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Employee Listing
Tenants Insurance
Name:
Address:
City:
Province:
Postal Code:
Phone Number:
Email Address:
Years Continuously Insured:
Estimated replacement value of personal property:
Policy Deductible Preferred:
$500
$1,000
Liability Amount Requested:
$1,000,000
$2,000,000
Have you had any personal property claims in the last 3 years:
Yes
No
Referred By:
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