Commercial Insurance
Name:
Address:
City:
Province:
Postal Code:
Phone Number:
Email Address:
Age of building:
Construction of building:
Is the building sprinklered?
Yes     No
How much area do you occupy?
Are you the only tenant?
Yes     No
Is there a hydrant within 1000 ft. (300 metres)?
Yes     No
Is there a fire hall within 5 miles (8 kms)?
Yes     No
Has insurance ever been denied or canceled?
Yes     No
What type of business?
How many years in the business?
Have there been any insurance
claims in the last 3 years?
What are the annual receipts?
What is the annual payroll?
Comments:
 

Disclaimer
This is a request to provide a quote only and is not an insurance policy. It is not an offer of insurance. Further information may be required in order for a complete quote to be provided. This quote request contains some information about coverage offered but it does not list all of the conditions and exclusions that apply to the described coverage. The actual wording of the policy governs all situations.

This quote request is only available to persons resident in the Province of Ontario.

The products described are subject to change without notice at any time.