EDI Implementation Problem Determination Reports

DECLARER INFORMATION:
Brokerage Name:
You must be a CSIO/Provincial Broker Association or CSIOnet registered member.
Name:
Email Address:
Phone Number:
REPORTED ISSUE INFORMATION:
Issue Reported for Company Members:	Select One Allianz Canada Aviva AXA Canada Inc. Bay of Quinte Mutual Ins. Co. Canadian Northern Shield The Citadel Assurance / L'Unique, Compagnie d'Assurances générales Dominion of Canada Dufferin Mutual Ins. Co. The Economical Insurance Group Farmers' Mutual Ins. Co. (Lindsay) Germania Farmers' Mutual Fire Ins. Co. Gore Mutual Insurance Grenville Mutual Ins. Co. The Guarantee Company of North America Halwell Mutual Ins. Co. Hamilton Township Mutual Insurance Howick Mutual ING Canada Insurance Brokers Association of Canada Kent & Essex Mutual Ins. Co. Lambton Mutual Ins. Co.  The North Waterloo Farmer's Mutual OPTIMUM GÉNÉRAL INC. Peace Hills General Insurance Company Peel Mutual Ins. Co. Pembridge Insurance Company Pilot Insurance Company Portage La Prairie Mutual Ins. Co. Promutuel Lévisienne-Orléans Promutuel Valmont Red River Valley Mutual Ins. Co. Royal & SunAlliance Saskatchewan Mutual Ins. Co. Scottish & York Insurance Co. Ltd. SGI CANADA Sovereign General Insurance Company Traders General Insurance Co. Trillium Mutual Insurance Company L'Union Canadienne, Compagnie d'Assurances West Wawanosh Mutual Ins. Co. Wawanesa Mutual Insurance Company York Fire & Casualty Insurance
Affected Party's BMS/Vendor:	Select One Applied Systems Inc. CGI Information Systems CIM-Data Ltd. Compu-Quote Inc. Custom Software Solutions Groupe Ultima Inc. Informco Inc. iter8 Keal Technology Logiciels Deltek Inc. Marshall  & Swift/Boeckh Promutuel Innovation Inc. SEH Computer Systems Sungard Sherwood Systems tec4 systems inc. Zycomp Systems Ltd.
Business Type:	Select one Auto Hab Email
Upload/Download Type:	Select one Upload Download
Date of Event:	yyyy/mm/dd
Policy Number (optional):
Type of Business Process:	Select one New Business Policy Change Cancellation
Description of Event: