Auto Insurance

Car, truck, van motorcycle? We have coverage that’s right for you. Whether you have multiple drivers, vehicles or just one, we can help you find the best price and coverage to protect both you and your car in the event that you do get into an accident.

Start Your Quote

To get a quote, simply fill out the form below and click “Submit.” One of our agents will contact you within one business day to help you select the best car insurance for your vehicle. For other questions, please feel free to contact us.

    Applicant Information

    Name (required)

    Address (required)

    City (required)

    Postal Code (required)

    Home Phone (required)

    Mobile Phone (required)

    Email (required)

    Occupation

    Employer

    How did you hear about our office?

    Vehicle Information

    Year Make Model & Trim VIN Purchase Date Renewal Date Current Premium
    1
    2
    3
    4
    KM to Work Annual KM Coverages (Collision/Comprehensive/Full Winter Tires? Principal Driver
    1 YesNo
    2 YesNo
    3 YesNo
    4 YesNo

    Have you ever been cancelled for non pay?
    YesNo

    If yes, when and why?

    Other Comments

    Driver Information

    Please fill out all that apply and the leave the rest blank.

    Driver 1

    Full Name on License

    Drivers License Number or Date of Birth

    Relationship

    How Long Insured

    G1 Date (mm/yy)

    G2 Date (mm/yy)

    G Date (mm/yy)

    Number of Tickets

    Number of Accidents

    Driver Training & When

    Good Student (80%)

    Ticket and Accident Detail With Dates

    Driver 2

    Full Name on License

    Drivers License Number or Date of Birth

    Relationship

    How Long Insured

    G1 Date (mm/yy)

    G2 Date (mm/yy)

    G Date (mm/yy)

    Number of Tickets

    Number of Accidents

    Driver Training & When

    Good Student (80%)

    Ticket and Accident Detail With Dates

    Driver 3

    Full Name on License

    Drivers License Number or Date of Birth

    Relationship

    How Long Insured

    G1 Date (mm/yy)

    G2 Date (mm/yy)

    G Date (mm/yy)

    Number of Tickets

    Number of Accidents

    Driver Training & When

    Good Student (80%)

    Ticket and Accident Detail With Dates

    Driver 4

    Full Name on License

    Drivers License Number or Date of Birth

    Relationship

    How Long Insured

    G1 Date (mm/yy)

    G2 Date (mm/yy)

    G Date (mm/yy)

    Number of Tickets

    Number of Accidents

    Driver Training & When

    Good Student (80%)

    Ticket and Accident Detail With Dates

    Need Assistance? Call

    905-793-3535

    Phone

    Our Office

    2131 Williams Parkway East Unit 1
    Brampton, ON L6S 5Z4