Minnesota Umbrella Insurance Quote – MN Personal Umbrella from Lakeville Insurance.com

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E-Mail:
info@insuring
minnesota.com

Phone Lines:
1-800-972-4292
ext. 425
1-952-469-0425

Fax:
1-952-469-1881

Mailing Address:
20960 Holyoke Ave
PO Box 1177
Lakeville, MN
55044

MN Insurance
License #:
44761

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Please report site-related technical problems to: info@insuringminnesota.com

On-Line Umbrella Insurance Quote Form One Simple Form - takes only 2-3 Minutes! Your Personal Data:

Your Name:
Property Address:
City:
Your "County" is?
State: (Must be Minnesota)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Umbrella coverage gives you a layer of liability coverage above your auto, homeowners, rental dwelling coverage, and RV (cycle, motor home, etc.), up to the limit you select. Standard policy is a $1 Million liability limit; but we also have policies available from $2 Million to $5 Million. Fill in ALL fields below:

Dwelling Information
# of dwellings you own and occupy (INCLUDING your home):

total UNIT count of all rental dwellings (NOT including units you own and occupy):

Number of acres of vacant land you own (If none, enter "none"):

Number of Automobiles you own (Describe Yr, Make & Model of each:

Number of RV's you own: (Include boats, RV's, motorcycles, motorhomes, etc.)

Vehicle Operator's Information
Number of Drivers:	1 2 3 4 or more

List AGES of all drivers: (Include all children and household members.)

Driving Records Clear? (If not, list all cites and accidents per driver.)

Coverage Information
Limit of Coverage:	$1 Million $2 Million $3 Million $4 Million $5 Million

Underlying Auto Limits:	$100/300/50 $250/500/100 $300,000 CSL $500,000 CSL

Underlying Homeowner Limits:	$300,000 $500,000

Underlying Rental Dwelling Limits: (Rentals must have $500,000 liability INCLUDING Personal Injury coverages)	$500,000 incl. P/I Other (not acceptable)

Currently Insured?	Yes No
Name of Carrier & how long insured?

Prior Claims?	Yes No
Describe claims in detail:

Comments/Remarks:

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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.

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