506-633-2121 info@allcoverage.ca

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Home Insurance Quote

Fill out and submit the form below and we will get back to you with a quote.

Please ensure you fill out as much information as possible about yourself, your home, garage, and outbuildings.

Applicant #1 - Full Name *

Applicant #2 - Full Name

Phone *

Email Address

Occupation *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Existing Policy Number (if applicable)

Date(s) of Birth of those listed on the policy (if applicable):

Questionnaire

Year House Built *

Current Value of Home

Mortgaged? *

Yes
No

Smokers? *

Yes
No

How long have you lived at current address? *

How long have you had home insurance in place? *

Claims in the last 5 years? *

Yes
No

Description of Claim(s) (if applicable)

Fire hydrants on your road/street? *

Yes
No

Nearest Fire Hall

Distance to Fire Hall (in Kilometres)

House Width (ft) *

House Length (ft) *

House Style *

bungalow
split-level
bi-level
other

If house style is 'other', please describe.

Number of storeys (excl. basement) *

1
2
3 or more

Physical Shape *

L-shape
Rectangle
Square
Other

If Physical Shape is 'other', please describe.

Construction Type (ie. wood frame, brick, etc) *

Construction Quality (ie. average, above average, etc) *

Exterior Finish (ie. vinyl siding, cedar shingle, block, etc) *

Year roof covering was last replaced *

Roof material (ie. asphalt, metal, etc) *

Number of FULL bathrooms *

Number of HALF bathrooms *

Number of porches *

For each porch, tell us if it is open/enclosed/screened and the dimensions (in ft).

Number of decks *

For each deck, tell us the dimensions (in ft) and the materials.

Types of heating (check all that apply) *

Electric
Oil
Wood
Heat Pump
Other

If OIL heat, age of oil tank

Type of oil tank (e.g. steel, double-wall steel, fibreglass, etc)

Oil tank location

Inside
Outside

Age of oil furnace

If any WOOD heat

Stove
Furnace

If you have a wood stove, is it WETT certified?

Yes
No

Cords used per year

Age of wood stove / furnace

Pellet Stove

Yes
No

Pellets burned per year

Basement description: 8' poured/slab/crawlspace? *

Any part of basement that does not have concrete? *

Yes
No

If yes, please describe:

Year of basement: *

Size of basement (ft) or same as house? *

Finished basement percentage (e.g. 50%) *

Other rooms (ie. finished attic, bonus room, breezeway, greenhouse, indoor pool, patio, solarium, etc). Provide dimensions and year constructed.

Any other items that would add value to the home?

House over 25 years old, updates to:

Plumbing date

Details

Back water valve with flapper?

Yes
No

Hot water heater age

Septic system?

Yes
No

What type of plumbing? (Copper, plastic, etc)

If any cast iron, length (ft):

Sump pump in a pit?

Yes
No

Main water shutoff type

Wiring date

Details

Number of BATTERY smoke detectors

Number of ELECTRIC smoke detectors

Electrical Entrance

100 amp
200 amp

Electrical Panel

Fuses
Circuit Breakers

If alarm system, what type?

Garage/Carport

Type of Garage/Carport? *

None
Attached
Detached

Size of Garage/Carport (ft)

Accommodates how many vehicles?

Year built

Heating system?

Yes
No

If there is a heating system, what type? (e.g. wood, propane, electric, etc)

Construction type (e.g. wood, brick, etc)

Siding type (e.g. vinyl, cedar shingle, etc)

Construction quality (e.g. average, above average, etc)

Current condition (e.g. excellent, average, poor, etc)

Age of roof covering

Roof covering material (e.g. asphalt, metal, etc)

Other Outbuildings

Any other outbuildings on the property? (e.g. shed, barn, etc) Please provide size and year built.

Construction type and quality of outbuildings

Any heat in outbuildings? If yes, type (e.g. wood, electric, propane, etc)

Any other detached structures? (e.g. boathouse, hot tub, outdoor pool, gazebo). Please provide size, year built, construction type, and quality.

Outdoor pool?

Yes
No

If you have an outdoor pool, is it fenced?

Yes
No

If you have a pool, is it vinyl lined?

Yes
No

Additional Information

Do you operate ANY business on this property? *

Yes
No

If yes, please describe

Other items you should include:

Phone

All-Coverage Insurance Ltd. (Uptown)

info@allcoverage.ca
85 King Street
Saint John NB
E2L 1G5
(506) 633-2121

All-Coverage Insurance Ltd. (North End)

info@allcoverage.ca
695 Somerset Street
Saint John NB
E2K 2Y6
(506) 633-0200

Bestway Insurance

info@bestwayinsurance.ca
4450 RTE 127
Chamcook NB
E5B 3A1
(506) 529-4504

St. George Insurance

info@stgeorgeinsurance.ca
21 Main Street
Saint George NB
E5C 3H9
(506) 755-6336

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