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  Knutson Insurance Agency
12280 Nicollet Ave Ste104
Burnsville,  MN   55337

Ph (952) 224-0110

Fax (952) 224-0400



Minnesota Umbrella Insurance Quote Request
This request form will provide you with an umbrella 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.


First Name   MI 
Last Name
Zip Code
Date of Birth      Spouse's Date of Birth (if applicable)
Occupation   Spouse's Occupation (if applicable)

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


Limit of Liability         
Number of Vehicles
Number of Drivers Under Age 21
Uninsured / Underinsured Motorist Yes No
Number of Recreational Vehicles (not including boats)
Number of Sailboats 25 to 50 feet
Number of Inboard Boats Over 50 hp   Length
Number of Inboard / Outboard Boats Over 50 hp   Length
Number of Outboard Boats Over 50 hp   Length
Vacant Land - Number of Acres
Rental Dwellings - Number of Units
Jet Skis & Sleds
Child Care Liability - Number of Children




Preferred Method of Contact
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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