Pay By Credit Card

"*" indicates required fields

Customer ID*

Contact Email Address*

Client First Name*

Client Last Name*

Amount*

Please enter a number greater than or equal to 0.

Make sure to include the dollars and cents e.g. 47.82

Invoice Number*

Invoice number cannot be reused.

This field is hidden when viewing the form

Tax

This field is hidden when viewing the form

Actual Calculated Tax

Credit Card Charge

Price: $ 0.00 CAD

Credit Card Information

Card Holder Name*

Address*

Address 2

City*

Province*

Postal Code*

Country*

Our Insurance Products & Services

https://prominenceinsurance.ca/wp-content/uploads/2024/11/Car-Insurance-1-1280x856.png

Car

For new & experienced drivers, old & new vehicles

https://prominenceinsurance.ca/wp-content/uploads/2024/10/Personal-Property-Insurance-1280x856.png

Home

For homeowners, condo-owners & tenants

https://prominenceinsurance.ca/wp-content/uploads/2024/11/Commercial-Insurance-1280x856.png

Business

For commercial property, liability & more

https://prominenceinsurance.ca/wp-content/uploads/2024/11/Life-Insurance-1280x856.png

Life

Protecting & securing the future of your loved ones

https://prominenceinsurance.ca/wp-content/uploads/2024/11/Travel-Insurance-1280x856.png

Travel

Travel protection to ensure peace of mind