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Avail Quick Quote
First Name
Last Name
Name of your company
Address
Email
Website
Description of business operations
Gross revenue for the last 12 months
What year did your business start ?
Total number of employees
Is your building over 25 years old ?
*
I don't own a building
Yes
No
Type of electrical
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Any sales outside of Canada ?
*
Yes
No
Total payroll
Do you have tenants in your building ?
*
Yes
No
Last year electrical was updated
Type of amps
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Type of plumbing
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Type of heating
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Roof deck
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Last year plumbing was updated
Last year heating was updated
Roof surface
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Type of building construction
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How many square feet is the building ?
Limit of liability requested
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Has your company ever been declined, non-renewed or cancelled by any insurer for Commercial General Liability insurance ?
*
Yes
No
In the last 5 years, has your company ever had a claim made against it ?
*
Yes
No
Do any vehicles need to be insured ?
*
Yes
No
Do you have any cyber insurance ?
*
Yes
No
Do you have group benefits ?
*
Yes
No
When do you want the insurance to start ?
*
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