Online Home Insurance Quote | Olsen-Sottile Insurance, Niagara Falls, Ontario

First Name: *

Last Name: *

Address: *

City: *

Province: *

Postal Code: *

Phone: *

Email: *

Are you:

Homeowner

Condo Owner

Renter

Date of Birth: *

Estimated Replacement value of dwelling: *

Estimated Replacement value of personal property: *

Preferred policy deductible:

Liability amount requested:

How many years have you consistently had a property policy in force: *

Number of claims in the past 10 years: *

How many years since last claim (if within 10 years): *

Do you smoke: *

Yes

No

Do you have a monitored alarm? (fire & burglary): *

Yes

No

Do you have a mortgage/secured line of credit on the property:

How many years since last time you moved:

Was your prior policy cancelled due to non payment:

Yes

No

Was your policy lapsed for any other reason by the insurance company:

Yes

No

Which insurance company has your current auto insurance:

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