Auto Insurance - Smith Williams & Bateman Insurance Brokers Ltd

Name:

Phone:

Email:

How many kms. to work do you commute one-way?

How many kms. per year do you expect to drive?

Vehicle Year

Make

Model

VIN

When did you purchase your vehicle?

Is the vehicle modified or customized?

Is it financed and if so, by who?

Do you have winter tires?

What is your address including your postal code?

What is your driver’s license number?

Have you had any convictions in the last 3 years?

Have you had any at-fault claims in the last 10 years?

How long have you had continuous car insurance?

Do you typically park your vehicle in a private driveway/garage at night?

Are there any other drivers in the household?