Minnesota insurance from Miller Hartwig Insurance Insurance
Meeting the Insurance Needs of Minnesota Residents & Businesses for Decades!
 
Personal Auto, Homeowners Insurance from Miller Hartwig Insurance
Personal Auto Insurance

Homeowners Insurance

Condo & Townhome Insurance

Motorcycle/ATV Insurance

Boat Insurance

Snowmobile Insurance


Business and Contractor Insurance Products from Miller Hartwig Insurance
Businessowners Insurance

Contractor Liability Insurance

Commercial Auto Insurance

Workers Comp Insurance


Life and Health Insurance Products from Miller Hartwig Insurance
Life Insurance

Health Insurance


Other Insurance Services from Miller Hartwig Insurance
More About Our Agency

Our Nine Office Locations

Customers - Service/Claims

Questions? E-Mail Us!
 
 
On-Line Snowmobile
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
YOUR PERSONAL DATA:

Your Name:
Street Address:
City:
County:
State: (Must be Minnesota)
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):
Were You Referred to an Agent?
If Yes, Whom?
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If no, type NONE)
 
Select Discounts you
will qualify for: 		Multi-units
Snowmobile Safety Course
Snowmobile Club/Association Discount

 
DRIVER INFORMATION #1
Name: Birthdate:
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: Comments or Remarks?
 
DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
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: Comments or Remarks?

Snowmobile Unit #1 INFORMATION
Year of vehicle: Make & Model:
Type (special features): Cost new: $
List Engine CC size, etc. Current Value: $
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
 
Medical Payments: $1000
$2000 PD
$10,000
 
Uninsured Motorists: $25/50,000
$50/100,000 PD
$100/300,000
 
Snowmobile Unit #2 INFORMATION
Year of vehicle: Make & Model:
Type (special features): Cost new: $
List Engine CC size, etc. Current Value: $
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
 
Medical Payments: $1000
$2000 PD
$10,000
 
Uninsured Motorists: $25/50,000
$50/100,000 PD
$100/300,000
 
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!

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

Miller Hartwig Insurance . PO Box 1177 . Lakeville, MN 55044
Phone: 1-952-469-0407 | Fax: 1-952-469-1881 | E-Mail us at: quotes@insurance4MN.com
Our Telephone Quoting Hours are: 8:00am to 5:00pm (Mon-Thurs), 8:00am to 3:00pm (Fri)
View Our Privacy Notice | Website Design © 2007, 2008 Miller Hartwig Insurance