If you would like any information sent by traditional mail, please fill out the fields below

City/Prov

Street Address/P.O. Box#

Postal Code

*(text areas must be filled in to submit form)

("PV" or Class Plates)
How Many Accidents In Last 5 Years? How Many Were Your Fault?
How Many traffic convictions In Last 5 Years?

Coverage Options
Deductable $100 $200 $350 $500
Liability $1,000,000 $2,000,000
Road Hazzard Glass Deductible $50 $100 $ 200
Loss of Use
Replacement Cost (for new Cars only) Value

Question or Comment:

Please send me more information on Auto Extension Insurance

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