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Commercial Auto Quote Form


Michigan Residents Only!



Do you currently have insurance?
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Number of Vehicles
Required
Vehicle 1 Year Model
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Vehicle 1 Make/Model
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Vehicle 1 VIN
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Full Coverage?
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Vehicle 2 Year Model
Optional
Vehicle 2 Make/Model
Optional
Vehicle 2 VIN
Optional
Full Coverage?
Optional


Vehicle 3 Year Model
Optional
Vehicle 3 Make/Model
Optional
Vehicle 3 VIN
Optional
Full Coverage
Optional


Vehicle 4 Year Model
Optional
Vehicle 4 Make/Model
Optional
Vehicle 4 VIN
Optional
Full Coverage?
Optional


Comprehensive Deductible
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Collision Deductible
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Collision Type
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Current Liability Coverage
Required
All drivers covered by medical insurance?
Required

All drivers covered by your workers compensation policy?
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Total number of employees?
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Number of Drivers
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Driver 1 (Full Name)
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Date of Birth
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/ /
Driver 2 (Full Name)
Optional
Date of Birth
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/ /
Driver 3 (Full Name)
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Date of Birth
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/ /
Driver 4 (Full Name)
Optional
Date of Birth
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/ /
Tickets/Accidents in last 3 years? (List driver, date, & violation)
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Owner/Officer Information
First Name
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Last Name
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Company Name
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Year Business Established
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How many years at current address?
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Street Address
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City
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ZIP / Postal Code
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Primary Phone Number
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E-Mail Address
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Preferred Method of Contact
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What lead you to our site?
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Any Additional Info?
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Submission Validation
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Important Notice:

Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages.  Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company.  If you have any questions, please feel free to contact us. Per the terms of our online privacy policy we will not resell your information to any third-party.

  
    Disclaimer: Schwab Insurance Agency is not affiliated with Charles Schwab & Co., Inc. or Charles Schwab Bank N.A.

    We Proudly serve all of Michigan, including Millington, Otisville, Columbiaville, Fostoria, & Otter Lake in Tuscola,
    Genesee, Saginaw, and Lapeer County.