Barbados Guardian General Home Insurance Online Quotation Form

HOME INSURANCE QUOTATION FORM

Agents for:

Name:_________________________________________________________________ Address: _______________________________________________________________ _______________________________________________________________ Age:_____________ Address of property to be insured: ________________________________________ ______________________________________________________________________ ______________________________________________________________________ Value of Property:_______________________________________________________ Construction of Roof: Concrete

Galvanised

Other

Tiles

Permaclad

_________________

Exterior Wall Construction: Wood

Concrete

Other

________________

Interior Wall Construction: Wood

Concrete

Other

________________

Other

________________

Type of floor:

Wood

Concrete

Number of storey’s: _______________________________________ Proximity to nearest building: _______________________________ Year of construction:

____________________

Are you a member of a Barbados Credit Union? Yes No If so, which one? _________________________________________________________ Current Insurance Company: _______________________________________________ Please note your request for a quotation does not guarantee acceptance by Guardian General.

Download and fax to 1 246 427 9038 # 5 0ceanCity, St. Philip, Barbados, West Indies Telephone: (246) 436-4745 Fax: (246) 228-6396 Email: [email protected] Bankers: RBC Royal Bank of Canada, Broad Street, Bridgetown