Request a Commercial Insurance Quote Name: Address: City: Province: Postal Code: Phone Number: Email:   Age of Building: < 1 year 1 - 20 years 20 - 35 years > 35 years Construction of Building: Frame Masonry Non-Combustible Fire Resistive Is the building sprinklered? Y    N How much area do you occupy? < 5,000 5,000 - 10,000 > 10,000 Are you the only tenant? Y    N Is there a hydrant within 500 ft. (150 metres)? Y    N Is there a fire hall within 3 miles (5 kms)? Y    N Has insurance ever been denied or canceled? Y    N What type of business? Retail Office Building Ownership Wholesale Operation Farm Service Operation Contractor Garage Operation Manufacturer Other How many years in the business? < 1 year 1 - 5 years > 5 years Have there been any insurance claims in the last 3 years? No <= 2 >= 3

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