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People's Insurance
195 SE 3rd St.
Bend, OR 97702
Phone: 541-323-7283
Fax: 541-323-7885
People's insurance offers you our satisfaction guarantee

Insuring Residents of Oregon for More Than a Decade!

On-Line Snowmobile Insurance Quote Form One Simple Form - takes only 2-3 Minutes! YOUR PERSONAL DATA:
Your Name:
Street Address:
City:
County:
State: (Must be Oregon)
Zip/Postal:
E-Mail (REQUIRED):
Phone:
Fax (optional):

Marital Status: Single Married	Homeowner? Yes No

Currently Insured? (If yes, list carrier, and # of years continuous. If no, type NONE)

Select Discounts you will qualify for:	Multi-units Snowmobile Safety Course Snowmobile Club/Association Discount


DRIVER INFORMATION #1
Name:		Birthdate:
Sex:		# Years U.S. Auto License:
Number & Type of Accidents within last 3 years:		Number & Type of MINOR Cites within last 3 years:
Number & Type of MAJOR Cites within last 3 years:		Comments or Remarks?

DRIVER INFORMATION #2 (if none, leave blank)
Name:		Birthdate:
Sex:		# Years U.S. Auto License:
Number & Type of Accidents within last 3 years:		Number & Type of MINOR Cites within last 3 years:
Number & Type of MAJOR Cites within last 3 years:		Comments or Remarks?

Snowmobile Unit #1 INFORMATION
Year of vehicle:		Make & Model:
Type (special features):		Cost new:	$
List Engine CC size, etc.		Current Value:	$
Snowmobile #1 COVERAGES:
Limits of Liability:	$25/50 BI / 15 PD $50/100 BI / 50 PD $100/300 BI / 50 PD

Comprehensive & Collision:	NO Coverage $250 Deductible $500 Deductible $1000 Deductible

Medical Payments:	$1000 $2000 PD $10,000

Uninsured Motorists:	$25/50,000 $50/100,000 PD $100/300,000

Snowmobile Unit #2 INFORMATION
Year of vehicle:		Make & Model:
Type (special features):		Cost new:	$
List Engine CC size, etc.		Current Value:	$
Snowmobile #2 COVERAGES:
Limits of Liability:	$25/50 BI / 15 PD $50/100 BI / 50 PD $100/300 BI / 50 PD

Comprehensive & Collision:	NO Coverage $250 Deductible $500 Deductible $1000 Deductible

Medical Payments:	$1000 $2000 PD $10,000

Uninsured Motorists:	$25/50,000 $50/100,000 PD $100/300,000


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