Home Insurance Quote Request | AeroRidge Insurance

ABOUT YOU

Salutation

First Name*

Last Name*

Address*

City*

Province*

Postal Code*

Email*

Do you currently have home insurance?*

Yes

No

Are you purchasing a new home?*

Yes

No

For how many consecutive years have you had any kind of property insurance in Canada on any property, either owning or renting?*

Have you had any policy cancellations for non-payment in last 5 years?*

Yes

No

Not Sure

Please provide details*

Have you had any claims in the last 5 years*

Yes

No

Please provide date and details*

What date did you (or will you) move into this property?*

Have you lived at this property for less than 3 years?*

Yes

No

Street Address*

Please provide your prior address

What is the date of birth of the oldest person on the deed?*

What year was the home built?*

What style is this home?

Square Footage (not including the basement):*

Construction Type*

Construction Quality*

Physical Shape*

Primary Exterior Siding*

Roof Material*

Number of full bathrooms (ie. 3 pieces or more):*

Number of half bathrooms (ie.2 pieces or more):*

Is the home on city water?*

Yes

No

Is the home located within 1000 ft. of a fire hydrant?*

Yes

No

Does the home have a sump pump?*

Yes

No

Does the home have a back water valve or flapper?*

Yes

No

Has the home been completely gutted in the last 25 years?*

Yes

No

Is the home on the historic registry?*

Yes

No

Type of basement*

What percentage of the basement is finished?*

Is there an apartament in the basement?*

Yes

No

Type of garage*

Type of pool*

Type of porch*

Does the home have a deck or balcony?*

Yes

No

Do you have a mortgage on the property?*

Yes

No

Do you have a line of credit on the property?*

Yes

No

Is this a single family home or do you rent out part of your home to others?*

Single family

Rent part of the home

If rented to others, how many families?*

1

2

3

More

Are there smokers in the home?*

Yes

No

Does the home have any monitored alarm system?*

Is the home 15 or more years old?*

Yes

No

Do you have any other properties that you own and use as a seasonal property or rent to others?*

Yes

No

Do you have a pleasure craft or snow machine to insure or any other*

Yes

No

Do you have any jewelry that you have scheduled on your current home policy?*

Yes

No

What group discount do you qualify for?*

SUBMIT YOUR INFORMATION

Upon submitting this request for an Home Insurance Quote, I understand my information will be forwarded to AeroRidge Insurance. By clicking the submit button below, I agree that the information provided is accurate, to the best of my knowledge. I understand that AeroRidge Insurance will be contacting me after they review the submitted information.