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There are 160 car insurance agencies and agents in Canada who could receive your request
About the principal driver:
Province:
City:
Your gender:
Birth day:
Marital Status :
Employer:
Occupation:
Traffic violations:
About the driver's license:
Province issued?
Obtained when:
About the vehicle:
Manufacturer:
Vehicle model:
Model year, as required:
Estimated value:
Acquisition date:
Tracking system:
Immobiliser system:
Anti-theft marking:
Other protection:
Annual kilometrage:
Kilometrage for business:
About the car insurance:
Insured for how many, years:
Policy come up for renewal:
Number of drivers:
Other information:
To work or to school or to go to public transportation:
Will this vehicle be used for commercial purposes?
Do you want the replacement value protection?
Do you currently hold an insurance policy?
Do you have more than one passenger vehicle to ensure?
Has this driver ever had a car insurance?
Has the driver successfully completed a driving course?
Has one of the drivers had his license suspended?
Drivers guilty of insurance fraud:
Has there been any break in insurance?
Modifications, additions other than the original parts?
Has a driver of this vehicle had an accident?
Information about the applicant:
Your name: *
Email:
Phone: *
Add other details to your request:
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