Please fill out the short form below to get started on your quote.
Unit Owner Information
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the mailing address the same?
Yes
No
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Owner
First Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
Date
Email address
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Previous Address
Occupation
Is there another owner of the unit?
Yes
No
Relationship Between Owner 1 and owner 2
Spouse
Immediate Family
Roommate
Name of Second Owner
First Name
Last Name
Second Owner Date of Birth
 -
Month
 -
Day
Year
Date
Email address (Second Owner)
example@example.com
Phone Number (Second Owner)
Please enter a valid phone number.
Format: (000) 000-0000.
Previous Address (Second Owner)
Occupation (Second Owner)
Claim History
Claims within the last 5 years
Yes
No
Claim Date
Claim Amount
Claims Status
Open
Closed
Claim Details
Claims within the last 10 years
Yes
No
Claim Date
Claim Amount
Claims Status
Open
Closed
Claim Details
Previous Insurer/Company
Policy Number
Have you ever been cancelled/denied/refused insurance?
Yes
No
Please Explain
Do you own/rent/occupy any farm land:
Yes
No
Number of Acres
Do you have additional locations to insure
Yes
No
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Location Information
Within 300m of hydrant:
Yes
No
Distance to fire hall
in km
Unprotected:
Building Type
Apartment
House
Duplex/Side by Side
Year Built
Is it a basement unit?
Yes
No
Number of Storeys
Square Feet
Number of Units
Construction type?
Wood Frame
Fire Resistive/Concrete
Fireplace
No Fireplace
Built-in
Insert
Wood Stove
Yes
No
WETT Inspected
Yes
No
Number of Cords Annually
Updates
Heating
Natural Gas
Electric
Hot Water
Wood Stove
Oil
Last Updated (year)
Age of Hot Water Tank
Extended Coverages
Does your Condominium Corporation have insurance in place?
Yes
No
Condominium Corporation Deductible
If possible, provide a copy of the Condominium Corporation Insurance Certificate
Browse Files
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Contents Limit (min. $50,000)
Deductible
$500
$1,000
Unit Value
Scheduled Coverages
Yes
No
Scheduled Coverages Amount
Storage Locker in Basement?
Yes
No
Mainline backwater valve
Yes
No
Sump pump/pit
Yes
No
Prior sewer backup losses?
Yes
No
Was sump/valve installed after loss?
Yes
No
Overland water coverage?
Yes
No
Ground water coverage?
Yes
No
Service line coverage?
Yes
No
Applicable Discounts
Alarm System?
Yes
No
Alarm System Type
Burglary
Fire
Both
Monitored?
Yes
No
Name of Monitoring Company
Number of Years in Current Home
Smoker in home?
Yes
No
Soft credit check consent
Yes
No
Mortgage free?
Yes
No
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Occupancy
Who will live in the condo
Owner
Immediate family member (parent/spouse/child)
Renter
Vacant
Under renovation
Details of renovation
Possession date of new condo
Current home
Sold
For sale
N/A
If this is a seasonal, does HUB insure the primary home?
Yes
No
Renters/rental suites?
Yes
No
Number or renters/rental suites
Number of families in rented dwelling
Purchase price of condo
Coverage needed for loss of rental income
Yes
No
Annual rent
Coverage needed for landlord’s contents
Yes
No
Limit
Coverage needed for outbuildings
Yes
No
Limit
Roommates/common-law partners
Yes
No
Number of roommates
If more than 2 adults, provide relationship details
Daycare operated in condo
Yes
No
Number of children
Ages of children
Do you own/operate a business
Yes
No
Is it a home based business?
Yes
No
Is commercial coverage already in place?
Yes
No
Are you interested in a review of coverage and comparison quote?
Yes
No
Nature of business
Do clients visit the home based business?
Yes
No
Value of business contents
Annual gross receipts/income
Address updated with MPI/SGI MVD?
Yes
No
Mortgage/Lawyer Information
Mortgagee
Mortgagee Address
Lawyer Name
Law Office
Law Office Address
Lawyer Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Lawyer Fax, if applicable
Please enter a valid phone number.
Format: (000) 000-0000.
Line of credit secured by the home
Yes
No
Mortgage life insurance through bank
Yes
No
Interested in a mortgage life insurance quote?
Yes
No
Additional Notes or Details
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