Connecticut Car and Auto Insurance Quote

We offer affordable truck and car insurance premiums from quality
insurance companies to residents in the following Connecticut counties
and cities: Fairfield County, New Haven County, Litchfield County,
Middlesex County, New London County, Hartford County, Tolland
County, Windham County, Stamford, Norwalk, Greenwich, Darien,
Riverside, Belltown, Springdale, Round Hill, Old Greenwich, East
Norwalk, New Canaan, Glenville, Byram, Cos Cob, Mianus, North
Stamford, Glenbrook, Wilton, Weston, Long Ridge, Noroton, West
Norwalk, Westport, High Ridge, Southport, North Wilton, Winnipauk,
Cannondale, Turn of River, South Wilton, Lyons Plains, Georgetown,
Ridgefield, Branchville, Redding, Topstone, Ridgebury, Redding Ridge,
Branchville, Dodgingtown, West Redding, Titicus, Hattertown, Bethel,
Danbury, New Fairfield, Newtown, Hawleyville, Botsford, Monroe,
Bridgeport, Stepney, Shelton, Huntington, Upper Stepney, Long Hill,
Trumbull, Stratford, Easton, Fairfield, Greenfield Hill, Stratfield, Nichols,
Oronoque, Rivercliff, Devon, Lordship, and East Bridgeport, New Haven,
Hartford, Torrington, Waterbury, Meriden, New Britain, New London,
Norwich, Manchester, East Hartford, Suffield, Granby, West Haven,
West Hartford, Branford, East Haven, Hamden, Woodbridge, Orange,
North Haven, Groton, Rocky Hill, Newington, Wethersfield, Glastonbury,
Bloomfield, Blue Hills, South Windsor, Naugatuck, New Hartford,
Chesire, East Lyme, Old Mystic, Wallingford, Southington, Middletown,
Bristol, Laurel Beach, Litchfield, Pleasure Beach, Mystic, North
Westchester, Double Beach, Willimantic, Storrs, Canaan, East Windsor,
Vernon, South Canaan, Putnam, Guilford, Windham, South Britain,
Willington, Windsor, East Hampton, Brooklyn, and Westchester, CT.

Information received from this Connecticut car insurance quote form sent to Stamford Insurance
Group will be for our use only and will not be sold, given to or distributed to any other parties. A
quote will be based on the car insurance information provided and does not guarantee
acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting
guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this
request you acknowledge that this is neither an offer to insure nor a guarantee of insurance.
Completion of this form does not entitle you to a Connecticut Car Insurance policy. We are
licensed in Connecticut, New York, New Jersey, Massachusetts, and Rhode Island. We will not
provide quotes for other states.

Full Name:
Home Address:
City:     State:     Zip Code:
Email Address: (Required)
Home Phone: Work Phone: Ext.
How to Contact You:
Date of Birth:             (mm/dd/yyyy)
Gender:         Marital Status:

Vehicle     Year           Make                Model                 Body Type
     1
     2
     3

Vehicle     Primary Use     Miles Driven to Work       Cost New
     1                         $
     2                         $
     3                         $

What type of air bag system is your car equipped with?
Vehicle
     1
     2
     3

What type of anti-lock brake system is your car equipped with?
Vehicle
     1
     2
     3

Do you have a car alarm?
Vehicle
     1
     2
     3

                      Liability                   Uninsured                                             Collision         Comprehensive
Vehicle    Limits(x $1,000)      Motorist(x $1,000)       Medical              Deductible           Deductible
     1
     2
     3

                                  Drivers                          Date of                                              Drivers
Driver                       Name                               Birth                  Gender                 License #
     1
     2
     3

Is your driving record accident & violation free during the past 5 years?
Driver
     1       If No, how many accidents?    How many violations?
     2       If No, how many accidents?    How many violations?
     3       If No, how many accidents?    How many violations?

Was your driver's license suspended during the past 5 years?
Driver
     1
     2
     3

Current Insurance Company:
Expiration Date: (mm/dd/yyyy)

Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your Connecticut Car insurance quote request.