Date of birth

Policy renewal date

Vehicule information

Vehicule year
Vehicule manufacturer
Vehicule model
Serial number (VIN)

Coverage

Public liability
Collision deductable
Accident without collision deductable
Replacement Cost Advantage
Purchase date

Usage

Kilometers to work
Kilometers for business
Kilometers yearly

Vehicule information

Vehicule year
Vehicule manufacturer
Vehicule model
Serial number (VIN)

Coverage

Public liability
Collision deductable
Accident without collision deductable
Replacement Cost Advantage
Purchase date

Usage

Kilometers to work
Kilometers for business
Kilometers yearly

Your information

Criminal record
Incidents from the past 6 years
Infractions from the past 3 years
Have been denied by an insurrer
Licence suspension

Driver's information

Full name
Date of birth
Criminal record
Incidents from the past 6 years
Infractions from the past 3 years
Have been denied by an insurrer
Licence suspension

Current insurrer

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Coverage

Public liability
Collision deductable
Accident without collision deductable
Replacement Cost Advantage
Purchase date

This is for a maximum of 2 vehicles.

Current insurrer

Specify

Coverage

Public liability
Collision deductable
Accident without collision deductable
Replacement Cost Advantage
Purchase date

Criminal record
Claims in the past 10 years
Denied or cancelled by insurrer
Do you allow insurrers to verify your credit score to provide you with the best quote possible
Type of resident
Deductable
Civil responsability
Main heat source
Auxilary heat source
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Current insurrer
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Effective date

Building insurance limit
Content insurance limit
Public liability

Content insurance limit
Public liability

Current insurrer

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