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Get a Quote - Group Benefits

    First Name
    Last Name
    Email
    Telephone
    Company Name
    Subject
    Renewal Date
    Present Insurer
    Duration
    Employee Name Sex Coverage:(S/F/CTS) Date of Birth:
    MM/DD/YYYY    		 Annual
    Earnings     		Hours/Week Occupation Hire Date:
    MM/DD/YYYY    		 Province
    Your Message

    Values for Health & Dental Coverage Are:

    S- Single

    F- Family

    CTS- Covered Through Spouse

    Checklist for Companies with Group Coverage:

    We will need a copy of your

    1. Current Benefit Booklet

    2. Most recent Renewal

    3. Employee Census (above)

    Please Return To:

    John Glynn
    Advisor, Barclay Insurance
    P: (604) 398-2399
    F: (604) 687-1554
    E: john@barclayinsurance.ca

    Get a Quote - Individual

      First Name
      Last Name
      Email
      Telephone
      Company
      Type of Insurance
      Date of Birth
      Amount of Coverage
      Smoker Status
      Your Message

      Get a Quote - Business

        First Name
        Last Name
        Email
        Telephone
        Company
        Type of Insurance
        Date of Birth
        Amount of Coverage
        Smoker Status
        Your Message

        Barclay Insurance Services Inc.
        #1501 - 1111 West Georgia St.
        Vancouver, BC V6E 4M3

        Tel: (604) 685-3707

        Fax: (604) 687-1554

        Email: info@barclayinsurance.ca

        Barclay insurance
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