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Recent changes in Wisconsin State Law have created the opportunity for large awards resulting from lawsuits involving wrongful death and/or serious injuries. We recommend liability limits of 250/500 for any homeowner and an umbrella policy for those with assets they'd like to protect. The additional cost for these coverages versus the old 100/300 standard is usually about $15 every 6 months (for each vehicle) and worth every penny.

Young Drivers
Drivers ages 16-25 benefit from special safe driver and good student discounts. Our agents have special materials available to help explain insurance to new drivers. Our Agency is also proud to offer all of our families "Teenage Safe Driving Contracts" free, upon request. Lastly, we can write your teenage driver on a separate policy, in his/her own name (if there is an additional vehicle), and still extend all home and multiple car discounts, so that the parent's insurance record will always be protected from their child's driving experience.
Here are some additional sites that may offer you more helpful information:

  • http://www.autohelp.com - Offers prices on new cars, and locates any make, anywhere in the world, plus dealer locations.
  • http://www.kbb.com - Gives you the blue book value for new and used cars.
  • http://www.carpoint.com - Offers detailed pricing information, repair and maintenance cost estimates, plus ratings and reviews from other services.

Recreational Vehicles
We offer a wide variety of recreational vehicle coverage designed to offer you the best protection for your motorcycle, boat, personal watercraft, camper, trailer, snowmobile or ATV. Our motorcycle and boat rates are discounted to offer you year-round protection for one low price. Since we only insure recreational vehicles for our own customers, we are able to offer superior coverages at very reasonable rates. Liability, comprehensive and collision coverage are all included in these packages. Many discounts are available. Please call us at 262-783-6275 or email us for more information. Remember, families with multiple vehicles and/or additional recreational vehicles should consider adding a personal umbrella to their insurance protection.

Auto Insurance Quote Request
Please note: We treat all quote and customer information as strictly confidential. We do not disclose your information to anyone without your permission. If you are at all uncomfortable sending us your information electronically, you can complete the form, print it, and fax it to: 262-783-6211 or mail it to: 3620 N. 126th Street, Brookfield, WI 53005 and we will promptly return your quote via the same method. All information contained on this site is intended as general information and is for illustrative purposes only. This Web site does not, in any way, provide an offer of insurance. Every effort is used to maintain accuracy on these pages, but we don't offer any guarantee that this information will apply to any/every specific situation. Please call us at 262-783-6275 with any special situations, and thank you for visiting our site.

WEST SUBURBAN INSURANCE AGENCY
AUTO INSURANCE QUOTE WORKSHEET
NO OBLIGATION!

Driver Information
Who are the drivers in your household?
Driver #1: Name

Birthdate Age
Address/City/State

Zip Code? Male/Female?
Single/Married?
Driver #2: Name

Birthdate Age
Male/Female?
Relationship to Driver #1
Driver #3: Name

Birthdate Age
Male/Female?
Relationship to Driver #1
Driver #4: Name

Birthdate Age
Male/Female?
Relationship to Driver #1
Please list all tickets/accidents/suspensions for each driver in the past 5 years, whether at fault or not. Please explain the details of any incident(s) and mention who was ticketed, if anyone. Write "None" if the driver has a clear record.
Driver #1
Driver #2
Driver #3
Driver #4
Vehicle Information:
Please list all vehicles below. It is very important that all information requested is
filled in for each vehicle.
Reminder: Our auto customers qualify for special motorcycle rates.
Year Make/Model Edition Antilock? Airbags? 2W/
4W?
Annual Miles
SL,LE
DX,EX
Yes/No None, 1, 2 For Trucks Commuter/
Pleasure

Current Insurance Company:
If none, type "None"
When do you need coverage to begin?

How did you find us?

Your Email Address:
Phone: () - Fax:( ) -

Best time to contact you:
Use Email/Phone/Fax?

Please fill out this form as completely as possible.


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Member Of The Professional Insurance Agents Of Wisconsin West Suburban Insurance Agency, LLC
3620 N. 126th Street
Brookfield, WI 53005
Phone: 262-783-6275
Fax: 262-783-6211
Toll-Free 800-564-0801
sales@insurewisconsin.net

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