Park Family Insurance - Sacramento Insurance 888-723-7275 Roseville Insurance Rocklin Insurance

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Get a Comparative Auto / Car Insurance Estimate

Thank you for your interest in Park Family Insurance. By filling out the below form, we will provide you a detailed auto / car insurance estimate from our major insurance carriers. Please ensure you enter your information accurately so that we may assist you in the most timely manner possible. If you have any further questions, feel free to contact us at (888) 723-7275.

---- Contact Information ----
First Name		Last Name
Address
Address1
City
State		Zipcode
Daytime Phone		Evening Phone
E-mail
---- Basic Insurance Information ----
Curent Policy With		Current Policy Expires
Years of Continuous Insurance
---- Vehicle Information---- Please enter the make, year, model and if possible submodel of each vehicle you wish to insure. Also, please select the level of both the comprehensive and collision deductibles for each of those vehicles.
Vehicle #1
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
Vehicle #2
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
Vehicle #3
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
Vehicle #4
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
Vehicle #5
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
Vehicle #6
Make		Year
Model		Comprehensive Deductible
SubModel		Collision Deductible
---- Driver Information---- Please enter the requested information for each driver. Also, please identify which of the vehicles above is the primary vehicle for that driver. Examples of Minor Violations: Speeding over 65, Failure to stop, U-turn, Seat belt, etc. Examples of Major Violations: DUI, Reckless Driving, Exhibition of Speed, etc. Accidents: Be sure to include each accident, even if it was not your fault.
Driver #1
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
Driver #2
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
Driver #3
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
Driver #4
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
Driver #5
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
Driver #6
Name		Birth Date
Gender		Marital Status
Years Licensed		One Way Mileage to Work or School
Primary Vehicle		Vehicle Usage
Minor Violations Last 3 Years		Accidents Last 3 Years
Major Violations Last 3 Years
---- Desired Coverage ----
Bodily Injury Liability		Property Damage Liability
Bodily Injury Uninsured Motorist		Property Damage Uninsured Motorist
Medical Payments		Rental Reimbursement
		Towing
---- Additional Information/Comments ----

Please double check the information you entered above and click the 'Send' button immediately below. We will make every effort to respond within 1 business day. If you do not hear from us by that time, please contact us at 888-723-7275.

!!! Client Referral Program !!!

When your referral obtains coverage through Park Family Insurance, you receive:

A $10 Starbucks Gift Card

An entry into a monthly drawing for a $50 dinner for two to a local restaurant

REFERRAL WINNERS FOR NOV 2009

$50 Dinner for 2:

Sherman Whitney
(Antelope, CA)

$10.00 Starbucks cards:

Tatia Davenport
(Roseville, CA)
Tim Lucke
(Rancho Murieta, CA)
Grace Reyes
(Roseville, CA)

DEC NOT-SO-TRIVIAL-PURSUIT CONTEST WINNER ($25 Gas Card):

Mike Blenner
(Roseville, CA)

Client Quotes

“Wow, was I surprised to see my name in the Thanksgiving newsletter as Client of the Month. I am happy to refer you based on the service I received. Also, I really appreciated getting my E & O renewal on CD-ROM. One less piece of paper to deal with; it is now on my hard drive where it belongs. Thanks for the great service… “ Hank Roitman, EA
Roitman Tax Service, Inc.
Sacramento, CA

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