Student Rental House Application Submission of this information does not represent a binding of any insurance contract or agreement. Additional information may be required in order to get an accurate quote of insurance Your Name First Last Your Contact Telephone Number*Your MAILING Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Email Student Rental PropertyPlease Answer Questions Below as They Pertain to Your Student Rental PropertyStudent Rental Property Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Have you Ever Had Any Claims/Losses in the Last 6 Years? Either on Homeowners or Rental Property Insurance PolicyYesNoDate, Description, Amount of Loss ($)Year BuiltHow Many Square Feet (Excluding Basement)Finished Basement? Yes No How Many StoriesSmoke/Fire Alarm On Each Floor? YES NO Number of BathroomsNumber of KitchensGarage No Yes – 1 Car – Detached Yes – 1 Car – Attached Yes – 2 Car – Detached Yes – 2 Car – Attached Any Detached Structures (other than garage) Yes No Please Describe Detached StructurePlease include what is used for, square footage and construction quality.# of Mortgages012Rental Property – ConstructionType of RoofWood – Ashphalt ShingleWood – SteelSteel DeckConcreteOtherUpdate Year*OtherElectricalCopperAluminumOtherOtherElectricalBreakersFusesAmps60 AMP100 + AMPUpdate Year*Type of PlumbingCopperPVCOtherOtherUpdate Year*Type of HeatForced Air GasElectricalOilOtherOtherUpdate Year*Year Of Hot Water TankYear You Purchased The PropertyHow Many Bedrooms Are There?Is There a Signed Rental Agreement With Tenants YES – 8 MONTH CONTRACT YES – 12 MONTH CONTRACT NONE Property Currently Vacant? YES NO No Smoking Policy in Force? YES NO Cooking Allowed in Rooms? YES NO Is there a Swimming Pool? YES NO Is There Fireplace In The Property YES NO Number of Students Living in the House123456789101112+Who is Looking after the Property Property Owner Professional Management Company Friend and/or Relative Other Other Please DescribeBuilding Coverage Limit ($)Annual Rental Revenue from Property ($)Liability Insurance $ 2 Million Appliances Coverage $ 5,000 $ 10,000 $ 15,000 Sewer Backup Limit $10,000 $15,000 $25,000 $50,000 $100,000 Additional CommentsFile UploadMax. file size: 40 MB.Although not necessary at this time, please attach anything that may help us in reviewing your property such as real estate listings, photosConsent* I agree to the Privacy Policy
