Glen Poier Vehicle Insurance Quote Click here to request a quote for your car, R.V. or motorcycle. Boat Insurance Quote Boat Estimate - GP If you are human, leave this field blank. Name of Organization/Company: Contact Name: * Address: City: * Province * Alberta Manitoba Saskatchewan Postal Code: ex: X1Y 2Z3 Phone Number: ex: 123-456-7890 Email Address: * Age: Policy Effective Date: Liability Requested: $1,000,000 $2,000,000 $3,000,000 $4,000,000 Boat Type: Sailboat Multi-Hull Sailboat Open Runabout Cabin Cruiser Ski Boat Houseboat Trawler Personal Watercraft Other Boat Type: Amount of insurance on boat: Boat Manufacturer: Year Built: Overall Length: Main Motor: None Inboard/Outboard Inboard Outboard Jetdrive Other Main Motor: Manufacturer: Horsepower: Max. speed of motor: Amount of insurance on motor: Twin Engine Yes No Trailer: Yes No Year of Trailer: Make and Model of Trailer: Amount of insurance on trailer: Years Operated: Years Owned: Courses and Level Completed: Loss Details: Has any company ever cancelled or refused insurance of this description? Yes No Home Insurance Quote Home Estimate - GP If you are human, leave this field blank. Name: * Address: City: Province: * Postal Code: ex: X1Y 2Z3 Email Address: * Phone Number: Do you own your own home, own a condo unit or rent? Homeowner Condo Owner Renter Estimated replacement value of dwelling: Estimated replacement value of personal property: Policy deductible preferred: $500 $1,000 $2,500 Liability amount requested: $500,000 $1,000,000 $2,000,000 Have you had any personal property claimed in the past three years? Yes No Business Insurance Quote Business Estimate - GP If you are human, leave this field blank. Name of Organization/Company: * Contact Name: * Address: City: Province: * Postal Code: ex: X1Y 2Z3 Email Address: * Phone Number: Fax Number: Age of Building Less than 1 year 1 to 20 years 20 - 35 years More than 35 years Construction of Building: Frame Masonry Non-Combustible Fire Resistive Is the building sprinklered? Yes No How much area do you occupy? Less than 5,000 5,000 to 10,000 More than 10,000 Are you the only tenant? Yes No Is there a hydrant within 500 ft. (150 metres)? Yes No Is there a fire hall within 3 miles (5 kms)? Yes No Has insurance ever been denied or canceled? Yes No What type of business? Retail Office Business Ownership Wholesale Operation Farm Service Operation Contractor Garage Operation Manufacturer Other What type of business? How many years in the business? Less than 1 year 1 - 5 years More than 5 years What are the annual receipts? Up to $50,000 $51,000 to $100,000 $101,000 to $500,000 $501,000 to $1,000,000 Over $1,000,000 Have there been any insurance claims in the last 3 years? Yes No Farm Insurance Quote Farm Estimate - GP If you are human, leave this field blank. Name of Organization/Company: * Contact Name: * Address: City: Province: * Postal Code: ex: X1Y 2Z3 Email Address: * Phone Number: Type of Farm: Beef Cash Crop Combination Dairy Hobby Hog Horse Poultry Sheep Other Type of Farm: Location Lot: Concession: Township: Acreage: Total building value: Claims - Past 3 years: Church Insurance Quote Church Estimate - GP If you are human, leave this field blank. Name of Organization/Company: * Contact Name: * Address: City: Province: * Postal Code: ex: X1Y 2Z3 Email Address: * Phone Number: Fax Number: Denominational Affiliation if Applicable: Membership with Canadian Council of Christian Charities? Yes No Current Policy Expiry Date: Age of Building: Less than 1 year 1 to 20 years 20 to 35 years More than 35 years Construction of Building: Frame Masonry Non-Combustible Fire Resistive Is the building sprinklered? Yes No How much area do you occupy? Less than 5,000 5,000 to 10,000 More than 10,000 Are you the only tenant? Yes No Is there a hydrant within 500 ft. (150 metres)? Yes No Is there a fire hall within 3 miles (5 kms)? Yes No Has insurance ever been denied or canceled? Yes No What type of operations? Church Congregation Non-Profit Daycare/Nursery Christian School Bible College/Seminary Christian Campground Counselling Centre Drop-In Centre Missions Organization Evangelistic Ministry Denomination Office How many years in the business? Less than 1 year 1 to 5 years More than 5 years Have there been any insurance claims in the last 3 years? Yes No Travel Insurance Quote Request a Quote Contact Glen Poier Branch Phone: (306) 955-4038 After Hours Claims: (877) 975-0950 Fax: (306) 955-4039 Email: gpoier@lakeviewinsurance.com Address: P.O. Box 23027 Saskatoon, SK S7J 5H3