be a mortgage for this property? (Such as Bank or Housing Authority)