Auto/Home Quote Sheet

Letter From The President

Community Involvement

Industry Association Memberships

Individual Life Insurance

Health Insurance

Property & Casualty

Employee Benefit Plans

Individual Life Insurance

Health Insurance

Property & Casualty

Employee Benefit Plans

Careers

Auto/Home Quote Sheet
Named Insured:
Address:
City:
State:	Zip:
Do you Own/Rent:	Own: Rent:
Home Phone:
Home Value:
Year Built:
Deductible:
Home Liability Limit:
DRIVER #1
Name:
D/O/B:	SSN:
DL#:

DRIVER #2
Name:
D/O/B:	SSN:
DL#:
	*Additional Drivers will require the same information.

Auto Liability Limits:
Bodily Injury Per Person:	Per Occurence:
Property Damage:

Uninsured Motorist Per Person:	Per Occurence:
Underinsured Motorist Per Person:	Per Occurence:
Comprehensive Deductible:
Collision Deductible:

Vehicle #1:
Year:	Make: Model: VIN#:
Vehicle #2:
Year:	Make: Model: VIN#:
	*Additional Vehicles will require the same information.
*For Boat, RV or Motorcyle quotes please get the year, make, model and VIN or Serial Numbers.

billmarkveassociates.com

Main Office
Bill Markve & Associates
625 Sioux Point Road
P.O. Box 349
Dakota Dunes, S.D. 57049
Phone: 605.232.3333
Fax: 605.232.9228
Toll Free: 800.742.8851

Northern Division
Bill Markve & Associates 15 West 7th Avenue Webster, SD 57274 Phone: 605.345.4503 Fax: 605.345.4505	Dakota Insurance 228 South Main Street P.O. Box 191 Milbank, SD 57252 Phone: 605.432.4566 Fax: 605.432.4573 Toll Free: 800.238.7935