Victoria Office
Phone: (250) 388-5555

Westshore Office
Phone: (250) 478-5588

Duncan Office
Phone: (250) 856-9440

Pemberton Holmes RentalAssure

Basic Information:

Name of Homeowner(s):
eg: John Smith


Postal Address:
eg: 830 Pandora Ave Victoria, BC, V8W 1P4


Email Address:
eg: name@domain.com
Primary Phone:
eg: 2501231234


Name of Property Manager:
eg: Oliver Smith
Email Address:
eg: name@domain.com


Policy Effective Date:
eg: 2018-01-30
Policy Expiry Date:
eg: 2020-01-30


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:
eg: 830 Pandora Ave Victoria, BC, V8W 1P4


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?