Tenant Quote Form - Capital Insurance Brokers

3-Step Tenant Insurance Quote

Estimated completion time: 3-5 minutes

Once you have filled out the information below, one of our licensed brokers will calculate rates and contact you to give you your estimated price for insurance. If you require assistance at any time, please do not hesitate to contact us directly.

Do you prefer speaking to a live insurance agent? Call us at 780-476-1600 any time between 8:30 am to 4:30 pm (MST), Mondays through Fridays. We look forward to hearing from you!

1 Basic Details

2 Residence Details

3 Contact Info

Name of Insured
First Last
Date of Birth (MM/DD/YYYY)
Occupation
Is there a co-applicant?
Name of Co-applicant
First Last
Date of Birth of Co-applicant (MM/DD/YYYY)
MM
DD
YYYY
Occupation
Address
Street Address City Postal Code

Is there a fire hydrant close to your home?
How far is your residence from the nearest firehall?
How many years have you had residential insurance?
How many residential insurance claims have you had in the past 6 years?
Have you been cancelled due to NSF or non-payment in the last 3 years?
Dwelling Information - Tenant Insurance
What kind of building do you live in?
What is the construction type of the building?
Please enter the approximate age of the building:
What is the heating inside of your unit?
How much contents coverage do you require?
How much liability coverage do you need?
Other than your own family, do you have renters/roomates living here?

Who should we contact regarding this quote?*
First Last
Home/cell phone number:*
Business/work number:
Email:*
When would be the best time for a broker to contact you with your insurance quotes?*
- Anytime, as soon as possible
- Morning (9:00 am to 11:59 am)
- Afternoon (12:00 pm to 4:30 pm)
By clicking "Get Quotes", I understand that the information from this form will be reviewed by ARC Insurance Brokers in order to provide an accurate quote. I also understand that ARC Insurance Brokers or an agent of ARC Insurance Brokers may contact me via phone or email to provide quotes or to obtain additional information needed to provide quotes.*
- I agree

3-Step Tenant Insurance Quote

3-Step Tenant Insurance Quote

Dwelling Information - Tenant Insurance

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