Request a Quote

For a quote on your business insurance:

Phone: (403) 296-2400
Toll-free: 1-800-565-8132
Email: info@rogersinsurance.ca

Or fill out the form below and we'll contact you.

Company:
Email:
Phone:
Address (Street):
Address (Mailing):
City:
Province:
Postal Code:
Primary Contact:
Position:
Are you the decision maker for insurance?
Phone:
Fax:
Email:
Describe the operations of your organization (i.e.breakdown of revenue by source etc.)
# of Employees:
Years in Business:
Gross Revenue:
Any sales to US or other countries?
If yes, % sales:
Current Insurer (Broker/Company)
Premiums
What do you need insured?
Liability (Damage to property of others or injury to others) List the amount you need
Automobile List all vehicles by make and year and the purpose/where it is driven
Other Coverage List other coverages required such as Business Interruption, Boiler & Machinery, Crime, Motor Truck Cargo, Property of Others etc., (this is only a few of the coverages available)
Claims/Losses List all claims in the past 5 years
What else should we know about you or your organization that would be important to placing insurance or to servicing you in the best way possible?