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Home Insurance
Condo Insurance
Tenant Insurance
Cottage or Seasonal Property Insurance
Life & Health Insurance
Travel Insurance
Umbrella Liability Insurance

Auto Insurance
Classic Car Insurance
Motorcycle Insurance
ATV & Snowmobile Insurance
Motorhome & Trailer Insurance
Watercraft Insurance

Industry Specific Insurance Policies
Farm Insurance
Commercial Property Insurance
Commercial Liability Insurance
Professional Liability Insurance
Surety Bonding Insurance
Commercial Auto & Fleet Insurance
Cyber Liability & Privacy Breach Insurance
Legal Expense Coverage

Cottage Associations
Bruce Power
Hole In One Insurance

Our Team
Contact Us
Daniel T. Craig Memorial Golf Tournament
Community Involvement
Testimonials

Self Serve
Make A Payment
Make a Claim
News
Refer A Friend

Client Portal Menu

Quote Form

Auto Insurance

1 Basic Information

2 Vehicle Information

3 Driver Information

4 Coverage Date & Submit

Basic Information
Full Name*
Phone
Email Address*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Total number of vehicles in household*
Numbers of licensed drivers living in your household (including yourself):*

Vehicle Information
Vehicle Year*
Vehicle Make*
Vehicle Model*
VIN (optional)
Purchase or lease date of vehicle:*
Purchase Condition:*
- New
- Used
Approximate number of kilometres driven annually:*
If you use your vehicle to go to work or school, please list your commute distance (one-way):
Is vehicle used for any business or commercial purposes:*
- Yes
- No
Name of the primary driver of this vehicle:*
Winter tires (All Season tires do not quality as winter tires):*
- Yes
- No
Add Additional Vehicle?
- No
- Yes
Additional Vehicle Information
Vehicle Year*
Vehicle Make*
Vehicle Model*
VIN (optional)
Purchase or lease date of vehicle:*
Purchase Condition:*
- New
- Used
Approximate number of kilometres driven annually:*
If you use your vehicle to go to work or school, please list your commute distance (one-way):
Is vehicle used for any business or commercial purposes:*
- Yes
- No
Name of the primary driver of this vehicle:*
Winter tires (this discount is not available with "All Season" tires):*
- Yes
- No
Add Additional Vehicle?
- No
- Yes
Additional Vehicle Information
Vehicle Year
Vehicle Make
Vehicle Model
VIN (optional)
Purchase or lease date of vehicle:
Purchase Condition:
- New
- Used
Approximate number of kilometres driven annually:
If you use your vehicle to go to work or school, please list your commute distance (one-way):
Is vehicle used for any business or commercial purposes:
- Yes
- No
Name of the primary driver of this vehicle:
Winter tires (this discount is not available with "All Season" tires):
- Yes
- No

Driver Information
Driver Name*
Date of birth*
Date Format: MM slash DD slash YYYY
Driver's licenses number
Marital status:*
License Class*
Date first licensed:*
Completed Driver's Training Program:
- No
- Yes
Years continuously insured:*
Years with current insurance company:*
Number of traffic tickets (excluding parking tickets) in the past 3 years:*
Number of claims, NOT involving accidents, in the past 6 years*
Number of claims involving accidents in the past 6 years*
Number of times driver's license suspended in the past 6 years:*
Number of times insurance coverage has been cancelled by an insurance company in the past 5 years:*
Reason for most recent cancellation:
Add Additional Driver?
- No
- Yes
Additional Driver Informaton
Full Name
Date of birth
Date Format: MM slash DD slash YYYY
Driver's licenses number
Marital status
License class:
Date first licensed:
Completed Driver's Training Program
- No
- Yes
Years continuously insured:
Years with current insurance company:
Number of traffic tickets (excluding parking tickets) in the past 3 years:
Number of claims, NOT involving accidents, in the past 6 years
Number of claims involving accidents, in the past 6 years
Number of times driver's license suspended in the past 6 years:
Number of times insurance coverage has been cancelled by an insurance company in the past 5 years:
Reason for most recent cancellation:
Add Additional Driver?
- No
- Yes
Additional Driver Informaton
Full name
Date of birth
Date Format: MM slash DD slash YYYY
Driver's licenses number
Martial status
License class:
Date first licensed:
Completed Driver's Training Program:
- No
- Yes
Years continuously insured:
Years with current insurance company:
Number of traffic tickets (excluding parking tickets) in the past 3 years:
Number of claims, NOT involving accidents, in the past 6 years
Number of claims involving accidents, in the past 6 years
Number of times driver's license suspended in the past 6 years:
Number of times insurance coverage has been cancelled by an insurance company in the past 5 years:
Reason for most recent cancellation:

General Comments
Coverage Start Date:
Date Format: MM slash DD slash YYYY
If there is a specific CMR Broker you would prefer to deal with please enter their name here:
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