Home Insurance Quote We represent over 30 of the world’s largest and best insurance providers in Canada. We will quickly find you the best home insurance rates with coverage suited to your needs. Complete the quote request form below or call 1-866-305-6205. HOME INSURANCE QUOTE REQUEST Complete the form below for a home insurance quote. Only those fields outlined marked by an asterisk (*) are required fields. Privacy Consent: By completing this form, you are giving us permission to use your information for the purpose of providing an insurance quote, apply for insurance, council or risk management service. Please read our Privacy Policy for more information.CONTACT INFORMATIONContact Name* First Last Address* Street Address City Ontario Province Postal Code Email* Phone*Reason for a new insurer or brokerFirst time insurance buyerNot happy with priceNot happy with serviceIssues with a claim settlementPrefer not to answerNot sureOtherLOCATION & DWELLING INFORMATIONOwner 1 Date of Birth* Owner 2 Date of Birth Are all members of the household non-smokers?YesNoAre you retired?YesNoHow many mortgages are on the house?0123What is the square footage of your home?What year was your home built?Number of Stories11.522.53DuplexTriplexOtherDo Not KnowWhat is the structure of your dwelling?DetachedSemi-DetachedTownhouseRowhouseDuplexTriplexOtherDo Not KnowWhat is the exterior of your dwelling?Brick Veneer - Wood FrameSolid Brick/Block MasonryFrameFire ResistiveSolid StoneAluminum SidingVinyl Siding - Wood FrameStucco on Wood FrameStucco on BrickClapboardOtherDo Not KnowHow far is fire hydrant from your residence?Within 300 metresNo fire hydrant within 300 metresHow far is your residence from a fire hall?Within 8 kms of a fire hallBetween 8 kms and 13 kmsOver 13 kmsDo you have a fire alarm?No Fire AlarmCentrally Monitored AlarmLocal AlarmOtherDo Not KnowDo you have a burglar alarm?No Burglar AlarmCentrally Monitored AlarmLocal AlarmOtherDo Not KnowDo you, as owner, occupy the dwelling?YesNoNumber of families occupying the dwelling123 or morePrimary heating and/or cooling sourceHeat Only - Gas FurnaceHeat and A/C - Gas Furnace, Central AirHeat Only - Oil FurnaceHeat and A/C - Oil Furnace, Central AirHeat Only - Hot WaterHeat and A/C - Hot Water, Central AirHeat Only - ElectricHeat and A/C - Electric, Central AirHeat Only - WoodHeat and A/C - Wood, Central AirOtherDo Not KnowAuxiliary heating source if anyNoneWood Burning StoveCombination FurnaceElectric Space HeaterGas Space HeaterOil Space HeaterCombination FurnaceFireplaceFireplace InsertOtherNot KnowElectricalBreakersFusesKnob and TubeOtherDo Not KnowElectrical - Amps200 Amp100 Amp60 AmpOtherDo Not KnowPlumbingCopperPlasticGalvanized SteelOtherDo Not KnowRoofingAsphalt ShinglesWood ShakesWood ShinglesTar and GravelSteel TilesConcrete TilesClay TileCopperCorrugated SteelOtherDo Not KnowGarageAttachedDetachedCarportBuilt-In (Basement)Built-In (Ground Level)ADDITIONAL COVERAGEEnter the values of additional items that require protection below.JewelleryFine ArtsFursBicyclesMusical InstrumentsGolf ClubsINSURANCE INFORMATIONCurrent Insurance CompanyHome Insurance Expiry Date Current insured value of your homeCurrent or requested deductible2005001000150025005000OtherDo Not KnowNumber of claims in the last 5 years0123 or moreHow many consecutive years you have had insurance?No current insuranceLess than 1 year1 year2 years3 years4 years5 or more yearsDetails of claims if any. Include date, description, and amount paid out (for claims).Additional CommentsOTHER INSURANCE PRODUCTSWould you be interested in receiving a free no obligation quote for your home, auto, cottage or other insurance? Simply provide the day and month of the expiry date of your policy or policies below and we will contact you approximately 1 month prior to the expiry date.Auto Insurance Boat Insurance Business Insurance Classic Car Insurance Cottage Insurance Motorcycle Insurance Personal Watercraft (PWC) Insurance RV & Trailer Insurance I would like to receive information on new products, services, promotions or to be reminded of my upcoming insurance renewal. We keep our communication to a minimum and you can withdraw your consent at any time. Please refer to our Privacy Policy or Contact Us for more details.CAPTCHA
