House Seasonal Seasonal Dwelling - House Name(s) of all owner(s) on title for this property: First Your mailing address: Your email address: Address of insured property including postal code: Best Phone number to call you back at:Date property purchased: Which date do you require insurance to be in place on this property? Birthdates of all owners on property? Any claims in the last 5 years? If yes, please state date of loss, amount paid out by ins. company and briefly outline what happenedYear home built: Please list the current insurer and policy number Or if this is the first time Insurance on this property please type: "first time insurance" Accepted file types: filemustbe10mborless, Max. file size: 10 MB.Accepted file types: filemustbe10mborless, Max. file size: 10 MB.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 choose the best option that most describes this property: This is my seasonal residence and I go this home about 1x30 days ( or sooner ) This is my seasonal residence and I go to this home about 1x60 day. I go to my seasonal residence 1 x 90 days. I spend 49% of the time here or less and spend 51% of the time or more at my principal residence Do you ever rent out your seasonal residence to others? Yes No Is this home within 300 meters of a fire hydrant? Yes Yes, but over 300 meters No, there are no fire hydrants near this property. Is this home within 8kms of a manned responding firehall? Yes The firehall is within 8kms but it is unmanned and volunteer The firehall is over 8kms and is unmanned and volunteer There is no firehall close to this property 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: 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 Approx. how many acres is this property? Any rivers, lakes or streams running through this property? Please briefly outline: Do you have any flat glass or dome glassed skylights? Is this property mostly 2x4 or 2x6 construction 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? 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 Log Other , not listed here What percentage of this property has 8 foot ceilings? What percentage of this property has 9 foot ceilings? What percentage of this property has 10 foot ceilings? What percentage of this property has vaulted ceilings? (over 10ft) Any balconies / sundecks? is so please list sq footage of each: What type of roof do you have? Asphalt shingles Torch on Tar and gravel Concrete tile Clay tile Metal Other What year was your roof last replaced? 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 None 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 5 6 How many bathrooms do you have? 1 2 3 4 5 6 Do you have wood burning fireplace(s)? Yes, 1 fireplace connected to a brick chimney Yes, 2 fireplaces connected to a brick chimney No, I do not have a brick chimney. Do you have any natural gas fireplaces/inserts? 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 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 Oil tank Galvanized Poly B plumbing WITHOUT copper fittings & crimp rings Poly B plumbing with copper fittings & crimp rings Please confirm type of electrical you have? 100 amp circuit breakers 200 amp circuit breakers Knob and tube Aluminum wiring Fuses Year 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 you. I was referred by someone I am a personal client of one of your producer / staff members I found you via google search. I noticed your office when I was driving/walking by. I am an existing auto insurance customer.