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  Knutson Insurance Agency
12280 Nicollet Ave Ste104
Burnsville,  MN   55337

Ph (952) 224-0110

Fax (952) 224-0400

info@knutsonagency.com

 

 
 
Minnesota Renters Insurance Quote Request
This request form will provide you with a renters insurance cost and coverage summary based on the information you provide below. This is not an application for insurance. We recommend that you have a current copy of your insurance policy to refer to as you complete this form. After you have completed this form, click the Submit button at the bottom of the page.

PERSONAL  INFORMATION

First Name   MI 
Last Name
Address
City
State
Zip Code

Disclaimer
To provide an accurate quote we will ask you a series of questions, some of which we will confirm through consumer reports which may include credit information. This information will be available to our representatives only. For more information, see our Privacy Statement. Do you want to continue?

I have read the disclaimer and want to continue: Yes No

 

PROPERTY  COVERAGES

Personal Property $         Contents Replacement Cost
Loss of Use
Personal Liability $
Guest Medical $
Additional Coverage 1)           Amount 
Additional Coverage 2          Amount 
Additional Coverage 3          Amount 
Deductible
Current Insurance Company

 

GENERAL INFORMATION

Year Built          Market Value
Non- Smoker Yes No
Protective Devices 1)
Protective Devices 2)

Claims

Date (mo./yr.)                      Description

Claim #1

    

Claim #2

    

Claim #3

    

 

CONTACT  INFORMATION

Preferred Method of Contact

 

E-mail

Phone Number

Fax Number

Postal Mailing Address

Questions or Comments

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

 

 

 

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