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Mechanical Breakdown Insurance Quote Request

We can send you a quote via e-mail if you complete the form below.

If you would rather just have us call you for a quote, click here.

Note: Due to individual state licensing restrictions, we are only able to provide quotes for residents of California.

Your Information: The name fields, the e-mail field and the zip code field are required. We will not send unsolicited e-mail (spam) to you, nor will we release your e-mail address to anyone else.

First Name*

Last Name*

E-mail Address*

Street Address*

City or Town*

State

CA

Zip Code*

Home Phone

Work Phone

x

*required field

Vehicle Information: Describe your vehicles as completely as possible. If you don't know the submodel, leave that field blank. All other information is required in order to give an accurate quote.

Year
Make
Model
Submodel
EX/DX/GT etc.
Date Purchased
Odometer Reading
Vehicle 1

Vehicle 2

Vehicle 3

Still under factory warranty?
Turbocharger
or
Supercharger?
All
Wheel
Steering
4-wheel drive
or
All wheel drive
Vehicle 1

Vehicle 2

Vehicle 3

Now all we need you to do is to indicate below how you would like us to contact you and then hit the submit button.

Please contact me via:
Phone E-mail Mail

 

Kennedy Professional Insurance Agency
P.O. Box 847
19167 Highway 18, Suite 1
Apple Valley, CA  92307
(760) 242-2345 Phone
(760) 242-2211 Fax
kpia@kpia.com

License#:  0B44021
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