Connecticut Car Insurance Quotes

**Information received from this Connecticut Car Insurance quote request form sent to ConnDriver.con / 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 Connecticut car insurance policy 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 and Rhode Island, and 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.**

We are a local Connecticut insurance agency, offering affordable
Connecticut car insurance policy services in the following cities
and counties: 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, Westchester, Fairfield County,
New Haven County, Litchfield County, Middlesex County, New London
County, Hartford County, Tolland County, and Windham County, CT.