Your Name:

    Your Email:

    Have you had a previous home, tenant, or condo insurance in the past 5 years? If so, please advise the following:

    Policy number:

    expiry date:
    for how many consecutive years have you had a home/tenant/condo policy?

    Have any of the owners’ had to make any property claims (other than auto) in the past 5 years? If yes to the previous question please advise the following:

    When each claim (if more than one) occurred:
    The cause of the damage for each claim:

    Has any insurer cancelled, declined or refused to renew or issue you insurance? If so, please give details as to why:

    Is there a mortgage on the home?

    Do you consent to a ‘Soft” credit score check? (this can save up to 30% with some companies depending on your credit score):

    Approximately how far (in km) is the house from the nearest fire hall?

    What is the date coverage is required (i.e. when is the possession date or when does your current policy expire)?

    Is there fire hydrant protection?

    Please indicate if the dwelling is a house, bareland condo, RMT, mobile or modular home (If a mobile or modular home, please do not proceed with this questionnaire any further and contact us directly for a quote)?

    Year built:

    Number of stories (if bi-level, please indicate so)

    Total square footage

    Number of Kitchens?

    Number of bathrooms?

    If there is a basement what percentage is finished

    Type of shingles (i.e. wood, asphalt, metal, other– if more than 1 option please list the approx. Percentage of each)?)

    Type of foundation (i.e. basement, walkout basement, crawlspace, slab – if more than 1 option please list the approx. Percentage of each)?)

    Type of exterior wall coverings (ie. vinyl, wood, stucco, brick, etc)?)

    Is there a garage or carport? If so, is the garage/carport attached or detached?

    Is there a centrally monitored alarm? If so, who is the alarm monitoring company/provider?

    If yes, is it monitored for:

    Is the home on a farm or acreage? If yes, how many acres are owned?

    If yes to the previous question, what type of farming is done (i.e. cattle, grain, etc.) & is it done by you or another party (ie. a family member, neighbor, etc)?

    Is there a swimming pool? If so please indicate the size, in square feet, as well as whether the pool is above ground of in ground

    Any Special type of Heating (Wood Burning Stove, Oil Heat)

    Is the home used, in whole or part, for any business?

    Is any part of the home rented out?

    If rented, how many suites are rented out and do any of the suites/rooms have more than 4 adult occupants?

    Is the home vacant? If so, how long will it be vacant for?