Auto Insurance Quote
(Washington, Idaho & Oregon residents only)

 



Please fill out our fast-form quote below to help in obtaining the appropriate quote for you.  There are no required fields, and any information you give will be confidential (we do not provide information to third parties—see our privacy policy).

If you prefer not to complete this form, please email your request to timo@cio.net, or you may obtain a quote by faxing your information and current auto insurance declarations pages to 509-326-7066.  As well, you can talk to one of our agents in person by calling 509-326-7060 x106  or toll free at 800-356-4231.

NOTE:  Some companies use credit as a means for quoting, which is called insurance scoring.  Though not required, you may benefit from allowing us to obtain an insurance score for you, no matter what your current credit standing is.
 

Auto Insurance Quote Fast-Form
Name 
Address 
City 
State  Zip 
E-mail (enter correctly or leave blank) 
Phone
Social Security Number
May we obtain an insurance score? YesNo
Present auto insurance company
Not Presently Insured
How long?
Date auto
insurance expires
Current
monthly payment
Length at present address
Time in current profession
Do you own a home? Yes No
Vehicle #
 Vehicle Identification
Number (VIN) if known		 Year Make
(i.e., Ford)		 Model & Class
(i.e., Windstar GL)
1
2
3
4
Vehicle #
 Business/Pleasure 2dr/4dr Miles to Work 
(one way)		 Annual Mileage
1
2
3
4
  Driver 1 Driver 2 Driver 3
Driver Name
Date of Birth
Sex
Drivers License Number
Marital Status
Occupation
Number of Violations Last 3 Years
Number of Accidents Last 3 Years
At fault?YesNo
At fault?YesNo
At fault?YesNo
  Driver 1 Driver 2 Driver 3
Percent of Use
Vehicle #1
Percent of Use
Vehicle #2
Percent of Use
Vehicle #3
Vehicle #
 Automatic
Seat Belts		 Anti-Lock
Brakes		 Air Bags Alarm Leased
Vehicle
1
 Yes
No		 2-wheel
4-wheel		 One
Two		 Active
Passive		 Yes
No
2
 Yes
No		 2-wheel
4-wheel		 One
Two		 Active
Passive		 Yes
No
3
 Yes
No		 2-wheel
4-wheel		 One
Two		 Active
Passive		 Yes
No
LIABILITY LIMIT FOR ALL VEHICLES*
Split Limits
Bodily Injury Property Damage
Combined Single Limit (choose one)
$25,000/$50,000 $10,000
$60,000
$50,000/$100,000 $25,000
$100,000
$100,000/$300,000 $50,000
$300,000
$250,000/$500,000 $100,000
$500,000
$500,000/$1,000,000 $500,000
$1.000,000
*Choose either Split Limits OR Combined Single Limit
Quote with Uninsured/Underinsured Motorists (UIM)
Quote with Personal Injury Protection (PIP)
Check here for state minimum limits only
Vehicle #
 Deductible
Comprehensive (theft, windshields, animals, etc.)		 Deductible
Collision
1
 $100 $250 $500 $250 $500 $1000
2
 $100 $250 $500 $250 $500 $1000
3
 $100 $250 $500 $250 $500 $1000
Vehicle #
 Towing Loss of Use
(Rental Reimbursement)
1
 YesNo YesNo
2
 YesNo YesNo
3
 YesNo YesNo
Please include comments (info on tickets, at-fault accidents, coverage requests, or auto safety features).

  

Please note this is for a quote only and does not bind coverage in any way.


Some of your available options:
• Transfer Discounts • Mature Driver Discounts • Business Use • SR-22 Filing
• Safety Discounts • Multi-Car Discounts • Young Driver • Broad Form
• Homeowner Discounts • Alarm Discounts • No Prior • 1 Month Down
• Safe Driver Discounts • Poor or No Credit • Bad Driving Record • Monthly Payments

 

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