IMPORTANT NOTICE: Effective SEPTEMBER 1, 2016 our product coverage limits and prices have changed. Please be sure to read the policy documents carefully.

RESRx Order Form

  • Your information is:

  • Customer information:

    The information provided here should reflect what appears on the Agreement of Purchase and Sale. To ensure policy accuracy and to avoid delay of policy issuance, please provide correct information when completing this application.
  • Address of property being transacted

    An eligible property is defined as: Only one (1) Primary Residence under 10,000 sq. ft. and is limited to a detached, semi-detached or row home, strata, a condominium, townhouse, modular home and manufactured home that has been anchored to a permanent foundation and not moved during the Coverage Period.
    Primary Residence is defined as an owner-occupied residence in which the homeowner resides for at least six (6) months of a year, and does not include vacation rentals, lease to own or any full or part time rented or leased properties, or commercial properties, or residences used for business purposes other than on an occasional basis, and in no event includes day care centres, fraternity or sorority houses, or nursing/care homes.
  • Disclosure

    Please note that we are unable to offer any coverage if you ARE aware of any circumstances which may prejudice coverage.
  • Coverage Selection

    Notice: Effective May 19, 2017, Commission Insurance is no longer available.
  • Buyer's name as it appears on the Agreement of Purchase and Sale (the warranty portion will be issued in the BUYER's name).
  • Please provide the email address you wish us to send a secure payment link. If someone else is paying the premium on your behalf, enter their email address.