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Motorcycle Insurance.ca
Motorcycle Insurance Canada.com
Please bookmark this page and read the notes and questions below carefully before replying

Due to licensing restrictions, this quotation request is only for residents of the Province of Ontario in Canada.

PLEASE CALL IF YOU'D PREFER THE QUOTE BY PHONE!

Don't be afraid to ask ANY questions!
We Are The Experts For
Motorcycle Insurance in Ontario

Contact Susan Wicks

(905) 764-7868 ext 227 or 1-800-917-7283 ext 227

Motorcycle Shield Insurance and McBride Cycle - A Winning Combination

Proudly Associated with McBride Cycle, Lindsay Cycle, Davies Harley Davidson and Ontario Motorcycle Association

Motorcycle Shield Insurance and Lindsay Cycle - a Winning Combination

Great Rates and Quick Claims Service.

Motorcycle Insurance Rates Quoted will be as accurate as possible, based on the facts provided to us. Rates are for the term of one year and are subject to any applicable interest charges relating to payment plans available.

Motorcycle Shield Insurance Ontario Quote Request Form
Please complete all boxes
(Complies with the requirements of the Personal Information
Protection and Electronic Documents Act, 2004)

Rider and Licence Information

*  indicates a required field entry

Your Full Name:

*

Address:

*

City:

*

Province:

*

Postal Code:

*

Phone Number & Area Code:

*

E-mail Address: (only one address please)

*

Fax Number:

Your Date of Birth: (M/D/Y)

*

Gender:

Male   Female 

Date Insurance Required:

*

Current 'M Licence" Level:
(Motorcycle Licence Level Explanation)

Safety Training Course:

Date M Licence Obtained
(month/year)

Date M2 Licence Obtained
(month/day/year)

Date M1 Licence Obtained
(month/day/year)

*

*

*

Please note the above 3 boxes require an entry. If not applicable, enter "void"

Your Ontario auto / motorcycle licence number?

*

Do you currently hold Motorcycle Insurance?

Yes     No 

If yes, please name Insurer, length of time insured, and any claims in the last 3 years:
(advise reasons for any policy cancellations)

Do you have any moving violation convictions (tickets) in the last 3 years?

Yes     No 

If "no", please enter "none"
If "yes", please explain (dates, violations, etc.):

*

Have there been any claims/accidents on motorcycle or auto in last 6 years?

Yes     No 

If "no", please enter "none"
If "yes", please explain (dates, details, etc.):

*

Please list other operators of Motorcycles in your household (names, ages, motorcycle licence level/class held etc):

Motorcycle Information
  • Motorcycles over twenty-five years old are excluded from this Program
  • THE FOLLOWING MOTORCYCLES ARE SURCHARGED BY JEVCO
    And the premiums will average $1,600 to $2,100 - click here for list

Quote Options:

Bike # 1

Bike #2

Year, Make and Model (full description if possible):

*

How Many cc's:

*

Purchase Date:

*

Current Actual Cash Value:

*

Bike has H-D factory security system / Sherlock anti-theft engravings / Gorilla / Viper alarm system (advise please in ADDITIONAL COMMENTS)

Yes     No  Yes     No 

Intended Use of Bike:

Coverages Information

Third Party Liability:

*

Direct Compensation - Property Damage
(deductible must NOT exceed motorcycle value)

*

Collision (see notes for Harleys / Indian)

*

Comprehensive / Specified Perils (see notes for Harleys / Indian):

*
*

Group Discount Rate?
(see approved group list):

Policy Payment Arrangement (see notes):

How Did You Find Us?

Additional Comments:
(Certain Harley & Super Sport bikes require proof of installation of approved alarm system to qualify for Specified Perils / Comprehensive cover)

Please check that you have supplied all information requested and correctly chosen available options. You can clear the form and start again if unsure. We'll provide a speedy quote!
Motorcycle Shield Insurance looks forward to serving you !

Please click only once

 

Contacts by Phone: 1-800-917-7283
Larry Libralato, Senior Sales Representative: extension 230
Susan Wicks, Senior Customer Service: extension 227
John Nelson, Sales: extension 220
Nadia Campoli, Sales: extension 225

OUR COMMITMENT TO YOU

NONE of your personal details given to us for purposes of obtaining a quote are shared with anyone other than the Insurance Company.
Email addresses and phone numbers are not sold or shared by Forever Young Insurance Brokers.
  • We will respond as soon as possible
  • We want to do our best for you
  • Our clients come first
  • Great coverage at Great Rates

MULTI-BIKE DISCOUNTS
(15%)

RENEWAL DISCOUNT
(10%)

GROUP DISCOUNT
(15%)

FAX COPIES OF YOUR AUTO / HOME POLICIES FOR MAJOR SAVINGS!

Susan Wicks

Phone: (905) 764-7868 ext 227; 1-800-917-7283 ext 227 (Ontario only)
Fax: (905) 764-9618   Email


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