Auto Insurance Agents in Sydney Mines & Cape Breton, NS Canada

Applicant's Info

First Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City Province Postal Code

Number of drivers in the household?*

Number of vehicles in the household?*

Driver(s) Info

Driver's Name*

First Last

Relation to applicant (if applicable)

Date that this driver's Nova Scotia license was obtained*

Does this driver possess a driver’s training certificate?*

How many years has this driver had continuous insurance coverage ?*

How many traffic tickets has this driver had in the past six years?*

How many at fault claims did this driver have in the last six years?*

How many not at fault claims did this driver have in the last six years?*

How many times has this driver's license been suspended in the past six years?*

How many times has this driver had his/her insurance coverage cancelled by an insurance company in the past 3 years?*

Vehicle Info

Vehicle Make*

E.g., Toyota, Honda, etc.

Vehicle Model*

E.g., Camry, Civic, etc.

Vehicle Year*

Please enter a number from 1900 to 2099.

Purchase Condition*

Primary use of vehicle?*

If used for commuting to and from work, how many kilometers one way?

Please enter a number from 0 to 1000.

How many kilometers driven annually?*

Please enter a number from 0 to 500000.

Please assign occasional operator to a vehicle (if applicable)

Coverage Info

Third Party Liability*

Optional Coverages

Comprehensive deductible

Collision deductible

Specified Perils deductible

All Perils deductible

Endorsements

SEF 20 loss of use

Yes
No

SEF 43r waiver of depreciation

Yes
No

SEF 27 legal liability for physical damage to non-owned automobiles

Yes
No

Six star driving record protector

Yes
No

Roadside Assistance

Yes
No

Car Insurance

Personal Use Car Insurance

Recreational & Off Road Vehicles

Motorcycles