Motorcylce Insurance
Please complete our on line quote form to receive a quote within 24 hours.
See our Motorcycle Insurance Page for details.

*Name:
City: Postal Code:
*Phone: *Email:
*Date of Birth:
Motorcycle Year
Make and Model:
cc of Motorcycle: List Price New:
Continuous Prior
Insurance:		 Current Value:
Name of
Insurance Company:
Policy Number: Due Date of Policy:
Ticket in last three years: Yes   No
Accident in last six years: Yes   No
Any cancellations for Non Payment in past 3 years (automobile or Motorcycle): Yes   No
Have you had a full M license for 3 years?: Yes   No
Do you currently insure an automobile Yes   No
How did you hear about us?

Add Additional Driver?
Add Additional bike?
Add Additional bike?
Add Additional bike?
 


Privacy Statement:
John Sutherland and Sons Limited is committed to protecting your privacy by complying with the laws and regulations under Personal Information and Electronic Documents Act (PIPEDA). We have procedures in place for the collection, use and disclosure of your personal information. If you have any questions, or would like to receive a copy of our privacy brochure contact our Privacy Officer at 1-800-263-1032, 519-822-0160 or lbetts@sutherlandinsurance.com.