EmailMeForm
Endorsement Request Form - Saskatchewan
Please fill in only the information that is required for your change. If something doesn't partain to the change, please leave it blank.
There are 2 areas for uploading all supporting documents needed for the endorsement. All documents you add will be emailed to sktoys@oasisins.ca once you've clicked submit.
A copy of the request and documents uploaded will also be sent to the broker email address entered.
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Description of change needed
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Policy #
*
Endorsement Effective Date DD/MM/YYYY
*
Insured Name
*
Brokerage Office
*
Brokers Name
*
Brokers Phone #
*
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Broker Email
*
Confirm
Insured's Address (if changed)
Street Address
City
State / Province / Region
Postal / Zip Code
Please enter unit details here.
Unit Type
ATV
Snowmobile
Trail Bike
Dune Buggy
Golf Cart
Year
Make
Model
CC's
VIN
If the unit is a Snowmobile, is the unit plated?
Yes
No
If yes, list plate number.
Plate Number
Is the unit New or Used?
New
Used
Delivery Date DD/MM/YYYY
Required on New Units
Purchase Price
$
Dollars
.
Cents
Required on New units.
Please select coverage.
Third Party Liability
$1,000,000.00
$2,000,000.00
Accident Benefits
Basic - $25,000
Enhanced - $50,000
Physical Damage
All Perils
Comprehensive
Insured Value
Deductible
$500
$1000
Section C Upload
Add File
Please add the Inspection, Bill of Sale, or previous insurance if Sec C is required.
Endorsments
Rider Plus
Replacement cost
Modifications - Include value of modifications
Optional - Truck Deck or Trailer - Include Value
Lien Holder (if applicable) include name, address, city, prov and postal code.
Principle Operator
Name of Principle Operator
Date of Birth DD/MM/YYYY
Drivers Licence #
Years Riding Experience
# of convictions in the last 3 years
# of claims in the last 3 years
Occupation
Additional Information
Is the Insured a member of;
SATVA
SSA
SMA
Turbos or after market enhancements
Factory Installed
After Market
After Market Performace Enhancement Equipment
Safety Course - AQCC/CASI or Canadian Safetly Counsel?
ATV
Sled
Trail Bike
Avalanche Course
Tracks for winter use?
ATV
Trail Bike
If tracks will be added at anytime during the policy please check off the unit type
Safety Immobilizer or Spot Trace tracking device?
Yes
No
Business Use - if applicable
Will there be Business Use on any Units?
Yes
No
If there is buiness use on any of the units please fill out the information below.
Unit(s) #
% of Business
% of Pleasure
How many KM driven anually?
Please describe the nature of the business
Remarks
File Upload
Add File
Please upload all supporting documents, these documents will be automatically emailed with your request to Oasis once submitted.
