Choice Mobile Site MN Choice Insurance

 Call 952-224-9190
or E-mail us 





Insurance 		Get a Quote
MN Choice Insurance

This Minnesota Motorcycle Insurance Quote inquiry form will allow us to provide you with a MN motorcycle insurance rates and coverages summary, based on the Motorcycle insurance information that you enter below.

Note: This is not an application for Minnesota motorcycle insurance coverage.

We recommend that you have a current copy of your Minnesota motorcycle insurance policy or declarations page to refer to as you are completing this form. When you have finished entering your MN motorcycle insurance quote information, click the 'Submit' button at the bottom of the page.

 

PERSONAL  INFORMATION
   
First Name *     MI  
Last Name *  
Address *  
City *
State *
Zip Code *
 
 
* Required
 
 
RIDER INFORMATION
     
  Rider One Rider Two
First Name
Last Name
Date of Birth
Gender
Male    Female
Male    Female
Marital Status
  
Single  Married 
 
Single  Married 
Bike Organization Member
Relationship to Rider One
Drivers Lic #  
State of Lic
Years of Motorcycle Riding Experience

 

DRIVING HISTORY

List all moving violations and claims in the past 5 years
         
  Incident 1 Incident 2 Incident 3 Incident 4
Rider  One Mo/Yr  Mo/Yr Mo/Yr  Mo/Yr 
Rider Two Mo/Yr  Mo/Yr  Mo/Yr  Mo/Yr 
 
MOTORCYCLE INFORMATION
     
  Motorcycle 1 Motorcycle 2
Year
Make
Model
Style
CCs
Altered/Modified
Yes     No
Yes     No
Primary Rider
Vehicle Usage
 
LIABILITY COVERAGES
   
Personal Liability
 Bodily Injury  $                                Property Damage  $
Uninsured/Underinsured Motorist $
Medical Payments $
 
ADDITIONAL COVERAGES
     
  Motorcycle 1 Motorcycle 2
Comprehensive
Collision
Towing
Yes    No
Yes    No
Optional Equipment (above $2,000)
Value  $
Value  $

 
INSURANCE  INFORMATION
   
Current Insurance Company
Length of Continuous Insurance
Renewal/Expiration Date

 

CONTACT  INFORMATION
   
E-mail *
Phone Number *
Questions or Comments
 

Enter Code

Please press the Submit button.
Wait a few moments for an online acknowledgment.

 

 
Home | Insurance Quotes | Resources | Learning Center | Contact Us