Property Quote

Please fill out the form below if you would like a Property Insurance Quote. A representative from our office will contact you by the next business day.

 

Contact Information:  
Name:  
Address:  
City:  
Province:  
Postal Code:  
Phone Number:  
Email Address:  
How do you wish to be contacted:  
Have you ever had insurance cancelled or refused?:   Yes No
Do you currently insure your property:  
Yes No
Number of years prior insurance:  
Expiry date with present insurer:  
(dd/mm/yyyy)
What is your date of birth:  
(dd/mm/yyyy)
Property Information Property #1 Property #2
Property Type:  
Use:  
Do you:  
Own Rent N/A Own Rent
Year Built:  
If property over 20 years old, which of the   following have been replaced or updated:  
Furnace
Roof
Wiring
Plumbing		 Furnace
Roof
Wiring
Plumbing
   
Auxiliary Heat:  
 Wood stove
Fireplace
Gas Fireplace 		Wood stove
Fireplace
Gas Fireplace
Is property equipped with alarm:   
 Yes No N/A Yes No
If yes, is your alarm:  
Local Monitored N/A Local Monitored
Are you within 300 m of a hydrant:  
Yes No N/A Yes No
Are you over 5km and within
13 km of a fire hall:  
Yes No N/A Yes No
Discount Information:  
  
I am mortgage free:  
Yes No
I am a non-smoker:  
Yes No
Amount of coverage needed:  
 **subject to a current property evaluation.
Building:  
Contents:  
Liability:  
 $500,000
$1,000,000
$2,000,000		 N/A
$500,000
$1,000,000
$2,000,000
Deductible:  
 $500 $1,000 $500 $1,000
Claims Information  
Recent Claims:   
Type
Date (mm/yyyy)
Location:  
1.
2.
3.
       
If you require any coverage on boats, jewellery or a home based business, add your request in the comments section below.
Comments:  
   
Please enter text seen on the screen
   
 

After Hours Claims Numbers

 
Aviva 1-800-590-5003 Economical 1-800-607-2424 Gore Mutual 1-800-265-8600
Guarantee 1-800-265-4262 Intact Insurance 1-866-464-2424 Jevco 1-514-919-8339
Kingsway 1-866-864-1112 Markel 1-888-627-5351 Nordic Facility 1-905-686-0200
Pafco 1-800-387-0462 Peel Mutual 1-800-268-3069 Western General 1-800-607-2424
Perth Insurance 1-800-607-2424 Pilot Insurance 1-888-887-4568    
           
 
 

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