Saturday, 27 July 2013

Home Owner Policy Quote





Basic Information

?Postal code?
?First name?
?Last name?
?Telephone number?  
?Email address?
?What type of policy would you like an estimate for?


?Effective date of the policy  

Location Information

City or town of residenceCALGARY
?Street address?
?How long have you been living at this address?
?How close is the dwelling to the nearest fire hydrant?
?How close is the dwelling to the nearest fire hall?

Applicant Information

?What is your date of birth?  
?Occupation?
?Is there a co-applicant?
?If yes, what is the co-applicant's date of birth?  
?How many years have you had residential insurance?
?How many claims have you had in the past ten years?
?Number of mortgages on this dwelling?
?Are all members of the household non-smokers?

Coverage Information

?Amount of insurance required for the residence?$ 

Dwelling Information

?Do you occupy the dwelling?
?Construction type?
?Structure type?
?Year dwelling was built?
?Number of units in the building?
?Primary heating source?
?Auxiliary heating source?

Security Information

?Burglar alarm?
?Fire alarm?
In respect of this quotation, any policy we issue and subsequent renewals or changes; we may order reports containing personal, credit and investigative information. This information, solely relating to your automobile and/or personal property policy is used in order to assess risk, investigate and settle claims and detect and prevent fraud.

Do you authorize us to collect, use and disclose this information to appropriate third parties?
By clicking on 'Next' it is understood that you have read and agreed to the Terms and Conditions.

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