| McFarlan Rowlands Insurance Brokers

Home Insurance Quote

Step 1 of 4

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Full Name*
Date of Birth
MM
DD
YYYY
Address
Street Address Address Line 2 City Province Postal Code
Phone*
Email Address
How did you hear about us?*

Home Details
Year Built
Square Footage (not including garage or basement)
Style of Home
ex) Ranch, Two Storey Home, Townhouse etc.
Number of Bathrooms ( please state how many full and half)
Type of Plumbing
When was your plumbing last replaced?
Type of Heat
Age of Furnace
Hydro (select applicable)
- 100 AMP
- 200 AMP
- Breakers
- Fuses
Exterior of Home
ex) Aluminum, vinyl siding, brick etc.
Type of Roof
ex) Shingles, steel etc.
When was your roof last replaced?
Do you have a porch or a deck? If so, what size?
Basement size (of finished area)
How far are you located from the closest fire hall?
Does anyone in your house smoke?
Do you have a sump pump?
Do you have a monitored alarm?
Do you have battery back up?

Garage
Type of Garage
Size of Garage
ex) One car, two car etc.
Garage Exterior
ex) Aluminum, vinyl siding, brick etc.
Garage Roof
ex) Shingles, steel etc.
Select all that apply to your garage:
- Separate heat
- Separate hydro

Do you have a mortgage?
Have there been any claims made at this address?
Type of Claim
Year Claim Made
Month Claim Made
How long have you continuously been insured for home insurance?
Please select your preferred deductible:
- $1,000
- $2,500
- $5,000
Select your preferred liability amount:
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