P: 780-532-7800
TF: 1-800-532-0099

Personal
Commercial
Farm
Claims
Registries
News
About
Contact Us
- Our Team

Sitemap

Are Dash Cams Right for Your Fleet?
Blog
Business Interruption Insurance
Cyber Liability Insurance
Cyber Risks & Liabilities Newsletter
Direct Compensation For Property Damage (DCPD) Insurance FAQs
Employee Engagement
Errors and Omissions Insurance
Form Test
Forms
- Auto Insurance Quote Form
- Commercial Insurance Quote Form
- Farm Insurance Quote Form
- Home Insurance Quote Form
- Oil & Gas Insurance Quote Form
Four Components of Effective Risk Management
Hazard Prevention & Control
Marijuana’s Impact on Driving
Navigating the Hardening Market
Preventing Ice Dams
Protecting Construction Sites From Fire
Recruiting Post-coronavirus
Registries Offices Opening
Remodelling Your Home
Reopening Your Business Post-COVID 19
Request A Quote Demo
Steps to Filing a Property Claim
Tenant Insurance – Why You Should Have It
The Basics of Commercial Property Insurance
The Cost of Poor Management
The Cost of Ransomware Demands
The Jean Fund – Supporting Our Community
Top Cyber Threats for 2021
Understanding Coinsurance
Understanding Your Auto Insurance Policy
Vacancy or Unoccupied Property
Winter Weather Liabilities
Wood Burning Stove Safety
Home
Personal
- Personal Auto Insurance
- Home Insurance
- Farm Insurance
- Travel Insurance
- Recreation Unit Insurance
  - Boat Insurance
  - Snowmobile Insurance
- Personal Umbrella Insurance
Commercial
- Commercial Auto Insurance
- Commercial Property Insurance
- Commercial General Liability
- Oil & Gas Services
- Contractors
- Transportation
- Bonding & Surety
- Professional Services
- Retail & Independent Business
- Technology
- Hospitality
- Manufacturing
- Not For Profit
- Other Specialty Industries
Claims
Registries
- Vehicle Registration
- Learners Permits
- Driver Licenses
- Vital Statistics
- Corporate Registries
- Land Titles
- Personal Property
- Alberta Healthcare
- Registries FAQ
PVI Connection
About
- MyPVi App
- Insurance Partners
- Community Involvement
- Resources
- FAQS
Contact Us
- Our Team
E-Payments
Privacy Policy
Sitemap

Questions?

Contact us and one of our brokers will be happy to assist you.

Contact Us

P: 780-532-7800
TF: 1-800-532-0099

© 2021 Prairie Villa Insurance (A division of Peace Country Insurance Brokers Inc.) All Rights Reserved.

Head Office 9917 – 116 Ave. Grande Prairie, AB T8V 3Y3

Privacy Policy
Sitemap

Local photographs provided by William Vavrek Photography

Oil & Gas Insurance

This quote will not be auto-generated. You will be contacted by a broker to collect required information.

Step 1 of 2

50%

Personal Information
Name*
First Last
Company Name*
First
Phone Number*
Email Address*
Street Address*
Address Line 2
City*
Province*
Postal Code*
*How do you want us to contact you?*
- Email
- Phone
Which office location would you prefer to contact you?*
- Grande Prairie
- Spirit River
- Sexsmith

Insurance Information
Would you also like a quote for any other type of insurance?
- Personal Auto
- Home
- Condo
- Mobile Home
- Tenant
- Rental Property
- Recreational Unit
- Travel
- Commercial Auto
- Commercial
- Not at this time
Why are you seeking a quote?*
- Price
- Service
- New in area
- New to province
- Newly licensed
- New homeowner
- New tenant
- New business
Have you ever been cancelled for non-payment*
- Yes
- No
How did you hear about us?*
- Facebook
- The Licence Centre
- Driving by
- Website/Google search
Word of mouth – if yes, who referred you?*
- Yes
- No
Who referred you
CAPTCHA

Home Insurance
Auto Insurance
Farm Insurance
Commercial Insurance
Oil & Gas Insurance

Commercial Insurance

This quote will not be auto-generated. You will be contacted by a broker to collect required information.

Step 1 of 2

50%

Personal Information
Name*
First Last
Company Name*
Company Name
Phone Number*
Email Address*
Street Address*
Address Line 2
City*
Province*
Postal Code*
*How do you want us to contact you?*
- Email
- Phone
Which office location would you prefer to contact you?*
- Grande Prairie
- Spirit River
- Sexsmith

Insurance Information
Would you also like a quote for any other type of insurance?
- Personal Auto
- Home
- Condo
- Mobile Home
- Tenant
- Rental Property
- Recreational Unit
- Travel
- Commercial Auto
- Commercial
- Not at this time
Why are you seeking a quote?*
- Price
- Service
- New in area
- New to province
- Newly licensed
- New homeowner
- New tenant
- New business
Have you ever been cancelled for non-payment*
- Yes
- No
How did you hear about us?*
- Facebook
- The Licence Centre
- Driving by
- Website/Google search
Word of mouth – if yes, who referred you?*
- Yes
- No
Who referred you
CAPTCHA

Farm Insurance

This quote will not be auto-generated. You will be contacted by a broker to collect required information.

Step 1 of 2

50%

Personal Information
Name*
First Last
Phone Number*
Email Address*
Street Address*
Address Line 2
City*
Province*
Postal Code*
*How do you want us to contact you?*
- Email
- Phone
Which office location would you prefer to contact you?*
- Grande Prairie
- Spirit River
- Sexsmith

Insurance Information
Would you also like a quote for any other type of insurance?
- Personal Auto
- Home
- Condo
- Mobile Home
- Tenant
- Rental Property
- Recreational Unit
- Travel
- Commercial Auto
- Commercial
- Not at this time
Why are you seeking a quote?*
- Price
- Service
- New in area
- New to province
- Newly licensed
- New homeowner
- New tenant
- New business
Have you ever been cancelled for non-payment*
- Yes
- No
How did you hear about us?*
- Facebook
- The Licence Centre
- Driving by
- Website/Google search
Word of mouth – if yes, who referred you?*
- Yes
- No
Who referred you
CAPTCHA

Auto Insurance

This quote will not be auto-generated. You will be contacted by a broker to collect required information.

Step 1 of 3

33%

Personal Information
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Phone Number*
Email Address*
Street Address*
Address Line 2
City*
Province*
Postal Code*
Do you give Credit Consent?
I give consent
Insurance providers often base quotes on credit ratings and if you are eligible for a payment plan. By giving consent you are allowing our brokers to source the best possible priced premium for you.
Number of years licensed*
Number of years with continuous auto insurance*
Any delivery type driving i.e. Skip the Dishes?*
- Yes
- No
Any traffic tickets in the last 3 years (excluding photo radar)?*
- No
- 1
- 2
- 3
- 4 or more (A broker will contact you for details)
Year*
Please provide type of traffic ticket*
Year*
Please provide type of traffic ticket*
Year*
Please provide type of traffic ticket*
Year*
Please provide type of traffic ticket*
Year*
Please provide type of traffic ticket*
Year*
Please provide type of traffic ticket*
Any "at-fault" auto claim(s)?*
- No
- 1
- 2
- 3 or more (A broker will contact you for details)
Year*
Please provide claim details*
Year*
Please provide claim details*
Year*
Please provide claim details*
Have you ever been cancelled for non-payment*
- Yes
- No
Any additional drivers?*
- Yes
- No
Additional Driver Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Number of years licensed*
Number of years with continuous auto insurance*
Does the additional driver do any delivery type driving i.e. Skip the Dishes?*
- Yes
- No
Has the additional driver had any traffic tickets in the last 3 years (excluding photo radar)?*
- No
- 1
- 2
- 3
- More than 3 (A broker will contact you for details.)
Year*
Please provide type of traffic ticket(s).*
Year*
Please provide type of traffic ticket(s).*
Year*
Please provide type of traffic ticket(s).*
Year*
Please provide type of traffic ticket(s).*
Year*
Please provide type of traffic ticket(s).*
Year*
Please provide type of traffic ticket(s).*
Has the additional driver had any "at-fault" auto claim(s)?*
- No
- 1
- 2
- 3 or more (A broker will contact you for details)
Year*
Please provide details of claim*
Year*
Please provide details of claim*
Year*
Please provide details of claim*
Any other additional drivers?*
- Yes
- No
Additional Driver Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Number of years licensed*
Number of years with continuous auto insurance*
Does the additional driver do any delivery type driving i.e. Skip the Dishes?*
- Yes
- No
Has the other additional driver had any traffic tickets in the last 3 years (excluding photo radar)?*
- No
- 1
- 2
- 3
- More than 3 (A broker will contact you for details)
Year*
Please provide type of traffic ticket(s)*
Year*
Please provide type of traffic ticket(s)*
Year*
Please provide type of traffic ticket(s)*
Year*
Please provide type of traffic ticket(s)*
Year*
Please provide type of traffic ticket(s)*
Year*
Please provide type of traffic ticket(s)*
Has the other additional driver had any "at-fault" auto claim(s)?*
- No
- 1
- 2
- 3 or more (A broker will contact you for details.)
Year*
Please provide the other additional drivers details of "at-fault" claim(s).
Year*
Please provide the other additional drivers details of "at-fault" claim(s).
Year*
Please provide the other additional drivers details of "at-fault" claim(s).

Vehicle Information
Make and model of vehicle*
Year of vehicle*
Type of coverage(s)*
- Select All
- Liability
- Collision
- Comprehensive
Do you have a second vehicle?*
- Yes
- No
Make and model of vehicle*
Year of vehicle*
Type of coverage(s)*
- Select All
- Liability
- Collision
- Comprehensive
Do you have another vehicle?*
- Yes
- No
Make and model of vehicle*
Year of vehicle*
Type of coverage(s)*
- Select All
- Liability
- Collision
- Comprehensive

Would you like a quote for any other type of insurance?
- Yes
- No
Which type of insurance?
- Personal Auto
- Home
- Condo
- Mobile Home
- Tenant
- Rental Property
- Recreational Unit
- Travel
- Commercial Auto
- Commercial
- Not at this time
Why are you seeking a quote?*
- Price
- Service
- New in area
- New to province
- Newly licensed
- New homeowner
- New tenant
- New business
How did you hear about us?*
- Facebook
- The Licence Centre
- Driving by
- Website/Google search
- Word of mouth
Who referred you
How do you want us to contact you?*
- Email
- Phone
Which office location would you prefer to contact you?*
- Grande Prairie
- Spirit River
- Sexsmith
CAPTCHA

Home Insurance

This quote will not be auto-generated. You will be contacted by a broker to collect required information.

Step 1 of 3

33%

Personal Information
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Phone Number*
Email Address*
Street Address*
Address Line 2
City*
Province*
Postal Code*
Credit Consent
I give credit consent
Insurance providers often base quotes and if you are eligible for a payment plan on credit ratings. By giving consent you are allowing our brokers to source the best possible priced premium for you.

Home Information
Value of Home*
Square Footage*
Year Built*
Is there a mortgage?*
- Yes
- No
How many kms to the closest fire hall?*
Have you had any claims in the past six years?*
- Yes
- No
How many claims in the past six years?*
- 1
- 2
- 2+ (A broker will contact you for information)
Date*
MM slash DD slash YYYY
Description of claim*
Date*
MM slash DD slash YYYY
Description of claim*
Date*
MM slash DD slash YYYY
Description of claim*
Have you ever been cancelled for non-payment*
- Yes
- No

Would you like a quote for any other type of insurance?
- Yes
- No
Which type of insurance?
- Personal Auto
- Home
- Condo
- Mobile Home
- Tenant
- Rental Property
- Recreational Unit
- Travel
- Commercial Auto
- Commercial
- Not at this time
Why are you seeking a quote?*
- Price
- Service
- New in area
- New to province
- Newly licensed
- New homeowner
- New tenant
- New business
How did you hear about us?*
- Facebook
- The Licence Centre
- Driving by
- Website/Google search
- Word of Mouth
Who referred you
*How do you want us to contact you?*
- Email
- Phone
Which office location would you prefer to contact you?*
- Grande Prairie
- Spirit River
- Sexsmith
CAPTCHA