New Brokerage Sign-up

Contact Information









Owner/Principal Information







(xxx-xxx-xxxx)

(for IBAS related emails)




Brokerage Information


Which of the following insurance companies are represented by your brokerage (check all that apply)?
 AVIVA Canada  
 GMS  
 Intact Insurance  
 My Mutual Insurance  
 Mutual Fire Insurance  
 Northbridge Insurance  
 Optiom Inc.  
 Palliser Hail Insurance Company  
 Peace Hills General Insurance  
 Portage Mutual Insurance  
 Red River Mutual  
 RSA Canada  
 Saskatchewan Blue Cross  
 Saskatchewan Mutual Insurance  
 SGI CANADA  
 Travelers Canada  
 Wawanesa Mutual Insurance Company  
 Wynward Insurance Group  


Name of sponsoring company
Other: 

Is brokerage owned or controlled (majority interest) by any insurer or financial institution
 Y    N



Does the Applicant hold a valid Property and Casualty insurance license?
 Y    N


Privacy Information

Do you consent to receive email communications from us?
 Y    N


Agreement

 Yes   I/we hereby agree to observe strictly the by-laws, rules and regulations of the Insurance Brokers Association of Saskatchewan (IBAS), as it now is, or may hereafter be constitutionally amended, holding faithfully to the spirit as well as to the letter of said by-laws, rules, and regulations, and also agree that violation by another broker shall not be deemed as in any manner waiving my/our obligations under this agreement.

 Yes   I hereby confirm that the information contained in this application is correct and authorize the Insurance Brokers Association of Saskatchewan (IBAS) to verify the information given with the appropriate sources.

 Yes   I agree to adhere to the BIP Logo Guidelines

 Yes   I hereby agree and acknowledge that, as a member of the Insurance Brokers Association of Saskatchewan (IBAS), our brokerage will automatically be enrolled in IBAS’s Consumer Protection Bond (CBP) until a time that IBAS is formally notified in writing of our brokerage’s intention to opt out. I acknowledge there is no additional cost to participate in the CBP program, nor shall IBAS remit compensation should our brokerage opt out. By participating in the CBP program, I also hereby agree that our brokerage, its directors, its officers, and its staff shall save harmless and indemnify IBAS from any claim, loss, costs, suits, damages, counsel fees, and expenses, which the surety provider (SGI CANADA) sustains by reason of executing the CBP.