Step 1 - Lets get Started!

Enter the Postal Code of the property you want to insure required

What is your street address (optional!)

What type for property insurance do you need? Tenant Condo Unit Owner Homeowner

When were you born? (for discount purposes)
January February March April May June July August September October November December 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990

Your Insurance History

How many years have you had a continuous property insurance policy?
none 1 yr 2 yrs 3 yrs 4 yrs 5 yrs 6 yrs 7 yrs 8 yrs 9 yrs 10 or more

How many property claims have you had in the past 7 years?
none 1 2 3 or more

How many years has it been since your last property claim?
no claims 1 2 3 4 5 6 7

In the past 5 years, have you had a property policy cancelled by an insurance company OR has an insurance company ever refused to insure you ? yes no

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Step 2

Your property information

City required

How is your property currently occupied?
You & Family You and one other family You & 2 or more families Vacant Property under construction Farm property

Describe the type of building that you live in
Detached Semi-detached high-Rise Townhouse Row house Duplex Triplex Basement suite Commercial property Other

How many mortgages do you have on your home?

What is the new rebuilding cost, or replacement value of your home? OR If you’re a tenant or live in a self owned condo, what is the replacement value of all your contents?
$

How many non-related roommates, roomers or boarders do you have?
none 1 2 3 4 or more

How old is your property? yrs

Has the roof of your property been replaced in the last 20 years?
yes no

What is the construction type of your property?
Wood, vinyl, metal, or stucco Fire resistive concrete Brick veneer Solid brick, concrete block or stone Log home Other

What is the primary method of heating in your property?
Natural gas Electric Hot water Oil Propane Wood Solar Radiant Other

What additional heating do you use to heat your property?
not applicable Certified wood stove Uncertified wood stove Fireplace insert Space heater Gas fireplace Other

How many years have you lived at your current address?
1 2 3 4 5 6 7 8 9 10 or more

What type of alarm system do you have in your property?
no alarm Unmonitored Monitored

How close to your property is the nearest fire hydrant?
0m - 305m (1000 ft) 305m - 610m (2000 ft) 611m-1000m More than 1000m

How close to your property is the nearest fire hall?
Within 8km (5 miles) 9km - 16km (10 miles) Over 16km

Do you operate a home-based business from your
home ? yes no
If so – Please briefly describe your business

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Step 3

You can add optional coverage to your quote to make sure you get the best coverage for your needs.

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Building Coverage - All Risk

Guaranteed replacement cost - Building - Included

Contents Coverage All Risk Named Perils

Replacement Cost - Contents - Included

Choose your liability coverage $1,000,000 $2,000,000

Choose a deductible $1000 $500 $200

Camera & equipment option (non professional)
no additional coverage $500 $1000 $1500 $2000 $2500 $3000 $3500 $4000 $4500 $5000 $5500 $6000 $6500 $7000 $7500 $8000 $8500 $9000 $9500 $10000

Jewellery & watches option
No additional coverage $1000 $2000 $3000 $4000 $5000 $6000 $7000 $8000 $9000 $10000 $11000 $12000 $13000 $14000 $15000 $16000 $17000 $18000 $19000 $20000 $21000 $22000 $23000 $24000 $25000

Earthquake coverage no additional coverage Yes - please include

Business/Personal Desktop & Laptop computer plus equipment option
(Please describe, and include the replacement value $ incl. tax of all items)

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Step 4 - Personal Info

This questionnaire is used for a standard quotation for tenants / condo or home insurance. If you require any additional coverage for items not listed, or a seasonal home, rental home, watercraft, commercial building or office, etc., we would be pleased to provide you with an insurance quotation, but will require more information, and will need to contact you. Thank you !


First Name and Last intial :
required

Reply by : E-Mail / Fax / Phone, at the following number / address :
required

Preferred reply method: email phone fax

Choose your recipient Nakamun Office Newcombe Alpine Somerset Murrick Killarney

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