Erb and Erb Insurance Brokers Ltd. Your Motorcycle Insurance Specialists

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Motorcycle/ATV/Snowmobile Quote Form

Thank you for coming to our recreational vehicle quote page. Please take the time to complete the form below and we'll provide you a no obligation quote.

Please refer to our detailed privacy page regarding your personal information: http://erb-erb.com/privacy-policy.php

While you're here, why not check out our contest?

Name:

Address:

Birth Date:

Year: Month: Day:

Year, Make, Model, CC's of the Bike, ATV, Snowmobile:

Coverage Requested:

Rider Training Courses Taken:

Total Years Licensed:

Dates You Obtained Your M1, M2 and if you went through Graduated Licensing:

Any Prior Bike Insurance in the Last 3 Years?:

N0 Yes

If the above applies, how long has your most recent policy been in force?:

Current Class of Bike License:

M1 M2 Full M

Any Tickets Receivedin the Last 3 Years?:

N0 Yes

If Yes above - please elaborate on the types of tickets you have received and roughly when you got them:

Any Accidents/claims in the Last 3 Years?:

N0 Yes

If so - please elaborate on the type of claim/accident, when it occurred, and whether or not you were deemed to be be at fault:

Has any insurance company cancelled you insurance in the Last 3 Years?:

N0 Yes

If so - please elaborate as to when this was, and why it was cancelled:

Any other riders living in your home not already insured? Id so, please complete this questionnaire for them as well?:

N0 Yes

Please indicate use of the bike, i.e.: Pleasure riding only, commuting (If commuting please indicate how many KM's you commute one-way), show bike only, racing, etc.:

Method of contact:

E-mail Phone

Phone Number:

E-mail Address:

Other Comments or Questions:

What our Clients are Saying...

"I want to take this brief moment to thank you for the exceptional service you provided to me following my accident. Your personal attention to my claim was incredible and I am very grateful for your diligence and effort at making the process as bearable as possible.

Thankfully, my accident was very minor, but the attention you gave me was above and beyond what I expected. Your promptness in returning my calls and patience in listening to my concerns was wonderful. I am confident that in Erb and Erb, I have found a firm that meets my needs and a broker who cares about me as a person and not just as a client."

Victoria De Wit - Kitchener

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