Business Insurance Quote

Instructions: Please fill in the following information and a Homestead Insurance Representative will contact you with your quote.

 

Note: Quoted prices are only valid within the Province of British Columbia, Canada.

  

Business Information

Is your building within 300 meters of a fire hydrant?

  Yes No

Is your building within 8 Km's of a fire hall?

  Yes No

Year Built

Heating

Construction Type

Theft Alarms  

  Yes No

Sprinklers

Yes No

  Other Occupants

Describe your business operations

Years Experience

Estimated gross annual Sales

% USA sales

% of subtrades

Name of Previous Insurer

Claims in last 5 years

 Yes No

Date

Type

Amount Paid

Please describe your past claims

 

 

Basic Coverage Amounts

Comprehensive Liability

 

Building Replacement

 

Contents Replacement

 

  Additional Coverage

  Amount  

Professional Liability

 

Loss of Earnings

 

Sewer Backup

 

Flood

 

Earthquake

 

Boiler and Machinery

 

Valuable Papers

 

Accounts Receivable

 

Computer or Data Processing

 

By-Laws

 

Crime

 

 

 

Additional information may be required in order to
 verify rating. One of our qualified representatives will
 contact you to confirm the information provided.

 

 

Contact Information

Name

Address

City

Postal Code

Email Address

Telephone #

Fax #

 

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