Insuring Minnesota Presents:

Insurance Programs for Minneapolis Residents! Highest Insurance Discounts With Quality Service!

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Insuring Minnesota
20960 Holyoke Ave
Lakeville, MN 55044
Phone: 952-469-0425
Fax: 952-469-1881

E-Mail us at:
info@insuring
minnesota.com

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Low Cost Minneapolis Snowmobile Insurance Rates! FREE
QUOTES!
 
Minneapolis Snowmobile
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


YOUR PERSONAL DATA:

Your Name:
Street Address:
City:
State: (Must be Minnesota)
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)


 
DRIVER INFORMATION #1
Name: Birth date:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR Cites within
last 3 years:
Number & Type of
MAJOR Cites within
last 3 years:
Minnesota
DL# & SS #:
Minnesota
Snowmobile Safety Course?
Yes No Comments or
Remarks?
 
DRIVER INFORMATION #2 ( if none, leave blank )
Name: Birth date:
Sex: # Years U.S.
 Auto License:
Number & Type of
Accidents within
last 3 years:
Number & Type of
MINOR Cites within
last 3 years:
Number & Type of
MAJOR Cites within
last 3 years:
Minnesota
DL# & SS#:
Minnesota
Snowmobile Safety Course?
Yes No Comments or
Remarks?


Snowmobile Unit #1 INFORMATION
Year of vehicle: Make & Model:
Type (special features): Performance Sled?
Annual Mileage: Value $:
List Engine CC size, etc.
Snowmobile #1 COVERAGES:
Limits of
Liability:
$25/50 BI / 15 PD
$50/100 BI / 50 PD
$100/300 BI / 50 PD
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
Snowmobile Unit #2 INFORMATION
Year of vehicle: Make & Model:
Type (special features): Performance Sled?
Annual Mileage: Value $:
List Engine CC size, etc.
Snowmobile #2 COVERAGES:
Limits of
Liability:
$25/50 BI / 15 PD
$50/100 BI / 50 PD
$100/300 BI / 50 PD
 
Comprehensive
& Collision:
NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Do you want
Medical Coverage?
Yes No   Uninsured
  Motorists?
Yes No
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Snowmobile Quote NOW!


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