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Quote Form
We will quote and respond within 24 hours!
Name:
Telephone Number:
Email Address:
Location Address:
Size of dwelling (ground floor in sq.ft)
Type of Occupancy:
Owner Occupied
Rented Dwelling
Vacant Dwelling
Other
Type of Construction:
Wood Frame
Log Home
Brick Veneer
Other
Age of Dwelling:
0-5 yrs
5-10 yrs
10-15 yrs
15-20 yrs
20-25 yrs
25-30 yrs
30-35 yrs
35-40 yrs
40+ yrs
Type of Heat:
Electric
Oil Furnace
Wood Furnace
Outdoor Furnace (WoodDoctor)
Propane
Other
Secondary Heat:
None
Electric
Woodstove
Wood Fireplace
Propane or Gas Fireplace
Oil Furnace
Wood Furnace
Wood Furnace
Propane
Are Heating Sources CSA or ULC Approved?
Yes
No
Type of Roof:
Asphalt Shingles
Steel
Other
Age of Roof:
0-5 yrs
5-10 yrs
10-15 yrs
15-20 yrs
20+ yrs
Number of Storeys:
Bungalow
1.5 Storey
2 Storey
Split Level
Fire Hydrant Protected?
Yes
No
Distance to Firehall?
0-5 kms
5-10 kms
10-15 kms
15-20 kms
20+ kms
Any Outbuildings?
Yes
No
Description of Garage or Outbuildings (size, type of heat, age)
Amount of Dwelling Coverage Required ($)
Amount of Contents Coverage Required ($):
Submit Form