Request a Quote

Please fill out the form below and we will send you an itemized quote for your insurance provider.

Date*
Date Format: MM slash DD slash YYYY
Name of Policy Holder*
First Last
Name of Intended User*
First Last
Address*
Street Address Address Line 2 City Province Postal Code
Phone*
Email*
Quantity
Items to be Quoted*
Add Accessories
- Foldable Shopping Basket
- Footrest Support Plate
- Suspension Seat Post
- TravelScoot Throttle Assist
- TravelScoot Travel Set
Foldable Shopping Basket
Price: $ 45.00 CAD
Footrest Support Plate
Price: $ 45.00 CAD
Suspension Seat Post
Price: $ 65.00 CAD
TravelScoot Throttle Assist
Price: $ 25.00 CAD
Beverage Holder & Mug Set
Price: $ 75.00 CAD
TravelScoot Travel Set
Price: $ 55.00 CAD
GST
Price: $ 0.00 CAD
PST
Price: $ 0.00 CAD
Total
$ 0.00 CAD
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