Tenant Insurance Lease Addendum

Upon signing up for Tenant Insurance, your account will be charged the premium amount choses plus administrations fee on the first of each month, commencing on the start date indicated on your sign-up form. If you re currently set up for pre-authorized payment, the payment amount will increase accordingly each month. If you submit your rent through the portal, please ensure you adjust your recurring payment accordingly to include the amount of your insurance premium and administration fee. Late fees will be applied in accordance with your lease terms for any payments not received on or before the first of each month.

"*" indicates required fields

Start Date for this Policy*

Name of Tenant(s)*

If more than one tenant is living in the unit and is a non-family member, please have them fill in their own addendum. Roommates are not covered under this policy

Suite #*

Building Address*

City*

Province*

Postal Code*

Email*

Phone*

I/we understand that, in accordance with the lease, personal property and third party liability must be in place.

INSURANCE OPTIONS (under Master Policy 4-449-1-0029)

Please read carefully and check an option

	Personal Property Limit	Personal Liability Limit	Additional Living Expenses In the event a tenant cannot occupy the unit as a result of an Insured Peril	Deductible Per Claim All selections, except $2,500 deductible for Earthquake	Personal Liability / Earthquake Deductible	Premium Per month per insured
Option 1	$15,000	$2,000,000	$6,000	$1,000	$2,500	$15.00
Option 2	$30,000	$2,000,000	$8,000	$1,000	$2,500	$20.00
Option 3	$60,000	$2,000,000	$10,000	$1,000	$2,500	$25.00
Option 4	I/we understand the options presented. It is understood I/we have chosen to obtain a tenant insurance policy from another provider. I/we will submit a copy of this insurance to Towers Realty Group and in addition recognize that failure to do so is a breach of the tenancy agreement.

TOWERS REALTY GROUP ADMINISTRATION FEE: CLIENT will apply a $4.00 (four dollars) service fee for the administration of the tenant program. This amount is an addition to the insurance premiums and will be administered by CLIENT.

AGREEMENT TO PURCHASE INSURANCE UNDER MASTER POLICY 4-449-1-0029

I/we wish to purchase the checked insurance coverage option. It is understood that the amount for the insurance selected must be paid. I/we hereby authorize Towers Realty Group to receive the premium and pay BFL CANADA Risk and Insurance Services Inc. on my/our behalf.

COVERAGE EFFECTIVE: Your coverage under Master Policy 4-449-1-0029 becomes effective on the “OCCUPANCY DATE” indicated on the first page. NOTE: Should your occupancy date change, this addendum must be updated to reflect this change or coverage will not be in place until the date shown on the document. I/we acknowledge that the only coverage effective under this agreement shall be in accordance with the insurance option exercised and that the premium must be paid to Towers Realty Group while occupying the captioned address. If payment is not paid to Towers Realty Group insurance coverage will be suspended until all outstanding premiums are paid up to date and or the policy has been cancelled.

ELIGIBILITY: I/we understand that insurance on personal property at the captioned address is available only to the tenant(s) and family member(s) who have also entered into a Lease/Rental agreement with Towers Realty Group and occupy the address on the agreement. I am also aware any roommates are not covered under this policy and will require their own coverage.

PREMIUM: It is understood that one (1) months’ notice of changes will be provided regarding premiums, fees, and or wordings. Any new rates shall be effective on the first (1^st) day of the month following the month in which advance notice of such change is provided. It is understood the insurance will continue on a month-to- month basis as long as I/we occupy the listed address and monthly premium is payable at the same time as that of the rent payment.

CANCELLATION: It is understood that this insurance product is being offered through the tenancy agreement with Towers Realty Group and can be cancelled at any time by Towers Realty Group. Thirty (30) days notice will be provided to all tenants by BFL CANADA Risk and Insurance Services Inc. in the event Towers Realty Group has chosen not to renew program.

INSURANCE INFORMATION: I/we have received a Coverage Summary (page 3 to 6 of this application). I/we understand this document represents the official insurance document and this document remains in effect until the cancellation of coverage, non-payment of premium or the end of the tenancy agreement. I/we understand that a copy of the complete specimen Master Policy is available for review by simply emailing bfltenantshelp@bflcanada.ca.

Consent & Disclosure: Where (a) The Tenant for this contract provided false particulars to the prejudice of the Insurer or knowingly misrepresents or fails to disclose any fact in any part of this application required to be stated therein; or (b) the Tenant contravenes a term of the contract or commits a fraud; or (c) the Tenant willfully makes false statement(s) in respect to a claim, the claim will become invalid and the Tenant(s) rights to recover are forfeited. The Tenant (s) have reviewed all parts and attachments of this application and acknowledge that all information is true, correct and understand that this application of insurance is based on the truth and completeness of this information. Some of this personal information may include, but is not limited to credit information and claims history. I/we authorize the broker or insurance company to collect, use and disclose any of this personal information, subject to the law and to the broker or insurance company’s policy regarding personal information, for the purposes of communication, assessing the application for insurance underwriting, evaluating claims, detecting and preventing fraud, and analyzing business results. Any and all individuals whose personal information is contained in this document have authorized that and agree to the above.

I/we hereby apply for insurance in the selected amount indicated on the application. I/we have voluntarily elected to purchase the insurance available through Towers Realty Group I/we have read the Coverage Summary on pages 3 to 5 of this agreement and understand that the insurance applied for under the Master Policy underwritten by XN Financial does have SPECIAL LIMITATIONS AND EXCLUSIONS.

Insurance Options*

Option 1: Premium of $15.00 + $4.00 service fee = $19.00 per month

Option 2: Premium of $20.00 + $4.00 service fee = $24.00 per month

Option 3: Premium of $25.00 + $4.00 service fee = $29.00 per month

Option 4: I/we have chosen to obtain a Tenants Insurance Policy from another provider.

Name 1*

First Last

Signature 1*

Name 2

First Last

Signature

By clicking Submit i/we confirm that i have read the beneficiary summary coverage found below.

THE UNDERWRITERS REPRESENTATIVE IS: XN Financial Services (Canada) Inc
THE INSURANCE BROKER IS: BFL CANADA Risk and Insurance Services Inc

FOR ALL QUESTIONS ABOUT YOUR INSURANCE COVERAGE:
PLEASE CALL 1 833 351 6825 or email bfltenantshelp@bflcanada.ca
BFL CANADA Insurance Services Inc – ask for Tenant Program specialist
TOWERS REALTY GROUP LTD. and their staff are not an Insurance Agent
Please do not address questions regarding the insurance to the Manager/Landlord.

Beneficiary Coverage Summary attached to
Group Policy 4-449-1-0029

CERTIFICATE PERIOD:

This insurance is effective 12:01am Standard time on the first day of insured move in date and after the first payment of premium unless otherwise stated. This insurance expires on the last day of the month that was paid for in full unless otherwise stated or canceled by the Broker or Insurer at which point cancellation date will be stated.

LIMIT OF LIABILITY:

The Liability Limit for each coverage section applies for each Beneficiary, for total of the amount shown in the Beneficiary Coverage Summary, as per selected Coverage Option.

COVERAGE OPTIONS / GROSS PREMIUM:

	Personal Property Limit	Personal Liability Limit	Deductible Per Claim (All sections)	Additional Living Expenses	Premium per month, per insured
Option 1	CAD 15,000	CAD 2,000,000	CAD 1,000	CAD 6,000	CAD 15.00
Option 2	CAD 30,000	CAD 2,000,000	CAD 1,000	CAD 8,000	CAD 20.00
Option 3	CAD 60,000	CAD 2,000,000	CAD 1,000	CAD 10,000	CAD 25.00
Deductible Per Claim	CAD 2,500 for each liability claim CAD 2,500 for each personal property loss due to earthquake CAD 1,000 for each loss under all other sections

FORMS APPLICABLE TO COVERAGE AND ATTACHED HEREON:

CD-BFL-4-04 (07-19), Agency Termination clauses 06/2019, 4033 (11/2013), 4067 (08/2012), CD-EN-MAS-AB (02-19)

APPLICABLE COURTS:

Worldwide

NOTICE OF CLAIMS:

To report a claim 1-877-807-5662 / xnbfl@sedgwick.com

UNDERWRITERS REPRESENTATIVE:

XN Financial Services (Canada) Inc.
600 De Maisonneuve Boul. W Suite 2310
Montreal (Quebec) Canada H3A 3J2

BROKER:

BFL CANADA Insurance Services Inc.
200-1167 Kensington Crescent NW
Calgary (Alberta) Canada T2N 1X7

SECTION 1

PERSONAL PROPERTY COVERAGE:

Coverage is provided against physical loss if your contents are damaged, destroyed, or lost.
The kinds of losses that are covered, and any special limits that apply, are explained in detail in the wordings.

Coverage Limit As per selected Coverage Option.

Applicable Deductibles

The deductible for each personal property loss is CAD 1,000
The deductible for each personal property loss due to an earthquake is CAD 2,500.

ADDITIONAL LIVING EXPENSES:

Coverage Limit As per selected Coverage Option

SPECIAL LIMITS OF INSURANCE (Applicable to Section 1):

For All Insured Losses

Money or cash cards
Business property, but only while on your premises
Securities
Watercraft, their furnishings, equipment, accessories & motors
Utility trailers
Spare automobile parts
Jewelry, watches, gems and furs
Coin or banknote collections
Stamp collections
Each bicycle, its equipment & accessories
Collectible cards including sports cards & comic books

Limit

500
5,000
5,000
2,000
1,000
1,000
6,000
1,000
2,000
2,000
2,000

SECTION 2

PERSONAL LIABILITY COVERAGE:

Your liability coverage covers damages for which you are legally responsible. We will pay up to the amount shown for each occurrence for bodily injury, property damage, or personal injury.

Coverage Limit As per selected Coverage Option.

Applicable Deductibles The deductible for each liability loss is CAD 2,500

VOLUNTARY MEDICAL PAYMENTS

Your voluntary medical payment coverage covers any reasonable expenses arising out of unintentional injury to a third party by you as described in the policy.

The maximum amount we will pay for each person in respect of one accident or occurrence is CAD 1,000

VOLUNTARY PAYMENT FOR DAMAGE TO PROPERTY

We will pay for unintentional direct damage you caused to property of others even though you are not legally liable as described in the policy.

Subject to a maximum amount of $500 per occurrence, we will pay whichever is the lower amount of what it would cost to repair or replace the property with materials of similar quality at the time of loss.

THIS POLICY CONTAINS A CLAUSE WHICH MAY LIMIT THE AMOUNT PAYABLE.

The beneficiary is requested to read this document, and if incorrect, return it immediately for alteration. In the event of an occurrence likely to result in a claim under this Insurance, immediate notice should be given to the Intermediary designated above.
This document is issued to provide a summary of the coverage only. It does not constitute a legal contract of insurance. The declarations page, wordings and applicable endorsements form the entire contract. This summary of coverage is furnished in accordance with, and in all respects is subject to the terms, conditions, limitations and exclusions of the group policy.

For purposes of Insurance Companies Act (Canada), the above information is from a document issued in the course of Lloyd’s Underwriters Insurance business in Canada