Vehicle Addition
Please fill in your details below.
Your Company/Client Name
*
Policy Number
*
Company Phone Number on File
*
Please enter a valid phone number.
Company Email
*
example@example.com
Vehicle Type
*
Please Select
TRUCK
TRAILER
Year
*
Make
*
Model
*
VIN
*
Vehicle Current Value
*
Without Taxes
Radius of Operation
*
Please Select
Local up to 160 kms
Alberta Wide
Canada Wide
Canada & US
Date to add the vehicle
*
-
Month
-
Day
Year
Date
Finance company name
*
If no finance company, please enter N/A
Finance company address
*
If no finance company, please enter N/A
Additional Information
Attach bill of sale or Registration
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Owner/Your Name
*
First Name
Last Name
Todays Date
*
-
Month
-
Day
Year
Date
Signature
*
By clicking on the below submit button you are consenting for us to add the vehicle to your policy based on the info you have entered
SUBMIT
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