Minnesota Motorcycle Insurance Quote

**Information received from this Minnesota Motorcycle Insurance quote request form
sent to the Baecker Insurance Agency will be for our use only and will not be sold,
given to or distributed to any other parties. A quote will be based on the motorcycle
insurance policy information provided and does not guarantee acceptance of the risk
by us. The precise coverage afforded is subject to meeting underwriting guidelines,
and the terms, conditions and exclusions of the policy as issued. By submitting this
request you acknowledge that this is neither an offer to insure nor a guarantee of
insurance. Completion of this form does not entitle you to a Minnesota Motorcycle
Insurance policy. We are licensed in Minnesota and Wisconsin and will not provide
quotes for other states.

We are your local St. Paul, Minnesota insurance agency, offering affordable
Motorcycle Insurance policy premiums in the following Twin Cities area towns
and counties: Minneapolis, Bloomington, Roseville, Maplewood, North St.
Paul, Oakdale, Woodbury, Cottage Grove, South St. Paul, Inver Grove Heights,
Eagan, West St. Paul, Richfield, Burnsville, Edina, Lilydale, Mendota Heights,
St. Paul Park, Lake Elmo, Newport, Cedar Grove, Savage, Shakopee, Eden
Prairie, Minnetonka, Hopkins, St. Louis Park, Plymouth, Golden Valley,
Columbia Heights, New Hope, Crystal, Robbinsdale, Brooklyn Center, Fridley,
New Brighton, Maple Grove, St. Anthony, Arfen Hills, Shoreview, Vadnais
Heights, Little Canada, White Bear Lake, Mahtomedi, Grant, Bellaire, North
Oaks, Gem Lake, Mounds View, Lino Lakes, Blaine, Coon Rapids, Spring Lake
Park, Lexington, Afton, Lakeland, Bayport, Stillwater, Apple Valley, Andover,
St. Cloud, Mankato, Rochester, Duluth, Anoka, Champlin, Andover, Oak
Grove, St. Michael, Hanover, Scandia, Forest Lake, Wyoming, Rosemount,
Hastings, Vermillon, Coates, Ramsey County, Hennepin County, Dakota
County, Anoka County, and Washington County, MN. We also offer
motorcycle insurance services in the remainder of Minnesota and throughout
Wisconsin.

Full Name:
Mailing Address:
City:
State: (Minnesota or Wisconsin)     Zip Code:
Email Address: (Required)
Home Phone: Work Phone: Ext.
How to Contact You:
Current Insurance Company:
Policy Expiration Date:          (mm/dd/yyyy)

  Cycle       Year             Make                 Model              Type
     1
     2

Cycle      Primary Use     Miles Driven to Work     CC's
     1
     2

Cycle
     1   Is motorcycle garaged?    If Yes, is it locked?
     2   Is motorcycle garaged?    If Yes, is it locked?

Does your motorcycle(s) have an alarm?
Cycle
     1
     2

                      Liability                 Property                   Uninsured
  Cycle    Limits(x $1,000)          Damage             Motorist(x $1,000)         Medical
     1
     2             SAME                       SAME                       SAME                   SAME

                   Collision         Comprehensive
  Cycle    Deductible           Deductible
     1
     2

                                  Drivers                          Date of                                        Drivers
Driver                       Name                               Birth            Gender                 License #             State
     1
     2

                                  Drivers                  How Long             Social                     Marital
Driver                    Occupation                Licensed            Security #                 Status
     1
     2

Is your driving record accident & violation free during the past 3 years?
If No, how many accidents?    How many violations?

Any claims of losses to motorcycle(s) or from liability in the past 5 years?
Description of losses:

Have you taken any safety courses in the last 5 years?

Additional Information or Comments

Click on the "Submit Quote Information" button below to
send your Minnesota Motorcycle Insurance quote request.**