House Rental Property All name(s) on title of this rental property: First Your mailing address: Your email address:* Birthdates of all person(s) on title. Please list name associated with birthdate below: MM slash DD slash YYYY Occupations of all person(s) on title. Please list name associated with occupation below: Address of property to be insured incl. postal code: Best Phone number to call you back at:Which date do you require insurance on this property? MM slash DD slash YYYY Any claims in the last 5 years? If yes, please state date of loss, amount paid out by ins. company and briefly outline what happened:Year home built:Insurance companies may give extra discounts based on a soft credit check. A soft credit check is the type of credit inquiry that does not hurt your credit score. Soft credit checks happen when you check your own credit report, for example. Please click yes if you authorize insurers to check your soft credit score. Yes No Please list the current insurer and policy number Or if this is the first time Insurance on this property please type: "first time insurance": If you have a current insurance policy on this location, please send first few pages:File must be 10 MB or lessMax. file size: 100 MB.Please send us a photo of your homeFile must be 10 MB or lessMax. file size: 100 MB.Please choose the best option that most describes this property: Home will be rented out upon my renewal/completion date Home be rented out within 30 days of my completion/effective date Home will be rented out AFTER 30 days of my completion/effective date. How many families TOTAL live here? one two three four What is the estimated annual gross rents $ derived from this property: Is this home within 300 meters of a fire hydrant & within 8kms of a manned firehall? Yes No Do you have a registered mortgage on this home? Yes - with a Bank in Canada Yes - with a private lender No - this property is clear title I have a credit line on this home and the bank does NOT need to be named on the policy. Square footage of basement below ground: If you do have a basement below ground, what % is finished? Square footage of first floor above ground Square footage of second floor above ground: Square footage of third floor above ground Do you have any of the following: Laneway house rented out to one family Shed detached Solarium attached solarium any other detached living space swimming pool Do you have any flat glass or dome glassed skylights: How many skylights do you have? Are the exterior walls of this property mostly: 2x6 2x4 I'm not sure Do you have a reverse sloping driveway? Yes No If you have a basement below ground, is it mostly: finished unfinished I do not have a basement Does your basement have a "walk out" door? yes no I don't have a basement below ground level What is the primary material of the exterior walls of the home: stucco stucco with 10% stone/brick veneer vinyl cedar combination of stucco and wood aluminum hardi plank other , not listed here What percentage of your home has 8 foot ceilings What percentage of your home has 9 foot ceilings What percentage of your home has 10 foot ceilings What percentage of your home has vaulted ceilings (over 10ft) Any balconies / sundecks? is so please list sq footage of each: What type of roof do you have? ashfalt shingles Torch on Tar and gravel concrete tile clay tile metal other What year was your roof last replaced? Or year of roof?Do you have any garages or carports? detached garage for 1 car detached garage for 2 cars detached carport for 1 car detached carport for 2 cars built in garage for 1 car built in garage for 2 cars attached garage for 1 car attached garage for 2 cars none of the above Please estimate percentage of each of these types of flooring in the entire home (hardwood, tile, carpet, laminate, linoleum, polished concrete )How many kitchens do you have? 1 2 3 4 More than 4 How many bathrooms do you have? 1 2 3 4 5 6 7 8 Type of chimney(s)? 1 brick chimney 2 brick chimneys 1 metal flue pipe 2. metal flue pipes How many wood burning fireplace(s) are in this building? 1 2 3 4 Do you have any natural gas fireplaces? Yes, 1 direct vent Yes, 2 direct vent Yes, 1 passing through a B-Vent Yes, 2 passing through a B-Vent No, I do not have a natural gas fireplace I have a propane fireplace Do you have a free standing wood burning stove? No Yes and I have a passed WETT inspection Yes and I do NOT have a WETT inspection. What type of heating do you have? Hot warm (forced) air (natural gas) Hot water baseboard (natural gas) Radiant in-floor hot water heating Electric Baseboard Electric in floor heating Do you have a cooling system? No, I do not Yes, and I use the same ducts as my hot air system Yes, and I use separate ducts as my hot air system. Yes, I have high efficiency central air using same ducts Yes, I have high efficiency using separate ducts Please check mark if you have any of the following: local burglar alarm monitored burglar alarm monitored burglar & fire alarm interior sprinklers water sensors Oil tank water leak detection system back water valve sump pump battery Please confirm type(s) of plumbing you have? Copper - original when year home was built Plastic - original when home Was built Copper - redone in the last 15 years Plastic - redone in the last 15 years cast iron galvanized Poly B plumbing Poly B plumbing with crimp rings Please confirm type of electrical you have? 100 amp circuit breakers 200 amp circuit breakers knob and tube aluminum wiring fuses aluminum wiringYear your electrical was replaced? Year hot water tank replaced? Year your furnace/boiler was replaced? Would you like an exterior glass breakage policy? Yes No I would like more information Have you ever been declined or refused insurance: Yes No How did you find out about our office? I have an existing home policy with your office I was referred by someone I am a personal client of one of your staff /producer members You found us via Google search I noticed your office when I was driving/walking by. I am an existing auto insurance customer. PhoneThis field is for validation purposes and should be left unchanged.
