Not Sure Which Location is Closest to You?Take a look at our locations map to find the office that is right for you! Find a Location! Step 1 of 3 33% GENERAL INFORMATIONInsured's Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Daytime Phone*Email Date of Birth* MM DD YYYY Years as a Boat Owner*Number of Years Experience*Boating Education and Courses*Member of Cruising Club*YesNoCurrently Insured?*YesNoRenewal Date or Date Last Renewed* Date Format: MM slash DD slash YYYY How Many Years Continuously Insured*Has your insurance ever been cancelled or refused?*YesNoWas your last policy cancelled due to non-payment?*YesNoDriving Record - Have you received any tickets in the last 3 years?*YesNoIf yes, please provide details:Previous Insurer:*Any boating losses in the last 3 years?*YesNoIf yes, please provide details: Watercraft/Engine InformationType of Vessel*Please Select OnePersonal Watercraft (Seadoo/Jet Ski)Jet DriveSmall RunaboutWater Ski BoatFishing BoatBass BoatHigh PerformancePontoonPower CruiserLarge YachtHouseboatRiverboatSailboatOtherIf other, please describe:Vessel Year*Vessel Make*Vessel Model*Length*ENGINE INFORMATIONEngine Type*Please Select OneInboardOutboardInboard/OutboardNumber of Engines*1234Total H.P.*Fuel*GasDieselHull Construction*FibreglassWoodSteelAluminumMax Speed (km/h)* POLICY INFORMATIONMarket Value*Trailer Value*Tender Value*Other (Examples: Dighy, Equipment & Miscellaneous Items)*Liability*$2,000,000$1,000,000Pleasure Use Only*YesNoHow Many Operators*Which Office Would You Like to Submit this Quote to?*Select your officeAgincourtAjaxAncasterBarrieBramptonBurlingtonChathamClairvilleCliffsideDanforthEssexEtobicokeGeorgetownGreater NapaneeGrimsbyHamiltonCampbellvilleCathedral TownKingstonLeamingtonLondon NorthMarkhamMiltonMississaugaNewmarketNiagara FallsOakvilleOttawaPelmo ParkPickeringRenfrewRichmond HillSault Ste. MarieStoney CreekStreetsvilleSudburyTecumsehVictoria ParkWaterdownWaterlooWillowdaleWindsorHornbyCallanderLondon SouthRouge ValleyPhoneThis field is for validation purposes and should be left unchanged.
