Tenant Insurance
Any scheduled articles (i.e, jewelry, watercraft, etc): Describe briefly
Name of present or prior Insurance Company:
Number of years continuously insured:
Details of Prior Insurance Coverage: Describe briefly
Are premises occupied by any unrelated individuals? Describe briefly
Details of any business use of the premise: Describe briefly
Details of any cancellations or non-renewals in the past 5 years: Describe briefly
Details of all property insurance claims in the past 5 years: Describe briefly
If not how far to the nearest firehall?
Yes
No
Is property hydrant protected?
Type of Dwelling:
Amount of Coverage Required:
Effective Date of Coverage:
Date of Birth:
(Work)
Name:
Address:
Over
40
years in business serving all of eastern Ontario and west Quebec
Phone Number: (Home)
Single Family
Townhouse
High Rise Apt Building