Garage Protection Request - Customer


* required

Contact Information

First Name *
Last Name *
Phone Number  *
Email *
Confirm Email Address *
Choose the type of vehicles that represent the majority of your stock. Dealership Auto Motorcycle Recreational Vehicle *

Is it located in an Auto Mall? Yes No *
Please confirm the protection and security of the
Auto Mall.
Please confirm the protection(s) in place at each
of the sales and storage locations.

Please confirm the protection(s) in place at each of the sales and storage locations.

Policy Details

Garage Policy Number *
Insured's Name *
Address of the specific sales/storage location. Address *
Unit/Suite Number
City/Town *
Province *
Postal Code  *
If there are multiple locations, the percentage of stock must add up to 100%. Percentage of stock at this location  % *

Perimeter Details

  Indicate the number of perimeters and type of protection for each perimeter.
Number of perimeters at this location *

Patrol Details

  Indicate the type of patrol after business hours.
Monitored alarm - A system that signals occurrence such as fire or burglar and monitored by an alarm monitoring company.

Guard dog - A large dog trained to guard persons or property.

Patrol service - The act of moving about an area by an authorized and trained person or group, for purposes of observation, inspection, or security.

Person living on-site - An individual resides on-site as the primary residence.

Watchman patrolling - A person who keeps guard over a building/lot at night, to protect it from fire, vandals, or thieves.
  Type of patrol of the open lot area after business hours
None
Monitored alarm
Guard dog
Patrol service
Person living on-site
Watchman patrolling  *

Building Details

  Indicate the number of buildings and type of construction of each building.
Are all motorcycles kept indoors when business is closed? Yes No *
Note: Coverage is only provided for stock kept indoors outside of business hours.

Number of buildings at this location *

Building 1

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 2

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 3

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 4

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 5

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 6

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 7

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 8

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 9

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *

Building 10

Type of Building Construction *
Is there a sprinkler system? Yes No *
Number of Building Entrances *

Entrance Way 1

Type of
Entrance Way 1
*
Is there a metal bar? Yes No *

Entrance Way 2

Type of
Entrance Way 2
*
Is there a metal bar? Yes No *

Entrance Way 3

Type of
Entrance Way 3
*
Is there a metal bar? Yes No *

Entrance Way 4

Type of
Entrance Way 4
*
Is there a metal bar? Yes No *

Entrance Way 5

Type of
Entrance Way 5
*
Is there a metal bar? Yes No *

Entrance Way 6

Type of
Entrance Way 6
*
Is there a metal bar? Yes No *

Entrance Way 7

Type of
Entrance Way 7
*
Is there a metal bar? Yes No *

Entrance Way 8

Type of
Entrance Way 8
*
Is there a metal bar? Yes No *

Entrance Way 9

Type of
Entrance Way 9
*
Is there a metal bar? Yes No *

Entrance Way 10

Type of
Entrance Way 10
*
Is there a metal bar? Yes No *


Please submit this form to An Autoplan BrokerICBC *
Email Address of Autoplan Broker *
Confirm Email Address *