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Fast Insurance Quotes by Phone or On-line from our New York Insurance Center.
Time Saving Cost Comparisons & Quality Service... Call Us Today!
 
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Low Cost
Insurance

High Quality
Service!

Call Us for a
RUSH Quote.
We can place
Coverage
INSTANTLY!

 
Or, Get A FREE
Quote On-Line
 
 
   Automobile Insurance
   "D.W.I." Auto Insurance
   Homeowners Insurance
   Mobilehome Insurance
   Renters Insurance
   Personal Umbrella
   Motorcycle & ATV
   Boat & Jetski Insurance
   Snowmobile Insurance
   Motorhome/Travel Trailer
   Business Owners Insurance
   Commercial Auto Insurance
   Contractor's Insurance
   Surety/fidelity Bonds
   Workers Compensation
   Landlord's Insurance
   Restaurant Insurance
   Life Insurance

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Contact Us
 
 
E-Mail:
john@joinsurance.com

Phone:
Toll Free:
 866-353-8817
Direct Line:
 716-823-1801

Facsimile:
716-823-2483

Mailing Address:
John Obstarczyk
Insurance Agency
16 Lake Ave.
Blasdell
NY 14219

More About
Our Agency!

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Our carriers offer 10% off your Home and Auto Insurance when we write both policies.

"Remember,
All Our Policies
Come with an Agent!"

We Are Proud Members of the Better Business Bureau!

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On-Line Umbrella
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
Your Personal Data

Your Name:
Property Address:
City:
State: (Must be New York)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail Again (for accuracy):
Phone:
Fax (optional):
 
Umbrella coverage gives you a layer of liability coverage above your auto, homeowners, rental dwelling coverage, and RV (cycle, motor home, etc.), up to the limit you select. Standard policy is a $1 Million liability limit; but we also have policies available at $2 Million and $5 Million. Fill in ALL fields below:
 
Dwelling Information

# of dwellings you own and occupy (INCLUDING your home):
 
total UNIT count of all rental dwellings    (NOT including units you own and occupy):
 
Number of Automobiles you own (Describe Yr, Make & Model of each:
 
Number of RV's you own:   (Include boats, RV's, motorcycles, motorhomes, etc.)
 
Vehicle Operator's Information

Number of Drivers: 1 2
3 4 or more
 
List AGES of all drivers:   (Include all children and household members.)
 
Driving Records Clear?   (If not, list all cites and accidents per driver.)
 
Coverage Information

Limit of Coverage: $1 Million
$2 Million
$5 Million
 
Underlying Auto Limits: $100/300/50
$250/500/100
$300,000 CSL
$500,000 CSL
 
Underlying Homeowner Limits: $300,000
$500,000
 
Underlying Rental Dwelling Limits:  (Rentals must have $500,000 liability INCLUDING Personal Injury coverages) $500,000 incl. P/I
Other (not acceptable)
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 

Comments/Remarks:
 
Send my quotation via: E-Mail
Telephone - please call
 Fax
Regular Mail

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release them from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a Quote NOW!

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Terms of Use/Privacy Notice/Copyright Info. This website last updated in September 2005.
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