Hickok & Boardman, Inc. - Home PageDescription of homeowners, auto and life insurance products offered by our agency.Description of the insurance products we offer commercial clients.Description of unique insurance programs for specialized industries or individuals with high valued homes.Get a quote by filling out the applications available here.Frequently requested forms and summary of some of the services H&B offers.Provides our history and job opportunities.


Please fill in the following information and an agent will contact you within the next business day. Your vehicle needs to be registered and garaged in Vermont in order for us to provide you with a quote.

Name

Address

City/State/Zip


Phone

Email Address

Currently Insured With

Renewal Date (mm/dd/yyyy)

Reason for seeking quote

How did you hear about us?

  Internet
  Newspaper
  Radio
   Mailing
  Referral from friend/relative
Driver #1
Name
Date of Birth (mm/dd/yyyy)
License Number
Driver #2
Name
Date of Birth (mm/dd/yyyy)
License Number
Driver #3
Name
Date of Birth (mm/dd/yyyy)
License Number
Driver #4
Name
Date of Birth (mm/dd/yyyy)
License Number
Vehicle #1
Make
Model
VIN #
Year
One way miles to work
# of days/week
 Airbags?
 Anti-lock brakes?
 Anti-Theft Devices?
Vehicle #2
Make
Model
VIN #
Year
One way miles to work
# of days/week
 Airbags?
 Anti-lock brakes?
 Anti-Theft Devices?

Limits:
Liability   Medical Payments  
Uninsured Motorist )
(incl. $10,000 Property Damage		   Collision Deductible  
Rental   Deductible
“Other than Collision” 		 
Towing  


Any Violations/Accidents Last 3 Years?
Yes  No 
If yes, please explain:

Any Claims In Last 3 Years?
Yes  No 
If yes, please explain:

Teenage Drivers?:
Yes  No 

Good Student?:
Yes  No   (Grades B Or Above)


Which office is most convenient for you?
Burlington
Stowe
St. Albans
 Lyndonville
Montpelier

Take me to the homeowners quote form after accepting this request (additional discounts are available if homeowners is written along with personal auto)

 

Here When You Need Us

Denis, Ricker & Brown
A Member of the Hickok & Boardman Insurance Group
PO Box 565 Montpelier, VT 05602 | 802.229.0563 | fax:802.229.9327
Affiliated Companies | Privacy Policy | Contact Us
 
Hickok&Boardman, Inc.
  Quote Request (overview)
  Homeowners
Personal Auto
  Business
Montpelier
Lyndonville

 Burlington
Stowe
St. Albans

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