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 motorcycle insurance quotes for other states.

We are your local St. Paul, MN insurance agency, offering affordable
Minnesota Motorcycle Insurance quotes 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 quotes 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

Minnesota Motorcycle Insurance Driver Information

                                  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.**