Home Insurance Get the right coverage tailored to your unique Home! Fill out the form below for a free quote or call (416) 862-5605 Home Insurance Quote Request Form Your Name(required) Email(valid email required) Phone Number(required) Do you currently have property insurance? yes no When does your current insurance expire? For How long have you had Home insurance? Do you have Automobile Insurance? Yes No Does anyone in the household smoke? yes no (required) Please choose a deductible: 0 500 1000 1500 2000 2500 3000 5000 Higher Do you have a mortgage? yes no multiple (required) Are your retired? yes no (required) Information about your home Address City Postal Code(required) Age of Home(required) What level of Fire Protection do you have? Hydrant & Firehall Firehall Only - within 8 kms No protection Other (please describe below) (required) Style Bunglow 1 1/2 Storey 2 Storey Side Split Townhouse Ranch Other (describe below) (required) Approximate Square Footage(required) Do you have a Finished Basement? 100% 75% 50 25% Not Finished (required) Do you have a walkout Basement? Yes No (required) Exterior Exterior Walls Brick Combination Brick/Stone Veneer Combination Brick & Siding Stucco Other (please describe below) (required) Roofing Asphalt Shingles Wood Shake Steel Roofing Other (please describe below) (required) Do you have any attached Structures? Yes, 1 Car Garage Yes, 1 1/2 Car Garage Yes, 2 Car Garage Yes. 3 Car Garage Yes, Other (please describe below) No attached structures (required) Do you have any porches or decks? Small Medium Large Open Porch Closed Porch Screened Porch Deck Do you have any Detached Structures? No 1Car Garage 2 Car Garage 3 Car Garage Other (please describe below) (required) Do you have any swimming pools, hot tubs or jacuzzi? Smal Medium Large Pool Hot Tub Jacuzzi (required) Interior Walls & Ceilings Drywall Plaster Combination (required) Please Describe the wall coverings in your home (Example: 100% Paint) Please describe the floor coverings in your home (Example: 50% Hardwood, 10% tile, 40% Carpet) How many Kitchens do you have? 0 1 2 3 4 or more (required) How many Full (3 or more piece) Bathrooms do you have ? 1 2 3 4 (required) How many Half l (2 piece) Bathrooms do you have ? 0 1 2 3 4 (required) Do you have a fireplace? No Single Double Gas other (required) Heating Electric Gas Oil (required) Air Conditioning None Same Ducts Separate Ducts Average Cost (required) Additional Information Please add any addional information below I give permission for my information to be used for the purpose of providing and insurance quote, council or risk management service follow Cipriani_IHC at http://twitter.com