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McFarlan Rowlands
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Condominium Insurance
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Second Home / Cottage Insurance
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Condominium Insurance Quote
Step
1
of
4
25%
Full Name
*
Date of Birth
*
Street Address
*
City
*
Province
*
Postal Code
*
Preferred method of contact
*
PREFERRED METHOD OF CONTACT*
Email
Phone
Phone
*
Email Address
*
How did you hear about us?
*
HOW DID YOU HEAR ABOUT US?*
Family or Friend
Online Advertising
Social Media
I am an existing client
Billboard
Google
Spotify
Other
IF YOU WERE REFERRED TO A SPECIFIC BROKER HERE, PLEASE PROVIDE THEIR NAME:
Profession
PROFESSION
Police
Fire
Paramedic
Other
Not a First Responder
What is your occupation?
Do you currently belong to a professional association?
DO YOU CURRENTLY BELONG TO A PROFESSIONAL ASSOCIATION?
Yes
No
ASSOCIATION NAME
Home Details
Contents Value (Total value of all of your possessions)
CONTENTS VALUE (Total value of all of your possessions)
$35,000
$50,000
$75,000
$100,000+
Year Built
Square Footage (not including garage or basement)
Type of Building
TYPE OF BUILDING
Apartment
Detatched
Semi-detatched
High Rise
Low Rise
Number of Full Bathrooms
NUMBER OF FULL BATHROOMS
1
2
3
4+
Number of Half Bathrooms
NUMBER OF HALF BATHROOMS
1
2
3
4+
Type of Plumbing
TYPE OF PLUMBING
Copper
Plastic
Cast Iron
PEX
When was your plumbing last replaced?
Type of Heat
Age of Furnace
Hydro
TYPE OF WIRING
Breakers
Fuses
Copper
Aluminum
Other
Hydro (AMP)
HYDRO (AMP)
100 AMP
200 AMP
Exterior of Home
MAJORITY OF EXTERIOR OF HOME
Siding
Brick
Stucco
Other
Type of Roof
TYPE OF ROOF
Steel
Asphalt
Other
When was your roof last replaced?
Basement size (of finished area)
How far are you located from the closest fire hall?
Do you have a fire hydrant within 1000 ft of your home?
IS THERE A FIRE HYDRANT WITHIN 1000FT OF HOME
No
Yes
Does anyone in your house smoke?
SMOKERS IN HOUSE
No
Yes
Do you have a sump pump?
SUMP PUMP
No
Yes
Do you have battery back up?
BATTERY BACK UP (ON SUMP PUMP)
No
Yes
Backwater valve
BACKWATER VALVE
No
Yes
Do you have a mortgage?
DO YOU HAVE A MORTGAGE?
Yes
No
Any claims in the last 5 years?
ANY CLAIMS MADE IN THE PAST 5 YEARS
No
Yes
Type of Claim
TYPE OF CLAIM
Sewer Back Up
Fire
Theft
Other
Year Claim Made
Month Claim Made
MONTH CLAIM MADE
January
February
March
April
May
June
July
August
September
October
November
December
How long have you continuously been insured for home insurance?
Preferred Deductible
PREFERRED DEDUCTIBLE
$1,000
$2,500
$5,000
CAPTCHA
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