Auto Quote Tenant Quote Life Quote Get a Quote NowHomeowner's Quote RequestGet a Quote - Home Have you had any cancellations, claims, or gaps in insurance? * Yes No Email * Name * Address * Address Address Address City City Province Province Postal Postal Phone * Date of Birth * Effective Date * As your broker, I am gathering this consent on behalf of the insurer who advises me that: in respect of this quotation/application, any policy we issue and subsequent renewals or changes, we may collect, use, and disclose personal information reports including policy history, claims history, investigative information, rating information, risk information and only with respect to you, your personal credit information including credit score, as permitted by law and in accordance with our privacy policies.Do you, and on behalf of others listed, authorize use to collect, use and disclose to appropriate third parties, including your broker, this information solely relating to your personal property policy for the purposes necessary to assess the risk, determine a premium, determine eligibility and conditions for a premium payment plan, investigate and settile claims, analyze business results and detect and prevent fraud?Do you agree with the following consent statement? * Yes NoInsured Years of continuous home insurance * 12345678910+ Date since continuously insured on home or tenant policy? * Current Insurer * Do you Have A CAA Membership? * Yes NoDo you operate a business out of your home? * Yes NoHome-Based Business Details What Is Your Business? * Please provide any other details on business. * General Distance to the nearest fire hydrant? * Within 150 metersWithin 300 metersUnprotected Distance to the nearest fire hall? * Within 5 kilometersWithin 8 kilometersWithin 13 kilometersOver 13 kilometers Do you have a mortgage? * Yes NoBuilding Information Square footage excluding the basement? * Year built? * Style of Home? * BungalowSplit EntrySemi-DetachedOne & a Half StoreyTwo StoreyOne LevelTri-LevelTownhouseOther If other, please explain. * Primary Exterior Siding * VinylWoodBrickCedarOther Bathrooms Number of Full Bathrooms * 012345 Number of Half Bathrooms * 012345 BasementFinished, Partially Finished, or Unfinished Basement? * Finished Partially Finished Unfinished Square footage? * Do you have a garage? * Yes NoGarageIs it Attached or Detached? * Attached Detached Square footage? * Year built? * Additional StructuresAre there any additional structures on the property? i.e. shed, garage, swimming pool, etc. * Yes No If yes, please provide year built, square footage, construction type, exterior siding, and roof material for ALL additional structures. * Dates / DetailsIs this your primary residence? * Yes NoWill you be moving to this address within 14 days of you coverage start date? * Yes NoAre there any renter or boarders? * Yes No Occupied Since? * Primary Heating Details? * Furnace - OilElectricHeat PumpOther If Furnace - Oil, what is oil tank year? If Furnace - Oil, where is the oil tank located? Inside OutsideIf Furnace - Oil, what is the oil tank construction type? Double-walled Steel Fibreglass Other Year the heating was last updated? * Chimney Type? * MetalBrickNone Do you have a secondary heat source? * Yes NoSecondary Heating DetailsType? * Electric Oil Wood Stove Pellet Stove Fireplace Fireplace Insert Heat Pump Other If Furnace - Oil, what is oil tank year? If Furnace - Oil, where is the oil tank located? Inside OutsideIf Furnace - Oil, what is the oil tank construction type? Double-walled Steel Fibreglass Other Year the heating was last updated? * Chimney Type? * Metal Brick NoneRoofing Details Year that the Dwelling's roof was last updated? * Roof Material * Ashphalt ShingleMetalOther Plumbing Details Year that the plumbing was last updated? * Plumbing Type? * Copper Plastic Kitec Cast Iron Mix - Copper/Plastic OtherSeptic System? * Yes NoDo you have a Hot Water Tank? * Yes NoHot Water Tank Year that the Hot Water tank was last updated? * Electrical Details Year that the Electrical Service was last updated? * Type of wiring? * CopperAluminumKnob and Tube Service? * 60 AMP 100 AMP 200 AMP Year that the panel was last updated? * Type of panel? * BrakersFuses Claims Number of claims on any property owned within the last 6 years? * 012345 Additional Information Any additional information? Submit