Quote home solutionsHomeQuote home solutionsHABITATION SOUS STANDARD SOLUTIONS (#46)PropriétéSituationRésidenceValeursIdentitéContactAdresseDatesHistoriqueConsentementService réservé exclusivement aux résidents du Québec. Vos réponses restent confidentielles et servent uniquement à préparer votre soumission.What type of property do you want to insure? Owner Co-owner Tenant RentalPreviousNextYour situation: Non-payment Vacant or vacant Criminal record or scroll Loss Frequency Precarious financial situation, including a discharged bankruptcy Housing in a congested area Insurance contract interrupted Employment-related reasons Tenant insurance in a commercial building Another problemPreviousNextHow many years have you been living at your current address?123456789101112131415More than 15 yearsPreviousNextWhat is the approximate value of your house?What is the approximate value of your content?PreviousNextFirst NameSurnamePreviousNextE-mailPhone/MobilePreviousNextAddressAddress Line 1TownProvinceZip codePreviousNextYour date of birth?When is your home insurance renewal?PreviousNextHave you had any cancellations of your insurance for non-payment in the last 6 years? Yes NoPreviousNextThe information collected in this section allows us, among other things, to pre-qualify for your insurance needs and potentially provide you with an insurance quote. The information provided is stored in order to meet legislative and regulatory requirements. In addition, by filling in the form, you consent to our use, communication or sharing internally and externally (in particular with partner firms and/or Assurancia firms and/or insurers) and that we retain this information. Yes I agree to receive personalized advice or occasional information about Assur360 Tek Inc.'s products and services by e-mail. You can withdraw your consent at any time. I agreePrécédentObtenir ma soumission Last updated: September 2, 2026
