To receive a free no obligation quotation, simply fill out all of the required fields.  An estimation of your premium will be e-mailed back to you within the next 48 hours.

The following forms are for quotation purposes only and they are not to be considered as an application for insurance nor a policy of insurance.

 

Name: E-mail: Telephone:
City: Province: Ontario Postal Code:
Renewal Date: Age of Applicant:

Best time to be contacted: Monday Tuesday Wednesday Thursday Friday 

9am-12pm  12pm-4pm 4pm-7pm 

Model Year of Mobile:
Trade Name of Mobile:
Model of Mobile:
Size of Model:
What type of heat is primary:  
Is there a woodstove:  yes no
Have you had any losses in the past three years: yes no
Is the mobile home fully skirted:  yes no
Occupancy: Owner occupied   yes no Rented to others: yes no Seasonal: yes no  
Do you require replacement cost  coverages on both the mobile and contents: yes no
If not, please advise of the coverage amount you wish to insure the mobile for:
Fire Protection: Within 1000 feet of fire hydrant                                       Within 5 miles of fire station Unprotected
IMPORTANT NOTICE - THE PERIL OF WATER ESCAPE, RUPTURE, FREEZING IS EXCLUDED ON UNITS WHICH ARE "1979 AND OLDER."

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