Excess Professional Liability Coverage Application

Please complete this application in full, since it forms the basis upon which insurance is provided. In the event of a non-disclosure and/or misrepresentation, the policy may be voided at the option of the Insurer.

Primary Contact Details

Do you have a Professional Corporation to add? *
Are you purchasing new excess coverage for the first time or renewing existing coverage? *

Lloyd Sadd Insurance Brokers Ltd.

Suite 700, 10240 124 Street
Edmonton, AB T5N 3W6