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Home Insurance
Select A Broker:
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Keswick Office – Andrea Hanlon
Keswick Office – Shannon Gardner
Newmarket Office – Paul Gaffney
Newmarket Office – Rhonda Laskovski
Newmarket Office – Trent Greschuk
Vaughan Office – Adrian Pagliaroli
Vaughan Office – Joe Craparotta
Vaughan Office – Robert Zolumoff
Name:
Address:
City:
Province:
Postal Code (X1Y 2Z3):
Phone Number (123-456-7890):
Email:
Do you own your own home, own a condo unit or rent:
Homeowner
Condo Owner
Renter
Estimated replacement value of dwelling: (homeowner only):
Estimated replacement value of personal property:
Policy deductible preferred:
$500
$1,000
Liability amount requested:
$1,000,000
$2,000,000
How many years have you consistently had a property policy in force:
Number of claims in the past 10 years:
How many years since last claim (if within 10 years):
Do you smoke:
Do you have a monitored alarm? (fire & burglary):
Do you have a mortgage/secured line of credit on the property:
What is your occupation:
How many years since last time you moved:
What is your age? (or oldest age of named insured person):
Was your prior policy canceled for non payment:
Was your policy lapsed for any other reason by the insurance company:
What is the amount of jewelry required to be scheduled:
Which insurance company has your current auto insurance:
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Overview
Auto Insurance
Home Insurance
Life/Disability/Critical Illness Insurance
Combined Home and Auto Insurance
Commercial Insurance
Boat Insurance
Farm Insurance
Forestry Equipment Insurance
Trucking Insurance
Recreational Vehicle Insurance
Travel Trailer Insurance
Motorcycle Insurance
Mortgage Insurance
Key Person Insurance
Tenants Insurance
Travel Insurance
Hole In One Insurance
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