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Homeowners Guarantee Worksheet

Contact Information
Name:
Address:
City:
Postal Code:
Phone #:
Work #:
Fax #:
E-mail:
Date of Birth:
Insurance History
Claims:
Type of Claims:
Approximate Payout:
Previous Insurance:
Policy #:
Expiry:
Is there a mortgage?
If so to what bank?
How long have you had house insurance?
General Information
Type of Home
Bungalow
Bungalow
1 1/2 Storey
1 1/2 Storey
2 Storey
2 Storey
Split Level
Split Level
Bi Level
Bi Level
Duplex
Duplex
Townhouse
Townhouse
Type of Siding:
(Stucco, Wood, Aluminum, Vinyl, Brick Veneer, Artificial Stone, Solid Brick, Native Stone)
Ground Floor Area (sq. ft.):
Percentage of Siding: % Basement Area (sq. ft.):
Year Built: Completed Area (sq. ft.):
Additional Features
Bathrooms Fireplace
Extra #: Chimney:
Full Baths (3 fixtures): Number of Hearths:
Half Baths (2 fixtures): Gas:
Garage Updates
Type: Roof: yr
Size: Plumbing: yr
Heated: Electrical: yr
    Heating: yr
Shingles Swimming Pool
Type: Is there a swimming pool?
Approximate year of installation: Type: Inground    Above ground   
    Construction: Cement    Vinyl   
    Size:
    Sauna, Hot Tub, Jacuzzi:
Other Features Other Items
Central Air Conditioning: Boat:
Central Vacuum System: Value of Boat:
Centrally Monitored Alarm: Motor:
Neighborhood Watch: Value of Motor:
Size of Wood or Cement Deck: HorsePower?
Roof Over Deck?: Motor Type: Inboard    Outboard
Size of roof over deck: Jewellry:
Built-In Features
Countertop Range: Dishwasher:
Dryer: Electronic Air Filter:
Garage Door Opener: Heat Exchanger:
Intercom System: Sprinkler System:
Jetted Tub: Microwave:
Oven: Refrigerator:
Skylight: Electronic Smoke Detectors:
Video Door Answering: Washer (built-in):
Water Purification System: Water Softener:
Wet Bar: Whole House Fan:
Wood Burning Stove:    

Polls

How likely are you to use our drive through for Plate and License renewal?
 
Would an online insurance quote program benefit you?
 
During which time of day will you do most of your insurance business?
 

Hours of Operation

 2007-07-25

Jordan Ewart Insurance is open 6 days a week

Monday to Thursday
8:00 am to 8:00 pm

Friday
8:00 am to 6:00 pm
Saturday
9:00 am – 5:00 pm.