Brokers
You won't need a contract to work with us.
Working with our underwriters, submitting a risk and getting a quote is as easy as one, two, three.
- Take a look around our site to see what we can offer you and if you don't see what you need please call our underwriters to see if your risk is something we can look at.
- Print off the application form from our downloads and forms and fax it to our direct fax line (780) 732-3686. You can also email us at submissions@groupassur.com
- Fill out the Broker Profile (below) so that we can enter you into our system to send you our quote.
Please visit our Bulletins to see what we've been sending out to Canadian Brokers once a month.
OUR SERVICE STANDARD IS 48 HOUR TURN-AROUND
WE ARE 100% CANADIAN OWNED AND CANADA WIDE
Email must be entered."; } else { $Email = $_POST[Email]; } $new_broker = $_POST[new_broker]; $change_broker = $_POST[change_broker]; $date = $_POST[date]; $brokerage_name = $_POST[brokerage_name]; $street_address = $_POST[street_address]; $postal_address = $_POST[postal_address]; $city_town = $_POST[city_town]; $province = $_POST[province]; $postal_code = $_POST[postal_code]; $phone = $_POST[phone]; $fax = $_POST[fax]; $broker_reg_number = $_POST[broker_reg_number]; $expiry_date = $_POST[expiry_date]; $agency_contact_person_one = $_POST[agency_contact_person_one]; $agency_contact_person_two = $_POST[agency_contact_person_two]; $contact_person_one_email = $_POST[contact_person_one_email]; $contact_person_two_email = $_POST[contact_person_two_email]; $accounts_dep_contact_person = $_POST[accounts_dep_contact_person]; $accounts_dep_contact_person_email = $_POST[accounts_dep_contact_person_email]; $eo_carrier = $_POST[eo_carrier]; $limit = $_POST[limit]; $ded = $_POST[ded]; $expiry = $_POST[expiry]; $number_of_employees = $_POST[number_of_employees]; $banking_institution = $_POST[banking_institution]; $banking_address = $_POST[banking_address]; $mail_via = $_POST[mail_via]; $hear_about = $_POST[hear_about]; $subject = "[CFI BROKER PROFILE] $Name"; $msg .= "New Broker: $new_broker \n"; $msg .= "Change Broker: $change_broker \n"; $msg .= "Date: $date \n"; $msg .= "Brokerage Name: $brokerage_name \n"; $msg .= "Email Address: $Email \n"; $msg .= "Street Address: $street_address \n"; $msg .= "Postal Address: $postal_address \n"; $msg .= "City / Town: $city_town \n"; $msg .= "Province: $province \n"; $msg .= "Postal Code: $postal_code \n"; $msg .= "Phone Number: $phone \n"; $msg .= "Fax Number: $fax \n"; $msg .= "Broker Resigistration Number: $broker_reg_number \n"; $msg .= "Expiry Date: $expiry_date \n"; $msg .= "Agency Contact Person (one): $agency_contact_person_one \n"; $msg .= "Agency Contact Person (two): $agency_contact_person_two \n"; $msg .= "Contact Person (one) Email: $contact_person_one_email \n"; $msg .= "Contact Person (two) Email: $contact_person_two_email \n"; $msg .= "Accounts Department Contact Person: $accounts_dep_contact_person \n"; $msg .= "Accounts Department Contact Person Email: $accounts_dep_contact_person_email \n"; $msg .= "E&O Carrier: $eo_carrier \n"; $msg .= "Limit: $limit \n"; $msg .= "Ded: $ded \n"; $msg .= "Expiry: $expiry \n"; $msg .= "Number of Employees: $number_of_employees \n"; $msg .= "Banking Institution: $banking_institution \n"; $msg .= "Banking Address: $banking_address \n"; $msg .= "Mail Via: $mail_via \n"; $msg .= "How did you hear about CFI UM: $hear_about \n"; //ini_set("SMTP", "webmail.cfiinsurance.ca"); //ini_set("sendmail_from", "emailaddress@replytoyourpost.com"); $mail_success = mail($to, $subject, $msg); // ini_restore("SMTP"); if ($mail_success){ $success_message = "Your broker profile was successfully sent"; } else { $success_message = "Unfortunatly your broker profile was not successfully sent, please try again."; } } else { $display_form = true; } ?>
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