Pedal Power Quote Form
This form is for direct client use only.
  • 10020 12th Avenue North Battleford, SK S9A 3A4
    Toll-Free Phone: 1-866-979-2747
    Email: pedalpower@oasisins.ca
  • Eligibility Questions

  • No Yes
    Do you compete in competitive events? (Note: This does not make you ineligible for coverage. You are not covered while practicing for or participating in an event, unless you've purchased the competitive event endorsement.)
    Does the operator suffer from any illness, medical condition, or mental or physical disability which might affect the safe operation of a bicycle?
    Have you ever had a recreational vehicle policy refused, restricted or cancelled?
    Are your units kept in Canada?
    Do you have a Canadian mailing address?
    Have you had any bike thefts or claims in the past 3 years?
    Will any of the units added on this application be used for business use?
    Are any of the units to be insured under this policy gas powered?
    Will any unit(s) on this policy be Electric Assisted?
    If electric assisted, will any unit(s) be over 500 watts and/or over 32km maximum speed?
    Will you be traveling with the unit to be insured, outside of Canada and the USA?
    Will you be traveling with the unit to be insured, to the USA for longer than 6 months?
    Will any of the units added on this application be a Scooter or Low Speed Motorcycle?
    Are any operators younger than 16 or older than 84 years?
    Are any of the units to be insured located within 25 km of an imminent threat of damage (e.g., fire, flood, earthquake aftershocks, etc.)?
  • Personal Information

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  • Membership Information

  • Unit Information

  • Note, coverage is only available for units with a maximum output of 500 watts and a top speed of 32 km/hr. Units exceeding these specifications are not eligible for coverage.
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  • Coverage Information

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    Please note, we can't backdate effective dates.
  • Lienholder Information (if applicable)

  • Unit #2 Information (if applicable)

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  • Unit #2 Coverage Information (if applicable)

  • This covers losses incurred while you are getting on, alighting from, operating or riding, including whilst riding as a passenger, on an insured unit during the policy term.

    Please note: Only available if Third Party Liability is purchased.
  • Unit #2 Lienholder Information (if applicable)

  • Claim Information

  • Date of Loss (DD/MM/YYYY) Type of Claim (Theft, Collision, Liability) Payout Amount
    Claim One
    Claim Two
    Claim Three
    Claim Four
  • Additional Information (if applicable)