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Property Insurance Quote
Information About the Property Being Evaluated:
Address:
City:
Province:
Postal Code:
Year Home Was Built:
Years You Have Resided Here:
Number of Families Residing in Household:
Square Footage (Excluding Basement):
Distance to Nearest Firehall:
Distance to Nearest Fire Hydrant:
Exterior:
Exterior Walls:
% Brick
% Wood
% Siding
% Vinyl
% Other
Number of Stories:
Is Your Home:
Detached
Semi-Detached
Townhouse
Back Split
Tri Level
Split Level
Attached Garage:
Yes
No
Rooms Above Garage:
Yes
No
Approx. sq. feet:
Detached Garage:
Yes
No
Size:
Single Car
Double Car
Other
Exterior Siding Material:
Room Material:
Other Detached Buildings:
(i.e. Garden Sheds, Cabanas)
Yes
No
Describe with Approximate square footage:
Do You Have?
Wooden Decks:
Yes
No
Approx. sq. feet:
Porches:
Yes
No
Approx. sq. feet:
Enclosed?
Yes
No
Hot Tub:
Yes
No
Swimming Pool:
Yes
No
Location:
In Ground
Above
Size:
Interior:
Interior Floor:
% Hardwood
% Laminate
% Carpet
% Ceramic Tile
% Other, Specify:
Foundation Type:
Basement
Concrete Slab
Crawl Space
Amount Finished:
%
Is It Rented?
Yes
No
Fireplace - How Many of:
Gas Fireplace:
Wood Burning Fireplace:
Wood Burning Stove:
Number of Bathrooms:
Half Bath:
Full Bath:
Number of Kitchens:
Windows - Number of:
Bay/Bow:
Picture:
Skylights:
Doors - Number of:
Atrium:
French:
Sliding Glass:
Steel:
Wood:
Central Air Conditioning:
Yes
No
Central Vacuum:
Yes
No
Smoke Detectors:
(On Each Floor)
Yes
No
Updates:
Furnace:
Year Replaced:
Furnace Type:
Oil
Natural Gas
Propane
GeoThermal
Electric
Age of Tank:
Location of Tank:
Inside Home
Outside
Plumbing (Piping):
Year Updated:
Plumbing Type:
Copper
ABS
Galvanized
Electrical:
Year Updated:
Electrical Type:
Circuit Breakers
Fuses
Amps:
60
100
200
Roof:
Year Updated:
Roof Type:
Asphalt Shingles
Tile
Steel
Other, Specify
Other:
Fire Alarm:
Yes
No
Type:
Monitored
Local
Burglar Alarm:
Yes
No
Type:
Monitored
Local
Mortgage On This Property:
Yes
No
More than one?
Yes
No
Smokers In The Household:
Yes
No
Occupation of Owners:
Date of Birth:
Owner 1:
Owner 2:
Contact Name:
Email:
Daytime Phone Number:
Do you own a car for which you would like an estimate on car insurance?
Yes
No
Will you be interested in Travel or Identity Theft Insurance?
Yes
No
Do you have a Home-based Business or require Business Insurance?
Yes
No
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