Fill out the form below (for ROMS BC members only).
Name(s) of insured:
Year Built:
Address of Property
Phone Number:
E-mail Address:
ROMS BC Membership #
Apartment Block
Townhomes
Construction Material:
Wood
Concrete
Number of Suites:
Type of heating:
Electric
Gas - Hot Water
Gas - Forced Air
Oil - Hot Water
Oil - Forced Air
H.V.A.C.
Any water leakage problems?
No
Yes
5 years claim history:
Condominium Owner
Home Owner
ROMS BC
Strata Plans
Tenant Packages
Townhouse Owner
Victoria Location
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