Snowmobile Insurance Quote


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Snowmobile Insurance Quote Application

Take a few minutes and provide us with a few facts about the snowmobile(s) you want to insure. Please note that this does not constitute a binding agreement but rather provides us with information that allows us to provide you with some options. We make every attempt to contact you by the next business day.

Before you begin your request, you should gather:

The declaration page from your current snowmobile insurance policy you're considering replacing.
Complete information on the model you're buying (for a new purchase).

Any information you submit is strictly confidential, and will not be shared with any other individuals or organizations.

General Information

Name (Titled Owner):
Mailing Address:
City:	State:	Zip:
Physical address where snowmobile is registered or principally operated.
Street:
City:	State:	Zip:

About the Snowmobile(s)

Snowmobile "Book" values are available at www.nada.com
Unit#	Year	Make	Model	cc's	Purchase Date
1
Vehicle ID Number
Current Value
2
Vehicle ID Number
Current Value
3
Vehicle ID Number
Current Value
4
Vehicle ID Number
Current Value

About the Driver(s)

	Driver 1	Driver 2	Driver 3
Name
Date of Birth
Sex
Marital Status
Drivers License	Number State None	Number State None	Number State None
Year Started Driving	Autos Snowmobiles	Autos Snowmobiles	Autos Snowmobiles
Have you completed a snowmobile safety course?	Date Completed	Date Completed	Date Completed
Are you a member of a snowmobile club?
Indicate date and type of any accidents and/or violations in last 3 years.	Accident 1 Date	Accident 1 Date	Accident 1 Date
	Accident 1 Type	Accident 1 Type	Accident 1 Type
	Accident 2 Date	Accident 2 Date	Accident 2 Date
	Accident 2 Type	Accident 2 Type	Accident 2 Type
	Accident 3 Date	Accident 3 Date	Accident 3 Date
	Accident 3 Type	Accident 3 Type	Accident 3 Type
What snowmobile do you drive?
Snowmobile 1
Snowmobile 2
Snowmobile 3
Snowmobile 4

Bodily Injury and Property Damage
Liability Limit For All Scheduled Snowmobiles

This coverage is required by law in many states and in Canada. It covers damage you may cause to other people's property and injuries to the people themselves. Passenger Liability is included at no additional cost. Please select the limit you desire.

LIABILITY:	Bodily Injury Per Person/Bodily Injury Per Accident/Property Damage Liability
	25,000/50,000/10,000 (Least expensive)
	50,000/100,000 /25,000
	100,000/300,000/50,000
	250,000/500,000/100,000 (Most expensive)

Optional Medical Payments Coverage

This optional coverage covers medical payments for those injured with a covered snowmobile. A $50 deductible applies.

$1,000

$2,000

$5,000

Optional Comprehensive and Collision Coverage

Collision covers damage to your snowmobile if it collides with another object or rolls over. Comprehensive covers damage or loss (including theft) other than collision. Snowmobiles must bee 9 model years or newer in order to be eligible. Collision cannot be purchased without comprehensive coverage.

Snowmobile 1	Comprehensive	Collision
Snowmobile 2	Comprehensive	Collision
Snowmobile 3	Comprehensive	Collision
Snowmobile 4	Comprehensive	Collision

Optional Transport Trailer Coverage

If you elect to insure at least one snowmobile for collision and comprehensive coverage you are eligible for Trailer Comprehensive Collision coverage. The annual premium is only $10.00 and a $100.00 deductible applies.

Include Trailer coverage at $10.00. I understand I will need to have comprehensive and collision coverage on at least one snowmobile.

(Fill in trailer information below)

Trailer Information

Year	Make	Serial Number	Purchase Price

How Can We Reach You?

E-mail	Address
Phone	Number Best Time to Call AM PM
Fax	Number

We will make every attempt to contact you within one business day.
You can call us at 1-800-562-6036.

PLEASE REVIEW ALL INFORMATION BEFORE SUBMITTING

Sled Insure is wholly owed by licensed independent property and casualty insurance agent / broker T. Samuel Hoye,
First Credit Corporation of New York, Inc. 21 North Main Street, Gloversville, NY 12078