Homeowners Application Form


Get A Free Quote Just Need A Few Minutes! Easy and Quick; No Need To Wait!

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. *
Classify:
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.
This site uses Google reCAPTCHA technology to fight spam. Your use of reCAPTCHA is subject to Google's Privacy Policy and Terms of Service.

Thank you! Your message was sent successfully. Our agent will contact you within 1 - 2 business day. For immediate assistant, Call us: 1-866-582-3777 (Toll Free) / (250) 861-3​777.
/
Lightbox image