Request a quote – Branch Referral "*" indicates required fields HiddenGclid What product does the client need a quote for?* Personal insurance Business insurance What product(s) is the client interested in?* Auto House Townhome Mobile Home Condo Tenant Home being Built Contents in Storage Motorcycle RV Travel Marine and boat Which of the following best describes your situation?* I own the home I rent the home I own and rent out the home It's vacant Please complete the questions below.Do you currently have Home or Business Insurance with Westland?* Yes No Do you know your policy number? (optional) Do you currently have business insurance?* Yes No Renewal Date (optional) MM slash DD slash YYYY What industry are you in?* Business & Professional Services Construction & Contracting Education Faith Based Organization Farm & Agriculture Forestry Healthcare Hospitality Manufacturing Not for Profit Oil & Gas Real Estate/Building Owner Recreation Retail/Wholesale Social Services Transportation & Logistics Wineries Welding Other Describe your business* Client's informationClient reference number First name* Last name* Company* Phone*Email* Province*Choose your ProvinceAlbertaBritish ColumbiaNew BrunswickNewfoundland and LabradorManitobaNova ScotiaOntarioPrince Edward IslandSaskatchewanAddress* Street Address Address Line 2 City ZIP / Postal Code Renewal Date (Optional) DD slash MM slash YYYY Limit of Liability Required*$1,000,000$2,000,000$5,000,000Description of Operations*Have you had any losses or claims in the past 5 years?* Yes No Thank you for requesting a business insurance quote from Westland Commercial. Unfortunately, based on current eligibility requirements, market conditions, and quote request volumes, we will not be able to provide a quote at this time. Please provide the following information for each loss or claim in the past 5 years:*Date of loss or damageCause or origin of loss or damageTotal amount of claim $ Add RemoveHas any insurer cancelled or declined to renew your policy or refused to provide insurance?* Yes No Thank you for requesting a business insurance quote from Westland Commercial. Unfortunately, based on current eligibility requirements, market conditions, and quote request volumes, we will not be able to provide a quote at this time. Please provide the following if you have had a policy cancelled, non-renewed or you were refused insurance.*Date of cancellation, non-renewal, or refusalReason or circumstances for the cancellation, non-renewal, or refusal: Add RemoveWhat year was your business started?* Years of related experience in this business?*What are your forecasted total annual Gross Sales this year?*$100,000 or less$100,000 - $250,000More than $250,000Do you have any sales outside Canada?* Yes No If yes, what amount*Number of employees?* Estimated Payroll*Is your business operated from your Home or a Commercial premises?* Home Commercial premises Do you own or lease the building your business operates from?* Own Lease Consent I agreeSome insurance companies offer a discount based on a personal soft credit check. This may help you achieve their most competitive price. Important note: this check will not affect your credit score and the credit score will always remain confidential. If you consent, provide the information below for the Business Owner or Majority Shareholder;Please give consent to process your quoteThank you for requesting a business insurance quote from Westland Commercial. Based on the information submitted, the estimated premium will be a minimum of $1,000, subject to receiving additional information about your business, do you want to continue?* Yes Thank you for requesting a business insurance quote from Westland Commercial. Based on the information submitted, the estimated premium will be a minimum of $750, subject to receiving additional information about your business, do you want to continue?* Yes First Name* Last Name* Date of birth* MM slash DD slash YYYY Home Address* How long you’ve been at your home address (if less than one year, provide previous address)* Additional information (Optional)Westland AdvisorAdvisor's Name* Advisor's Email* Branch*First ChoiceSecond ChoiceThird ChoiceHead Office Department*CommercialOnline AutoSelect Client ServicesCAPTCHAIf you are interested in learning more about how Westland protects your personal information, please visit www.westlandinsurance.ca/privacy-policyEmailThis field is for validation purposes and should be left unchanged.
