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About
Team
Products
Careers
Articles
Claims
Claims Form
Contact
Claims Form
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Policy Number
Type of Loss
*
Type of Loss
Water
Theft
Fire
Liability
Snow/Ice
Impact
Animal
Crime
Collapse
Power Surge
Vandalism
Falling Object
Mechanical Breakdown
Type of Risk
*
Type of Risk
Property
Liability
Umbrella and Excess
Date of Loss
*
Description of Loss
*
Insured/Principal Information
Insured/Principal’s name
*
Primary Contact Name
*
Contact Phone Number
*
Contact e-mail address
*
Brokerage Information
Brokerage’s name
*
Primary Contact Name (Broker)
*
Contact Phone Number (Broker)
*
Contact e-mail address (Broker)
*
Is there any immediate action (s) required to protect the site and prevent any loss deterioration ?
Is there any immediate action (s) required to protect the site and prevent any loss deterioration ?
Yes
No
Address
City
Postal Code
Country
*
Country
Canada
Name
Submit
