Minnesota Snowmobile Insurance Quote

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

Snowmobile      Year          Make            Model                Serial #
     1
     2

Snowmobile      Primary Use          CC's       Liquid Cooled
     1
     2

Snowmobile
     1   Is snowmobile garaged?    If Yes, is it locked?
     2   Is snowmobile garaged?    If Yes, is it locked?

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

Snow        Collision         Comprehensive
Mobile    Deductible           Deductible
     1
     2
     3

                                  Drivers                          Date of                                     Drivers
Driver                       Name                               Birth            Gender              License #               State
     1
     2
     3

                  How Long              Social                 Marital
Driver       Licensed              Security #              Status
     1
     2
     3

Driver
     1           Years of Snowmobile Experience:     Years Experience this Size Sled:
     2           Years of Snowmobile Experience:     Years Experience this Size Sled:
     3           Years of Snowmobile Experience:     Years Experience this Size Sled:

Anyone had a safety course in the last year?
If Yes, please list who?

Member of a Snowmobile association?
If Yes, please list Association and number?

Any claims or violations on record (this includes driver's record)
within the last 3 years for any driver listed on policy?
Please explain claims or violations:

Additional Information or Comments

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

We are your local St. Paul, Minnesota insurance agency, offering
affordable Snowmobile 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 snowmobile insurance coverages in the remainder of Minnesota
and throughout Wisconsin.

**Information received from this Minnesota Snowmobile 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
snowmobile 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 Snowmobile Insurance policy. We are licensed in Minnesota and
Wisconsin and will not provide quotes for other states.