Request A Quote Download our Mobile AppHomeowners Quote First Name * Last Name * Phone * Address City * Province * Postal Code * Type of Residence * Single family homeCondominiumTown homeDuplexApartment Residence Use * PrimarySecondarySeasonalRental Property Date of Birth * 12345678910111213141516171819202122232425262728293031 / 123456789101112 / 191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014Is the home jointly owned? YesNo What is your occupation? Co-Owner Information First Name * Last Name * Date of Birth * 12345678910111213141516171819202122232425262728293031 / 123456789101112 / 191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014 Purchase Date 12345678910111213141516171819202122232425262728293031 / 123456789101112 / 1930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Estimated Year Built* 12345678910111213141516171819202122232425262728293031 / 123456789101112 / 1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Type of construction* Aluminum SidingBrickCement Board SidingLog HomeStuccoVinyl SidingWood SidingBlockOther Type of roof* Asphalt ShingleMetalTileWood ShakeOther Number of stories * Full Bathroom* 12345 Half Bathroom* 12345 What is the total square footage of your home? Basement YesNoDeadbolt Locks YesNoSmoke Detector YesNoFire Extinguisher YesNoMonitored Fire Alarm YesNoBurglar Alarm YesNoHome Located Within 8 kilometres of a responding fire hall? YesNoHome Located Within 1000 Feet Of A Fire Hydrant YesNoSwimming Pool YesNoHome Located Within City Limits YesNoDo you currently have home insurance coverage? YesNoWho is your insurance currently with? Have you ever had a policy cancelled by a company in the past five years? YesNoWhen does your policy expire? 12345678910111213141516171819202122232425262728293031 / 123456789101112 / 20182019202020212022202320242025Coverage Amount What is your annual premium Are you currently receiving any discounts YesNoDeductible Desired $500$1000$2500Amount Of Liability Coverage $1,000,000$2,000,000Earthquake Coverage Desired? YesNoNumber of Homeowner’s Claims(*) 01234Jewelry And Watches $ Silver$ Guns $ Furs $ Stamp And Coin Collection $ Would you like to see if we can save you more money by bundling any of the following policies? AutoBoatRV/TrailerFine Arts And Breakable Items $ Please give any additional comments you feel appropriate for this quotation. Current email address(*) Current Email Address Again(*) Refer aFriend Refer a Friend, We'll Take Great Care of Them!+ REFER A FRIEND GET IN TOUCH(905) 576-2234Toll Free: 1-800-565-4048ONLINE