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Add or Replace a Vehicle Service Request Form

You are here: Home1 / Add or Replace a Vehicle Service Request Form

Add or Replace a Vehicle Request Form

"*" indicates required fields

Will this vehicle replace an existing vehicle on the policy?*

New Vehicle Information

How is the vehicle titled?*
How is the vehicle owned?*
What best describes your need for Loan or Lease GAP coverage?*
Which of the following best describes the use for the vehicle?*
Will this vehicle be used for any Transportation Network Services (Uber, Lyft, Amazon, Shipt, DoorDash)?*
Will this vehicle be used for any Peer-to-Peer vehicle sharing platform (Turo, ZipCar)?*
What is the garaging address for this vehicle?*
Which of the following safety features are present on your vehicle?*
Are you interested in telematics for additional discounts?*

Coverage Selections

What would you like your comprehensive deductible to be?*

What would you like your collision deductible to be?*

What would you like your glass deductible to be?*

Would you like to include towing and/or AAA?*
How much rental reimbursement would you like to include?*

If eligible: Would you like to include Accident Forgiveness in your policy?*
If eligible: Would you like to include coverage for Diminution of Value?*
If eligible: Would you like to include coverage for New Car Replacement?*

Deleted Vehicle Information

Our Mission

Our mission is simply stated, yet earnest. We provide families and business owners peace of mind by safeguarding their assets through risk management expertise. Our proven process ensures you understand your risk tolerance while feeling informed, educated, and protected.

How Can We Help?

Please do not include any sensitive personal information like your social security number here.

Wayzata

1907 Wayzata Blvd Ste 210,
Wayzata, MN 55391

Call or Text

952-930-3661

Hours

Mon. – Thurs.: 8:00 am – 4:30 pm
Friday 8:00 am – 2:00 pm

Coon Rapids

8960 Springbrook Drive, Suite 100
Coon Rapids, MN 55433

Call or Text

763-755-7000

Hours

Mon. – Thurs.: 8:00 am – 4:30 pm
Friday 8:00 am – 2:00 pm

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