If you currently have insurance, please provide current insured limit(s)
|Do you smoke:|
|Do you have a mortgage/secured line of credit on the property:|
|Was your prior policy canceled for non payment:|
|Have you ever been cancelled, declined, or refused personal insurance:|
|Kilometers to the nearest Fire Hall:|
|Is Fire Hall:|
|Distance to the closest fire hydrant:|
|Primary heating system serviced annually:|
|Solid Fuel Burning Stoves in the unit:|
|Solid Fuel Burning Units are for:|
|Oil tanks above or underground:|
|Short-term rentals of property to others:|
|Any roomers, boarders, or exchange students living in the home:|
|Cannabis grown at this location:|
|Business activities conducted from the unit/dwelling:|
If you do not have another primary business location your business is considered to be operated from your home.
|Scheduled Jewellery Coverage Required:|
Most policies include a limit of coverage for jewellery of $6000 or less subject to the policy deductible. Please advise if additional coverage is required.
|Scheduled Bicycles Coverage Required:|
Most policies include a limit of coverage for bicycles of $1000 to $2500 per bike (or less) subject to the policy deductible. Please advise if additional coverage is required.
Please use this area to tell us anything else you feel is important
front & back if available