J.M. Strange & Company -- Insurance * Bonds

Call Us:	(713) 622-1494
Email:	Send Email

J.M. Strange & Company: Insurance - Bonds

Automobile Insurance Quote

We would like to offer you with a free, no-obligation automobile insurance quote. Please provide as much information possible for the most accurate quote. This information will be kept confidential and will be used for quote purposes only.

Disclaimer

Please note completion of any request(s) for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting a request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.

	I have read and agree with the above disclaimer.
	(Box must be checked before request can be sent)

Personal Information
Name:
Address:
City:	State: Zip:
Day Phone:	Night Phone:
Best Time To Call:	AM PM
Email Address:
Best Contact Time:

Current Auto Insurance Information
Company Name (not agency):
Policy Expiration Date:	Premium Amount: $
Term:	6 Months 1 Year Other:

Vehicle Information
(include all cars you or your family members own or lease)
Car #1	Year	Make	Model	Body Type	Vehicle ID# (VIN)

Name of Title Holder		Annual Mileage	Drive to school/work?	# of miles (one way)	Airbags	Car Alarm
			Y N		Y N	Y N
If vehicle is kept at an address other than that listed above, please indicate below
Location City: State: Zip:

Car #2	Year	Make	Model	Body Type	Vehicle ID# (VIN)
Car #2
Name of Title Holder		Annual Mileage	Drive to school/work?	# of miles (one way)	Airbags	Car Alarm
			Y N		Y N	Y N
If vehicle is kept at an address other than that listed above, please indicate below
Location City: State: Zip:

Car #3	Year	Make	Model	Body Type	Vehicle ID# (VIN)
Car #3
Name of Title Holder		Annual Mileage	Drive to school/work?	# of miles (one way)	Airbags	Car Alarm
			Y N		Y N	Y N
If vehicle is kept at an address other than that listed above, please indicate below
Location City: State: Zip:

Car #4	Year	Make	Model	Body Type	Vehicle ID# (VIN)
Car #4
Name of Title Holder		Annual Mileage	Drive to school/work?	# of miles (one way)	Airbags	Car Alarm
			Y N		Y N	Y N
If vehicle is kept at an address other than that listed above, please indicate below
Location City: State: Zip:

Liability Limit For ALL Cars

Choose either Bodily Injury and Property Damage

or Single Limit

Bodily Injury

Property Damage

Single Limit

Deductibles and Misc.
Car#	Comprehensive Deductible	Collision Deductible	Towing	Loss of Use
1			Yes	Yes
2			Yes	Yes
3			Yes	Yes
4			Yes	Yes

Driver Information
(include all licensed drivers in your household)
Driver #1	Driver's Name		Drivers License Information
			DL#: State: Yr's Licensed:
Relation	Date of Birth	Sex	Marital Status	Courses Completed Last 3 yrs
		M F	Married Single	Drivers Ed: Y N Accident Prevention: Y N

Driver #2	Driver's Name		Drivers License Information
			DL#: State: Yr's Licensed:
Relation	Date of Birth	Sex	Marital Status	Courses Completed Last 3 yrs
		M F	Married Single	Drivers Ed: Y N Accident Prevention: Y N

Driver #3	Driver's Name		Drivers License Information
			DL#: State: Yr's Licensed:
Relation	Date of Birth	Sex	Marital Status	Courses Completed Last 3 yrs
		M F	Married Single	Drivers Ed: Y N Accident Prevention: Y N

Driver #4	Driver's Name		Drivers License Information
			DL#: State: Yr's Licensed:
Relation	Date of Birth	Sex	Marital Status	Courses Completed Last 3 yrs
		M F	Married Single	Drivers Ed: Y N Accident Prevention: Y N

Driver History
List ANY convictions for ANY driver convicted of moving traffic violations* in the past 3 years*
Driver	Date	Type of Conviction	Fines	Speed Over Limit
			$	mph
			$	mph
			$	mph
			$	mph

List ANY driver who has had license suspensions, revocations or DUI convictions* below*
Driver	License Suspended or Revoked	DUI Conviction For:
	Suspended Revoked	Alcohol Drugs
	Suspended Revoked	Alcohol Drugs
	Suspended Revoked	Alcohol Drugs
	Suspended Revoked	Alcohol Drugs

List ANY driver involved in accidents, regardless of fault, in the past 5 years
Driver	Date	Description	Cost	Fines	Injuries	At Fault
			$	$	Yes	Yes
			$	$	Yes	Yes
			$	$	Yes	Yes
			$	$	Yes	Yes

Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have
additional information where there was not enough fields above, please enter them here.

Please click on the "Submit Quote" button to send your quote request.
One of our representatives will respond to your submission as soon as possible.

Refer a Friend

You made a good decision when you placed your trust in us, now we'd like you to share your experience with friends and family so that they get the insurance coverage they need, at a price they can afford.

Annual Risk Review

To get the most out of your insurance coverage for the least cost, you should submit an Annual Policy Review of your Homeowners' (Condo/Apartment) and/or Automobile policies. Click below to complete an online review. It should take less then 15 minutes!

Address:
800 Bering Dr. Ste 310
Houston, TX 77057

Email Us:
Send Email

Phone:
Fax:

(713)622-1494
(713)622-1861

Office Hours:
Monday thru Friday
9:00 a.m. - 4:00 p.m.

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Important Note: This Web site offers only a simplified description of coverages and is not a statement of contract. None of the information offered on the website is a guarantee that insurance will be provided or that the agency is obligated to procure insurance for the website visitor. Coverage may not apply in all states. Misstatements or omissions of relevant information can lead to price variation or even declination or rescission of coverage. For complete details of coverages, conditions, limits, and losses not covered, be sure to read the policy, including all endorsements, or prospectus, if applicable. Coverage CANNOT be bound, amended, or altered by leaving a message on, or relying upon, information in this Website or through E-Mail, Voicemail or Text.

Licensed in the following States: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Georgia, Idaho, Louisiana, Michigan, Mississippi, Missouri, Montana, New Mexico, New York, North Carolina, Oklahoma, Texas, Washington, Wyoming.