Welcome to Holman Insurance Brokers on-line Commercial Automobile Insurance quick quote page. Please ensure you complete the form as accurately as possible in order to ensure the best possible estimate. If you would rather speak to one of our sales representatives, please call us at (905) 886-5630 or 1-800-567-1279.

Completion of this form is for informational purposes only, and is just an estimate.
This WILL NOT result in a new policy, or change to an existing policy.

* Required Fields

Contact Information
Company Name*
Contact First Name*
Contact Last Name*
Address*
City*
Province*
Postal Code*
Phone*
Phone 2
Fax
Web Site
E-Mail*
Type of Business
Contact Method
Phone Email
Insurance Information
Are you presently insured? If yes, what company?* (enter "none" if you are not insured)
Policy Number* (enter "none" if you do not have a policy number)
Expiry Date
What is your current annual premium?
$
Why are you looking for a new insurer or broker?
Vehicle Information (Please call for a quote on more than 4 vehicles)
Information
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Year
Make
Model
Style
Gross Vehicle Weight (except cars)
Radius of Work (daily)
Vehicle Use
Annual kilometers
Replacement Cost
Driver Information (Please call for a quote on more than 4 drivers)
Information
Driver 1
Driver 2
Driver 3
Driver 4
Name
Date of Birth
Lisense Number
Mandatory Coverages
Coverage
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Third Party Liability
Accident Benefits (see below for optional increase)
standard
standard
standard
standard
Uninsured Automobile Coverage
included
included
included
included
Direct Compensation Property Damage - Deductible
Optional Coverages (select any of the desired coverages below)
Coverage
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Bodily Injury
Property Damage Deductible
Comprehensive Deductible
Collision Deductible
Loss of Use
Increased Accident Benefits (Standard benefits are already INCLUDED in your mandatory coverage)
Coverage
Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Income Replacement
Income Replacement Indexation
Increased Limit for Medical, Rehabilitation & Attendant Care
Increased Death Benefit
Increased Caregiver and Dependant Care Coverage
Claims (Please list all claims in past 6 years. Include non accident claims, ie. theft)
Driver name
Date of Claim
Claim Payout ($)
Details of Claim
Convictions (Please list all tickets, excluding parking tickets)
Driver name
Date of Ticket
Details of Ticket
Additional Comments



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Thank you for trusting Holman Insurance Brokers Ltd. for your insurance needs, one of our representatives will contact you soon with your quote!
Commercial Auto Quote