Vachon Enright & Peter Insurance Ltd.

CAR INSURANCE QUOTE

Welcome to Vachon's on-line car insurance quick quote page. Your quote is free and we guarantee a response within one business day. Please ensure you complete the form as accurately as possible - all of the information has a bearing on the premium you will pay.

If you would rather speak to one of our sales representatives, please call us at (416) 239-3373 or email getaquote@vachoninsce.com

PERSONAL INFORMATION
NAME:
EMAIL:
PHONE:
CITY/TOWN:
POSTAL CODE:
How many consecutive years have you been insured in Canada without any interruption of coverage?	years months
Have you had any insurance cancellations for non-payment in the last three years?	Yes No
Are you a member of a Group Car and Home Insurance Program managed by Vachon Insurance?	Yes No
If yes, enter your group:
Discounts for Firefighters or OLBEU Employees
VEHICLE INFORMATION
Vehicle 1: *Vehicle Particulars and Use*
Year:
Make: (ie: Volkswagen)
Model: (ie: Jetta)
Body Type
Annual km driven:
Vehicle use:
Commute distance one-way:
*Insurance Coverages Required*
Liability:
Comprehensive deductible:
Collision deductible:
Optional coverages:	Loss of Use (replacement car coverage) Non-owned vehicle coverage (for rental car coverage)
Vehicle 2:
Year:
Make: (ie: Volkswagen)
Model: (ie: Jetta)
Body Type
Annual km driven:
Vehicle use:
Commute distance one-way:
*Insurance Coverages Required*
Liability:
Comprehensive deductible:
Collision deductible:
Optional coverages:	Loss of Use (replacement car coverage) Non-owned vehicle coverage (for rental car coverage)
DRIVER INFORMATION
Driver 1:
Name:
Age:
Date 1st Licensed in Canada: (YYYY/MM/DD)
Driver Training:	Yes No
Driver 2:
Name:
Age:
Date 1st Licensed in Canada: (YYYY/MM/DD)
Driver Training:	Yes No
Driver 3:
Name:
Age:
Date 1st Licensed in Canada: (YYYY/MM/DD)
Driver Training:	Yes No
CLAIMS & CONVICTION INFORMATION It is important to understand the difference between claims and accidents. You could have your radio stolen or windshield replaced and report a claim and still have no accidents
Please list all claims for the above listed drivers in the last six years. include: driver name, date of claim, claim payout and other details
Please list all convictions (ie. speeding tickets, seat belt tickets but not parking tickets) for each of the above listed drivers. include: driver name, date of conviction, and other details
How would you like us to contact you?	email phone
Before submitting this quote request to our office, please leave us any comments you may have (i.e. additional information on any of the above questions).
`This is a request for an insurance quotation only. Completing and submitting this form does not put any insurance coverage in place. The quotation is subject to underwriting guidelines established by the insurance company.`