Thank you for your interest in a quote! In order to find the market that will give you the best price and coverage for your situation we need some information about you and the property to be insured. Please note that currently we can only accept online quote requests for locations in the Southern Vancouver Island area. For quotes in other geographical areas please Call Us directly. Thank you

Contact information - You must provide at least one method of contact in order for us to respond to your request.

Name:

How would you prefer to be contacted? Please Select Email Phone

Email:

Phone:

Location of property to be insured

Street:

City:

Postal Code:

Policy information

Renewal date of current policy:

Or If no current policy, when do you require coverage to begin?

Has any insurer cancelled or refused you insurance in the past 5 years? Please Select Yes No Not Sure

Have you had any losses or claims within the past 5 years? Please Select None One Two Three Four More Than Four

Is there business conducted on the premises? Please Select Yes No

Property information

Year Home was built:

Type of primary heat: Please Select Oil Gas Electric Woodstove

How much coverage do you require on the dwelling? Use the dwelling coverage amount from your existing policy, replacement cost if you have a current appraisal or we can do a calculation for you over the phone - just answer "I don't know" to this and we will contact you for additional details about your home.

Is this your primary residence? Please Select Yes No

Is there a rental suite in the home that is rented to others? Please Select None One Suite Two Suites Three or More Suites

Discount information

What is your age? Please Select Under 45 45-59 50-64 65 or over (please choose the age of the oldest person who will be named on the policy)

Is there an alarm system? Please Select None Monitored Not Monitored

Is there a mortgage on the property? Please Select No Yes

Are you a member of Block Watch? Please Select Yes No

Do you have any other insurance policies (Home or Auto) currently with Harbord Insurance? Please Select Yes No

If yes, what is the policy number?

Additional coverages

Would you like earthquake coverage? Please Select Yes No

If yes, choose a deductible: Please Select 5% 10%

Thank you for your interest in a quote! One of our Home Insurance Specialists will find the market with the best price and coverage for you and will contact you shortly. A request for a quote is not confirmation of coverage.

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150-805 Cloverdale Ave, Victoria BC  V9X 2S9     #9-1594 Fairfield Rd. Victoria, BC  V8S 1G1    
#3-9764 Fifth St, Sidney BC  V8L2X2
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