Connecticut auto insurance quotes from CT Low Cost Auto Insurance.com
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satisfied CT auto insurance customer testimonial from CT Low Cost Auto Insurance.com
"Only $88 Down Got Me Started!"
 “After having trouble finding insurance because of an accident on my record, it was great to find a company that could get me liability coverage on my 96 Honda Accord at only $88.00 down! Thanks again for issuing my insurance ID card the SAME DAY!"
J.M., Hartford, CT

satisfied CT auto insurance customer testimonial from CT Low Cost Auto Insurance.com
"2 Speeding Tickets - No Problem"
 “I had several agents tell me they could not help me because I had 2 speeding tickets. Not only did you welcome me, but you found me a policy for only $154 a month on my 1987 Toyota MR2 - $300 less than I was paying!"
T.M., Bridgeport, CT

satisfied CT automobile insurance customer testimonial from CT Low Cost Auto Insurance.com
"Young Female With Ticket OK!"
 “My parents were upset with me because I got a ticket and their rate went up. I got a quote from you online, and it was actually LESS than I was paying with my parents. Liability on my 2000 Toyota Corolla was only $142 a month. Thanks again - and my parents thank you too!"
C.C., New Haven, CT

satisfied CT car insurance customer testimonial from CT Low Cost Auto Insurance.com
"I Got a DWI Ticket - But You Found Me Insurance for only $109/Month!"
 “Unfortunately, I got pulled over for a DWI ticket and was sure I would lose my license. But you found me a policy I could afford on my 2002 Mitsubishi Galant at only $109 a month. Not only that, you took care of all the DMV papers concerning insurance. I recommend you to anyone needing help!"
F.W., Naugatuck, CT

satisfied CT auto insurance customer testimonial from CT Low Cost Auto Insurance.com
"3 Tickets but Only $130 a month!"
 “What can I say - I'm 23 years old and I got three tickets in a short time. My insurance costs went through the roof! You found me a liability policy on my 1990 Buick for only $130 a month and saved my license for me! I thought I would have to stop driving because I couldn't afford insurance - thanks again!"
R.E., Oakdale, CT

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Your Name:
Street Address:
City:
State: (Must be Connecticut)
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Boat Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type N/C)
 
Is this Boat Co-owned?
(If yes, list all owners names)

OPERATOR INFORMATION #1
Name: Birthdate:
Sex (M/F): # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations, and approximate DATES of each in the fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

OPERATOR INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

VESSEL & UNDERWRITING INFORMATION
Year of Boat: Make & Model
(be specific):
 
Boat Length: Hull Type
(wood, Metal,
fiberglass, etc):
 
Max. Speed
(in MPH):		 Market Value: $
 
Engine Make: Engine Type:
(Inboard, I/O, Jet)
 
Engine Horse
Power:		 Fuel Type:
(Gas, Diesel, etc.)
 
Trailer Cov.
Needed?		 Yes No Yr./Make/Model
of Trailer:
 
Trailer Value: $ Where is boat
moored or stored?
 
Describe waters
boat taken on?		 Describe boat
general usage?
(fishing, ski, etc.)

VESSEL COVERAGES:
Limits of
Liability:		 $15/30 BI / 10 PD $25/50 BI / 15 PD
$50/100 BI / 25 PD $100/300 BI / 50 PD
$250/500 BI / 100 PD
 
Hull Coverage: NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Water Ski
Medical Coverage?		 Yes No   Uninsured
  Motorists Cov.?		 Yes No
 
Comments or Remarks:
(List additional drivers,
special coverages, etc. here)

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