We’ll find you the right coverage at the right price. You may qualify for significant discounts when you hold multiple policies with our brokerage. In order to get the most accurate quote, one of our team members will be in touch with you directly. "*" indicates required fields Your Name* Email* Preferred Phone Number*Your Home Address* City* Postal Code Are you looking for Auto, Home and/or Business? (Check that apply)* Auto Home Tenant Condo Motorcycle Business Other (Please describe, We'll follow up!) Life Insurance Travel Insurance HiddenAre you looking for Auto, Home and/or Business? (Check that apply) - dropdown*Please Select OptionAutoHomeTenantCondoMotorcycleBusinessOther (Please describe, We'll follow up!)Other (Please describe, We'll follow up!)*Vehicle Specific QuestionnaireLet's get rolling.Consent to Run Driving Reports I give permission to run driving reports for the purposes of quoting Driver's License Number/s CAA Membership # if applicable If you already have Auto Insurance, when is your renewal date? MM slash DD slash YYYY How many vehicles?*12More Than 2Vehicle #1Year, Make and Model* VIN # (If Known) This helps us be more accurate with quoting as some vehicles have lots of different configurations. You can leave it blank for quoting, we may ask for it later.Primary Driver*Please enter a number from 1 to 10.Occasional Driver/s (If Any)Please enter a number from 1 to 10.Name* Date of Birth MM slash DD slash YYYY Driver's License Number* Use of the Vehicle* Pleasure To Work Business (Describe Use) Business Description*Distance One-Way in KM*Please enter a number greater than or equal to 1.Approx KM in a Year*Please enter a number greater than or equal to 1.Do you have Winter Tires that you change seasonally?* Yes No Coverages Requested $1M Liability $2M Liability Collision - $500 Deductible Collision ( - $1000 Deductible Comprehensive - $500 Deductible Comprehensive - $1000 Deductible All Perils Additional Accident Benefits Accident Forgiveness - Claim Protection (If you qualify) OPCF20 - Rental Car Coverage OPCF43 - Waiver of Depreciation (On newly acquired vehicles) Other Typically we recommend $2M Liability, Collision ($1000 Deductible), Comprehensive ($500 Deductible), OPCF20 (Rental Car Coverage) and Accident ForgivenessOther Coverage Requested*Vehicle #2Year, Make and Model - vehcle 2* VIN # (If Known) - vehcle 2 This helps us be more accurate with quoting as some vehicles have lots of different configurations. You can leave it blank for quoting, we may ask for it later.Primary Driver - vehcle 2*Please enter a number from 1 to 10.Occasional Driver/s (If Any) - vehcle 2Please enter a number from 1 to 10.Name 2* Date of Birth - 2* MM slash DD slash YYYY Driver's License Number - 2* Use of the Vehicle - vehcle 2* Pleasure To Work Business (Describe Use) Business Description - vehcle 2*Distance One-Way in KM - vehcle 2*Please enter a number greater than or equal to 1.Approx KM in a Year - vehcle 2*Please enter a number greater than or equal to 1.Do you have Winter Tires that you change seasonally? - vehcle 2* Yes No Coverages Requested - vehcle 2 $1M Liability $2M Liability Collision - $500 Deductible Collision ( - $1000 Deductible Comprehensive - $500 Deductible Comprehensive - $1000 Deductible All Perils Additional Accident Benefits Accident Forgiveness - Claim Protection (If you qualify) OPCF20 - Rental Car Coverage OPCF43 - Waiver of Depreciation (On newly acquired vehicles) Other Typically we recommend $2M Liability, Collision ($1000 Deductible), Comprehensive ($500 Deductible), OPCF20 (Rental Car Coverage) and Accident ForgivenessOther Coverage Requested - vehcle 2*3+ Vehicles - Please list Year, Make Model # VIN (if known)*HiddenSection Break - HomeCAA Membership # if applicable Home, Tenant or Condo Specific QuestionnaireYour Date of Birth* MM slash DD slash YYYY Current / Previous InsurerSelect your Current / Previous InsurerI'm a first time home-owner or haven't had insurance beforeAvivaCAADefinityGore MutualIntactThe CommonwellWaterlooOtherOther Insurer* Policy # Renewal/Expiry Date or Closing Date* MM slash DD slash YYYY Were you Declined, Cancelled, Refused or Non-Renewed in the last 3 years? Not that I know of Yes (Please Describe) Describe - Were you Declined, Cancelled, Refused or Non-Renewed in the last 3 years*Have you had any Claims in the last 5 years? No Yes (Please Describe) Describe - Have you had any Claims in the last 5 years*What storey do you live on?*Please select Story do you liveIts a Condo or High-RiseBasement123Approximate Year Built*Please enter a number greater than or equal to 1.Number of Stories*Please select Stories1234+How many bedrooms?*Please enter a number greater than or equal to 1.Number of bathrooms? Are they 2, 3, or 4 piece?*Please enter a number greater than or equal to 1.Exterior Finish*Select Exterior FinishBrickVinylStone VeneerStuccoMetalOther / Not SureDescribe - Exterior Finish*Approx. Square Footage of the House or Unit*Please enter a number greater than or equal to 1.What is the approx. value of your contents?*Please enter a number greater than or equal to 1.Ie. furniture, rugs, jewellry - anything that isn't affixed to the unit that you ownValue of the upgrades? Ie everything above and beyond the "basic unit"*Please enter a number greater than or equal to 1.Do you have any of the following?* Centrally Monitored Burglar or Fire Alarm? Woodstove/insert? Primary Heating Type*Select Primary Heating TypeForced Air / Central FurnaceBoiler and RadiatorsHeat PumpWoodstove or Pellet StoveWood Burning or Gas FireplaceElectric Baseboard or Space HeatersOtherWhen was the heating system last updated? (If Applicable)Please enter a number greater than or equal to 1.Electrical Panel Amperage*Select Electrical Panel Amperage60 Amp100 Amp200 AmpOther or Not SureWhen was the electrical panel last updated? (If Applicable)Please enter a number greater than or equal to 1.Roof Type*Select Roof TypeAsphalt ShinglesMetal/SteelClayIts a CondoOtherDescribe - Roof Type*Do you know the age of the roof?*Please enter a number greater than or equal to 1.In YearDo you have a Sump Pump?*Do you have a Sump Pump?NoYes - AlarmedNot SureAge of your hot water tank?*Please enter a number greater than or equal to 0.1.Nice work! You made it. One last question in this section - Do you have other properties that you're interested in getting a quote for?*Nice work! You made it. One last question in this section - Do you have other properties that you're interested in getting a quote for?NoYes (I'll follow up)Ie cottage, 2nd residenceDescribe - Do you have other properties that you're interested in getting a quote forHiddenSection Break - MotorcycleMotorcycle Specific QuestionsIf you already have insurance, when is your renewal date? MM slash DD slash YYYY M1 License Date MM slash DD slash YYYY M2 License Date MM slash DD slash YYYY M License Date MM slash DD slash YYYY Date since you've held continuous motorcycle insurance MM slash DD slash YYYY Have you taken a motorcycle safety course? Yes No Year, Make and Model of the Bike/s* Vin #'s (If Known) Helps be a bit more accurate with quotingDo you commute to work or school on the bike?* No Yes (Describe distance one way in km) Describe - you commute to work or school on the bike*Approx KM you ride in a season*Please enter a number greater than or equal to 1.Coverages Requested - vehcle 2 $1M Liability $2M Liability Collision - $500 Deductible Collision ( - $1000 Deductible Comprehensive - $500 Deductible Comprehensive - $1000 Deductible All Perils Additional Accident Benefits Accident Forgiveness - Claim Protection (If you qualify) OPCF20 - Rental Car Coverage OPCF43 - Waiver of Depreciation (On newly acquired vehicles) Other Typically we recommend $2M Liability, Collision ($1000 Deductible), Comprehensive ($500 Deductible), OPCF20 (Rental Car Coverage) and Accident ForgivenessVehicle Specific Questionnaire Let's get rolling.Driver's License Number/s* CAA Membership # if applicable HiddenBusiness QuestionnaireBusiness Questionnaire Businesses are all unique. I'll get some initial info to look up your business and follow up.Name of Your Business* What kind of business? What kinds of operations?*HiddenLife InsuranceName* Phone*Email* Your Date of Birth* MM slash DD slash YYYY GenderMaleFemaleSmoker or Non SmokerSmokerNon SmokerAmount of Coverage* HiddenTravel InsuranceName* Phone*Email* Your Date of Birth* MM slash DD slash YYYY GenderMaleFemaleDate of Travel* MM slash DD slash YYYY Destination* Auto Home Tenant Condo Motorcycle Business Other Submit