Continuous Renewal
Upload Updated Policy & Premium Information for Renewal of Existing Continuous Plan Contracts
Agent Name Providing Information
First Name
Last Name
Brokerage Name or Broker Code
Email of Sender
Agent@insurancebroker.ca
Merit Continuous Account Number
Starting with C or CC
Customer Name, for account Identification purposes
First Name
Last Name
Customer Name, if an Entity
For identification of Account Purposes
Renewal Premium Amount
Renewal Policy Fee
Renewal Tax
Effective Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Renewal Dec Page
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