Arthur D. Calfee Insurance Agency

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Automobile Insurance Quote Request

To request an estimated quote on your Massachusetts Personal Automobile Insurance please provide the following information and we will be happy to get back to you. If you would like to request a quote on another vehicle, please submit another request. (You may indicate "Same drivers" in the Comments section.)

About Your Vehicle
Year
 Make
 Model
 VIN
Town of Garaging
 Registration Number
 Odometer
 Annual Mileage (last year)
0-5000
 5000-7500
 7500+
Passive Restraint
None
One air bag
Two air bags
Automatic seat belts
Anti-Theft Device
No
Yes (Describe)
Used In Business?
No
Yes

All Customary Operators not listed on other policies
(show Principal Operator first)
Last Name Date Of Birth License Number Experience
0-3 yrs 3-6 yrs 6+ yrs

Coverages
Part 1 Bodily Injury to Others (per person/per accident) $20,000/$40,000
Part 2 Personal Injury Protection $8,000
Part 3 Bodily Injury Caused By
an Uninsured Auto (per person/per accident)
Note: Amount chosen may not be greater than the amount chosen for Part 5
Part 4 Damage To Someone Else's Property
Note: See below regarding other options		 $100,000
Part 5 Optional Bodily Injury to Others (per person/per accident)
Part 6 Medical Payments
Part 7 Collision (ACV with waiver of deductible) No
Yes, with deductible of
300
500
1,000
2,000
...or, Part 8 below
Part 8 Limited Collision No deductible
Part 9 Comprehensive (ACV) No
Yes, with deductible of
300
500
1,000
2,000
Part 10 Substitute Transportation (per day/maximum) None
15/450
30/900
100/3,000
Part 11 Towing and Labor (per disablement) None
50
100
Part 12 Bodily Injury Caused by an Underinsured Auto (per person/per accident)
Note: Amount chosen may not be greater than the amount chosen for Part 5
Please indicate if you are a member of:
AAA

 

The most common coverage options are shown but others are available, some of which produce major coverage reductions for only minimal cost savings. If you wish to discuss something special (for example, deductibles on Parts 2 and/or 8; reduction of Part 4; elimination of Parts 5, 12, and/or the waiver under Part 7; glass deductible on Part 9; etc.) please indicate this in the Comments section below.

 

Your Contact Information
First Name
Last Name
Mailing Address
Town
State
Zip Code
E-mail Address
Daytime Telephone

Evening Telephone

Comments:

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Last updated on October 23, 2006.