Homeowners Application Form

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Field with " * " - must answer before you submit your application.

Consent for a soft credit score (This doesn’t affect your credit score & gives an additional discount.)*
Is there previous Insurance?*
Have you experienced any claims in the last 5 years? *
Is there a mortgage or secured line of credit?*
Do you have mortgage insurance?*
Have you experienced our insurance canceled due to: *
Any smokers residing in the unit?*
Is there Farming Activity?*
A swimming pool?*
Guard dogs?*
Any business activity*
Do you have business insurance already?
Building style:
Is any unit being rented or is it owner occupied?*
Any short term rentals?*
Building foundation:
Is there a basement?*
Is there a garage?*
Fire alarm?*
Burglary alarm?*
If "Yes", is it centrally monitored?
# of bathrooms and half bathrooms. *
Sump pump:*
Earthquake insurance?*
Building located on leased land?*
Building is vacant?*
Underground oil tank on property?*
Any past or present marijuana growing operation?*
Fire hydrant within 300m?*
Fire hall within 13km?*
Type of wiring and amperage?
Type of plumbing:
Type of roof:
What kind of heating systems?
Any wood stoves?*
I understand any information I provide will affect the amount of the quote and future coverage to my property.*
I/we declare that to the best of my/our knowledge and belief the answers given on this proposal whether by me/us or on my/behalf are complete and true and that I/we have not withheld any material Information.
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