Property Insurance Questionnaire


For Alberta Residents

Name(s):
Email:
Telephone Number:
Property Address:
Occupancy
Current/Prior Insurance/for how many years:
Claims in past 3 years (details):
Security (Central/Local Alarm):




Rating Information

Year Built:
Fire Protection (within 300m of hydrant, within 5 km of fire hall, within 8 km of fire hall):
Structure Type (detached/semi detached/townhouse/mobile home):
Renovations/Upgrades (electrical, heating, plumbing, roofing):
Heating (central furnace, any supplementary sources? woodstoves, space heaters):
Additional Liability exposures (Location rented to others, rooms rented, additional properties, day home, business operations):


Limit of Coverage Requested:

  Dwelling Building
  Personal Property
  Legal Liability
  Sewer Backup

Scheduled Property (description and value required):
Jewelry:
Furs:
Watercraft:
 
   
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