Stratford Private Auto: Fill Up Form

Stratford Private Auto

• Thank you for inquiring about Stratford Private Auto. In order for us to provide you the best possible quote and determine eligibility please answer the questions below.
  
  
  

• 1) Have you had more than 1 at-fault accidents in the last 5 years?
  • YES
  • NO
• 2) Have you had more than 6 penalty points in the last 5 years?
  • YES
  • NO
• 3) Have you ever had your drivers license suspended, cancelled, or prohibited in the 5 years?
  • YES
  • NO
• 4) Have you have ever been declined, cancelled insurance or the insurer refused to renew your policy?
  • YES
  • NO
• 5) Are you using this vehicle for delivery for compensation or hire?
  • YES
  • NO
• 6) Is this vehicle an imported right-hand drive vehicle?
  • YES
  • NO

• If you answered YES to any of the questions above, unfortunately you are not eligible for Stratford Private Auto coverage at this time. You still however, are qualified for ICBC optional coverage. Please contact a Sussex Insurance location near you or fill out our ICBC Online request form to submit your request for renewal online. www.sussexinsurance.com/icbc-renewals

• Good News! If you answered NO to all of the questions above you may quality for a Stratford Private Auto! In order to provide an accurate quote the agent will need additional information when they contact you. Please fill out your contact info below and we'll be in touch soon.

• First Name*
• Last Name*
• Date of Birth*
• Phone*
• Email*
• Insurance Expiry*
• What is your Vehicle Model & Year?*
• How is the vehicle being used?
  Please SelectPleasureTo and From WorkBusinessCommercial (Including Delivery)FleetOther
• What is the Postal Code where the vehicle is being parked?
• Would you like a quote on an additional vehicle?*
  • YES
  • NO
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  What is your Vehicle Model & Year?*
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  Are you a Sussex Insurance Agent?*
  NoYes
• Agent Name
  First Last
• Agent, Select your Sussex Insurance office below:*
  Abbotsford - 1812 Vedder Way (Inside Walmart)Abbotsford - 2855 Gladwin Rd (Inside Superstore)Campbell River - 1424 Island Hwy (Inside Superstore)Campbell River - 1477 Island Hwy (Inside Walmart)Cranbrook - 2100 Willowbrook Dr (Inside Walmart)Cranbrook - 2100 17th St N (Inside Superstore)Chilliwack - 45779 Luckakuck Way (Inside Superstore)Chilliwack - 8249 Eagle Landing Parkway (Inside Walmart)Chilliwack - 6014 Vedder Rd (Inside Save On Foods)Coquitlam - 1301 Lougheed Hwy (Inside Superstore)Coquitlam - Westwood Mall (Inside Superstore)Coquitlam Centre - 2738 -2929 Barnet HwyCourtenay - 757 Ryan Rd (Inside Superstore)Courtenay - 3199 Cliff Ave (Inside Walmart)Duncan - 291 Cowichan Way (Inside Superstore)Duncan - 3020 Drinkwater Rd (Inside Walmart)Kamloops - 910 Columbia St W (Inside Superstore)Kelowna - 2280 Baron Rd (Inside Superstore)Kelowna - 1555 Banks Rd (Inside Walmart)Langley - 19851 Willowbrook Dr (Inside Superstore)Maple Ridge - 11850 224 St (Inside Walmart)Mission - 32136 Lougheed Hwy (Insurace Superstore)Nanaimo - 2-6435 Metral Dr (Insurance Superstore)New Westminster - 805 Boyd St (Inside Walmart)North Vancouver - 136 W 3rd StNorth Vancouver - 333 Seymour Blvd (Inside Superstore)Penticton - 275 Green Ave (Inside Walmart)Pitt Meadows - Unit 2-201-19800 Lougheed Hwy (Inside Superstore)Port Coquitlam - 2150 Hawkins Street (Inside Walmart)Prince George - 2155 Ferry Ave (Inside Superstore)Richmond - 130-4651 No. 3 Rd (Inside Superstore)Salmon Arm - 2991 10th Ave SW (Inside Walmart)Surrey - 1000 Guildford Town Centre (Inside Walmart)Surrey - 3000 Central City 10153 King George Blvd (Inside T&T Supermarket)Surrey - 14650 104th Ave (Inside Superstore)Surrey - 2332 160 St (Inside Superstore)Surrey - 7550 King George Hwy (Inside Superstore)Surrey - 2285 160th St (Inside Grandview Corners Plaza)Surrey - 12451 88th Ave (Inside Walmart)Vancouver - 2800 East 1st Ave (Inside T&T)Vancouver - 3185 Grandview Hwy (Inside Superstore)Vancouver - 370 East Broadway (Kingsgate Mall)Vancouver - 350 SE Marine Drive (Inside Superstore)Vernon - 5001 Anderson Way (Inside Superstore)Vernon - 2200 58th Ave (Inside Walmart)Langford - 860 Langford Pkwy (Inside Walmart)Langford - 835 Langford Pkwy (Inside Superstore)Victoria - 3460 Saanich Rd (Inside Walmart)West Vancouver - 1471B Clyde AveWest Kelowna - 3020 Louie Dr (Inside Superstore)
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  Select your closest Sussex Insurance location:*
  Abbotsford - 1812 Vedder Way (Inside Walmart)Abbotsford - 2855 Gladwin Rd (Inside Superstore)Campbell River - 1424 Island Hwy (Inside Superstore)Campbell River - 1477 Island Hwy (Inside Walmart)Chilliwack - 45779 Luckakuck Way (Inside Superstore)Chilliwack - 8249 Eagle Landing Parkway (Inside Walmart)Chilliwack - 6014 Vedder Rd (Inside Save On Foods)Coquitlam - 1301 Lougheed Hwy (Inside Superstore)Coquitlam - Westwood Mall (Inside Superstore)Coquitlam Centre - 2738 -2929 Barnet HwyCourtenay - 757 Ryan Rd (Inside Superstore)Courtenay - 3199 Cliff Ave (Inside Walmart)Duncan - 291 Cowichan Way (Inside Superstore)Duncan - 3020 Drinkwater Rd (Inside Walmart)Kamloops - 910 Columbia St W (Inside Superstore)Kelowna - 2280 Baron Rd (Inside Superstore)Kelowna - 1555 Banks Rd (Inside Walmart)Langley - 19851 Willowbrook Dr (Inside Superstore)Mission - 32136 Lougheed Hwy (Insurace Superstore)Nanaimo - 2-6435 Metral Dr (Insurance Superstore)New Westminster - 805 Boyd St (Inside Walmart)North Vancouver - 333 Seymour Blvd (Inside Superstore)Penticton - 275 Green Ave (Inside Walmart)Pitt Meadows - Unit 2-201-19800 Lougheed Hwy (Inside Superstore)Port Coquitlam - 2150 Hawkins Street (Inside Walmart)Prince George - 2155 Ferry Ave (Inside Superstore)Richmond - 130-4651 No. 3 Rd (Inside Superstore)Surrey - 1000 Guildford Town Centre (Inside Walmart)Surrey - 3000 Central City 10153 King George Blvd (Inside T&T Supermarket)Surrey - 14650 104th Ave (Inside Superstore)Surrey - 2332 160 St (Inside Superstore)Surrey - 7550 King George Hwy (Inside Superstore)Surrey - 2285 160th St (Inside Grandview Corners Plaza)Surrey - 12451 88th Ave (Inside Walmart)Vancouver - 2800 East 1st Ave (Inside T&T)Vancouver - 3185 Grandview Hwy (Inside Superstore)Vancouver - 370 East Broadway (Kingsgate Mall)Vancouver - 350 SE Marine Drive (Inside Superstore)Vernon - 5001 Anderson Way (Inside Superstore)Vernon - 2200 58th Ave (Inside Walmart)Langford - 860 Langford Pkwy (Inside Walmart)Langford - 835 Langford Pkwy (Inside Superstore)Victoria - 3460 Saanich Rd (Inside Walmart)West Vancouver - 1471B Clyde AveWest Kelowna - 3020 Louie Dr (Inside Superstore)
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• Submit your request and we'll get back to you as soon as possible. Please note: In order to provide an accurate quote the agent will need additional information when they contact you.

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