RESIDENTIAL
QUOTE |
1. |
Name
Date of birth |
Day:
Month:
Year:
|
2. |
Name
Date of birth |
Day:
Month:
Year:
|
(For people renting, or for condo owners, please
only complete Section 1)
|
Section
1 for Renter and Condominium Owners |
7. |
Value of contents (minimum $25,000)
|
$
|
8. |
Level of Fire Protection |
|
9. |
Year of construction of building |
|
10. |
Type of building
(ie. house, townhouse, high rise apartment, low
rise apartment) |
|
11. |
Source of heat
(ie. gas furnace, oil furnace, electric baseboard
heat) |
|
12. |
Expiry date of current residential
insurance policy |
Day:
Month:
Year:
|
13. |
Number of consecutive years with
residential insurance |
|
14. |
Number of residential insurance claims
in past 10 years |
|
15. |
If more than 0, please give details
of loss(es) |
|
|
16. |
Level of Fire Protection |
|
17. |
Year of construction of building |
|
18. |
Type of building |
|
19. |
Number of stories |
|
20. |
Exterior construction
(ie. Vinyl siding 50%, Brick Veneer 50%) |
|
21. |
Source of heat
(ie. gas furnace, oil furnace, electric baseboard
heat, woodstove) |
|
22. |
Square feet of residence (excluding
the basement) |
|
23. |
Flooring (ie Ceramic Tile 50%, carpet
20%, hardwood 30%) |
|
24. |
Number of full bathrooms
(with bathtub or shower) |
|
25. |
Number of powder rooms
(toilet & sink only) |
|
26. |
Garage |
|
27. |
If yes, attached or detached from
main dwelling |
|
| 28. |
If yes, how many cars |
|
29. |
Basement finished (ie. 50% finished) |
% |
30. |
Monitored alarm |
|
| 31. |
If yes, monitored by whom |
|
32. |
Custom Features that will increase
the value (ie. granite counter-tops, $6,500) |
|
33. |
Do you carry a mortgage |
|
34. |
Expiry date of current residential
insurance policy |
Day:
Month:
Year:
|
35. |
Current limit of insurance |
$
|
36. |
Number of consecutive years with
residential insurance |
|
37. |
Number of residential insurance claims
in past 10 years |
|
38. |
If more than 0, please give details
of loss(es) |
|
39. |
Have you moved in last 3 years |
|
|
|
