McGoey Brothers Insrance Brokers Ltd.

Online Home Quote

Name: Address:  

Phone: (home) (bus) (fax)

Home Owner #1 Birthdate:

Home Owner #2 Birthdate:

Is there a home based business? YesNo

Are you firehall or hydrant protected? FirehallHydrant if firehall how close is it to you ? km

Number of stories(1,2 storey etc.)

Type of houseTown HouseDetachedSemi-Detached if other please specify below:

Year Built:

Outer wall: Brick VeneerVinyl SidingAluminum SidingWoodSolid BrickOther if other please specify below:

Roof : AsphaltClay tilesShakesRegular shingles if other please specify below:

Total square footage of home:

Number and type of bathrooms (4pc, 3pc Etc.):

Number of Fireplaces and type (wood, gas) :

Wood stove? YesNo

WETT certified? YesNo

Central Air? YesNo

Electrical:Amp?

Electrical : BreakerFuse

Type of wiring: CopperAluminumKnob and TubeOther if other please specify below:

Type of Heat: GasElectricOilOther If other please specify below:

If oil please specify location and age of tank below:

Garage (number): (Type):AttachedDetached

Is your basement finished? YesNo

What percent of the basement is finished ? %

Is it a walkout basement? YesNo

Flooring percent

Wood % Carpet % Tile % Vinyl %

Other (specify type and %)

Extra (Central vac, Hot tub, skylights, extra kitchen) please specify below:

Pool (please specify below whether it is above or inground, also its size):

Detached structures (ex. Gazebo, Cabana, Shed, etc.) please specify structures below:

Decks/ porches (please specify type and square footage below) :

Updates

Please specify the year of any updates to the following:

Electrical: Roof: Plumbing:

Heating: Mortgage:

Any Claims? (please specify below):

Additional Comments:

* QUOTES ARE ESTIMATES ONLY AND DO NOT BIND INSURANCE COVERAGE IN ANY WAY

(After submitting a quote a broker will contact you as soon as possible)