Free Auto Quote Subscribe to our mailing list * indicates required First Name Last Name Email Address * Postal Code Current Policy Expiry Date / / ( mm / dd / yyyy ) Phone Number () – (###) ###-#### Years Insured Vehicle 1 Year Vehicle 1 Make Vehicle 1 Model Drive to Work Yes No KM driven to work? KM Driven Annually Liability Limit $1,000,000 $2,000,000 Physical Damage All Perils $500 All Perils $1,000 Physical Damage Collision $500 Collision $1,000 Physical Damage Comprehensive $500 Comprehensive $1,000 Accident Benefits Standard Benefit $65,000 and $1,000,000 Combination 1 – $130,000 and $2,000,000 Combination 2 – $1,000,000 and $3,000,000 Driver Name Date of Birth / / ( mm / dd / yyyy ) Class of Licence GG2G1 Number of Years Licensed Claims past 10 years Yes No Tickets past 3 years Yes No Marital Status Single Married