Pemberton Holmes RentalAssure Basic Information: Name of Homeowner(s): Postal Address: Email Address: Primary Phone: Name of Property Manager: Email Address: Policy Effective Date: Policy Expiry Date: Previous insurance on this property? yesno Previous insurance on this property declined or cancelled by insurer? yesno Any claims in last 5 years? yesno Please provide details: Location Details: Location Address: Monthly Rental Income: Value of additional buildings on property: Year Built: Number of Suites: Roof covering: ShakeTorch OnAsphalt ShingleT&GOther Total Building sqft: # of Stories: Basement? # of Bathrooms: # of Kitchens: Heating Type: Electrical Type: Plumbing Type: Updates: Heating: Roof: Plumbing: Wiring: Oil tank age: Within 300m of Fire Hydrant? Within 8km to a responding fire hall?