Quote Questionnaire

Applicant Information

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How did you hear about us?
If Other, how did you hear about us?
Who is your current insurance with?
Who is your current insurance agent?
What is your current premium?
When does your current insurance expire?
MM slash DD slash YYYY
Are you being cancelled by your current insurance carrier?
Explain why you are being cancelled by your current insurance carrier*
What would you like a quote for?
- Homeowners
- Automobile
- Umbrella
- Renters
- Motorcycle
- Farm & Ranch
- Rental Dwelling
- Recreational Vehicle
- Flood
Privacy Disclosure
- Do you agree to the privacy disclosure?
Like most insurance agencies, we use information from you and other sources such as your driving, claims and credit histories to calculate an accurate price for your insurance. These reports can be requested at any time.

Would you allow us to run these reports to continue with your quote?

Save and Continue Later

How long have you owned the Trampoline?
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Name	Breed	Age
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Driver Name	Date of Birth	Drivers License Number
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Mark took the time to answer all my questions and review my options. I appreciate it, his honesty and his time. It was a very...

4 months ago

Roni Gabel

I navigate towards quality people and then look at the services they provide. If it works for me, I go that direction. Suhr & Lichty...

5 months ago

Del Ficke

Suhr & Lichty have been my Insurance Agents for a long time. They are always very friendly and willing to help both in person and...

3 years ago

Pat Grimes

We appreciate the expertise and support of all the professionals and friends at Suhr and Lichty. We have used their Agency for many years...

Dixie Zabka

Suhr and Lichty Insurance Agency was a great company to do business with while in Seward. I can't thank them enough for what they have...

JUSTIN HETZ

Homeowners Insurance

Type of Board:	Position on the Board:	How Long have you held the position?

When did the claim/violation happen?	Please describe the claim/violation in detail
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