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Underwriting Forms

Facility Association Common Management Attestation

Application by Broker for Appointment to a Servicing Carrier

Commercial Vehicle Supplement

Explosives Questionnaire

Fleet Rating Frequently Asked Questions

Fleet Vehicle Count Template

Facility Association Garage Rating/Underwriting Supplement (.docx)

Indemnification and Hold Harmless Agreement

Radioisotope Questionnaire

Taxi/Limousine Questionnaire

Motorcycle Inspection Form

Winter Tire Declaration Form

Verification of Automobile Insurance for Leasing Companies or Lienholders

Alberta

Endorsement Forms

FA 82Deductible Amount Endorsement

Underwriting Forms

Section C – Declaration Letter

Other endorsement forms and application forms can be found here

New Brunswick

Endorsement Forms

8AEnglish Property Damage Reimbursement for Operation by Named Person Endorsement (Section A Only) (for use in the Atlantic Provinces)

9EnglishMarine Use Excluded Endorsement (amphibious automobiles)

9Français Exclusion du Risque Maritime (automobiles amphibies)

13cEnglishComprehensive Cover – Deletion of Glass Endorsement

13cFrançais Suppression de la Garantie de la Division 3 du Chapitre C en ce qui Concerne les Glaces

16English Agreement for Suspension of Coverage Endorsement

16Français Suspension de Garanties pour Remisage

19English Limitation of Amount Endorsement

19Français Limitation Visant le Chapitre C

28English Reduction of Coverage as Respects Operation by Named Person(s) Endorsement

28Français Restriction de la Garantie - Conducteurs Désignés

30 English Excluding Operation of Attached Machinery Endorsement

30Français Restriction Visant l'Équipement et/ou le Matériel

37English Limitation to Automobile Sound and Electronic Communication Equipment Endorsement (for use in the Atlantic Provinces)

37Français Limite - Accessoires de Son et de Communication Électronique

40English Fire and Theft Deductible Endorsement

40Français Franchise en Cas d'Incendie ou de Vol

Underwriting Forms

EnglishBinder Control Register

FrenchBinder Control Register

Newfoundland and Labrador

Endorsement Forms

9Marine Use Excluded Endorsement (amphibious automobiles)

13cComprehensive Cover – Deletion of Glass Endorsement

16Agreement for Suspension of Coverage Endorsement

19Limitation of Amount Endorsement

28aExcluded Driver Endorsement (Newfoundland and Labrador Only)

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment Endorsement (for use in the provinces of NL)

38Increased Limit, Automobile Sound and Electronic Communication Equipment Endorsement (for use in the provinces of NL)

40Fire and Theft Deductible Endorsement

Underwriting Forms

Automobile Insurance – Facility Association Reporting Forms (Public Utilities Board Website)

PUB Monthly Electronic FA Submission 125 (.xlsx)

PUB Monthly Electronic FA Submission 750 (.xlsx)

Garage Rating Underwriting Supplement

Northwest Territories

Endorsement Forms

8aProperty Damage Reimbursement for Operation by Named Person Endorsement (Section A Only)

9Marine Use Excluded Endorsement (amphibious vehicles)

13dComprehensive Cover - Limited Glass (for Alta., Nunavut, N.W.T. and Yukon)

16Agreement for Suspension of Coverage Endorsement

19Limition of Amount Endorsement

28Reduction of Coverage as Respects Operation by Named Person(s) Endorsement

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment

40Fire and Theft Deductible Endorsement

Nova Scotia

Endorsement Forms

9Marine Use Excluded Endorsement (amphibious automobiles)

13cComprehensive Cover – Deletion of Glass Endorsement

16For use in Nova Scotia only - Agreement for Suspension of Coverage Endorsement

19Limitation of Amount Endorsement

28aExcluded Driver Endorsement (Nova Scotia Only)

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment Endorsement (for use in the provinces of NL)

40Fire and Theft Deductible Endorsement

Underwriting Forms

Binder Control Register

Nunavut

Endorsement Forms

8aProperty Damage Reimbursement for Operation by Named Person Endorsement (Section A Only)

9Marine Use Excluded Endorsement (amphibious vehicles)

13dComprehensive Cover - Limited Glass (for Alta., Nunavut, N.W.T. and Yukon)

16Agreement for Suspension of Coverage Endorsement

19Limition of Amount Endorsement

28Reduction of Coverage as Respects Operation by Named Person(s) Endorsement

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment

40Fire and Theft Deductible Endorsement

Ontario

Endorsement Forms

FA 82Deductible Amount Endorsement

OCPF 19Limiting the Amount Paid for Loss or Damage Coverages

Automobile Insurance Policy (O.A.P.1), Garage Automobile Policy (O.A.P 4), Application and Endorsement Forms

Underwriting Forms

Refusal Letter

Prince Edward Island

Endorsement Forms

9Marine Use Excluded Endorsement (amphibious automobiles)

13Comprehensive Cover – Deletion of Glass Endorsement

16Agreement for Suspension of Coverage Endorsement

19Limitation of Amount Endorsement

28aExcluded Driver Endorsement

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment Endorsement (for use in the Atlantic Provinces)

40Fire and Theft Deductible Endorsement

Underwriting Forms

Garage Rating Underwriting Supplement

Yukon

Endorsement Forms

8aProperty Damage Reimbursement for Operation by Named Person Endorsement (Section A Only)

9Marine Use Excluded Endorsement (amphibious vehicles)

13dComprehensive Cover - Limited Glass (for Alta., Nunavut, N.W.T. and Yukon)

16Agreement for Suspension of Coverage Endorsement

19Limition of Amount Endorsement

28Reduction of Coverage as Respects Operation by Named Person(s) Endorsement

30Excluding Operation of Attached Machinery Endorsement

37Limitation to Automobile Sound and Electronic Communication Equipment

40Fire and Theft Deductible Endorsement