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	•	Boat

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Name:

Email Address:

Address:

City:

Province:

Postal Code:

Phone Number:

Do you own your own home,
own a condo unit or rent?

Homeowner

Condo Owner

Renter

Estimated replacement value
of dwelling (homeowner only)

Estimated replacement value of
personal property (condo & renters only)

Policy deductible preferred:

Liability amount requested:

Have you had any personal property
claimed in the past three years?

Yes