Automotive Insurance

Insurance Resources

coverageglossary.com
Insurance Resource

www.iii.org
Insurance Resource

hwysafety.org
Automobile Resource

cslb.ca.gov
Remodeling Resource for Homeowners

wcirbonline.org
Workers' Compensation Resource

www.fema.gov
Disaster/flood Resource

earthquake.usgs.gov
Earthquake Resource

quake.abag.ca.gov
Earthquake Resource

No matter what type of vehicle you drive, you
purchase insurance to protect yourself in the event of a loss.
You want to be insured by a company that provides you with
the best coverage value, but you also want a company that
will respond promptly if you have a claim.

Crist, Fritschi and Paterson, Inc. represents many companies
to choose from. Please complete the Personal
Automobile Questionnaire and one of our representatives
will contact you.

automobile questionnaire - All fields are required

Please take a moment to fill out the following questionnaire.

If you have specific questions feel Free to e-mail CF&P or give us a call at 510-433-4200

CF&P agent's e-mail
Insured's name
Insured's address:
Driver's name(s), date of birth and drivers license number: (One per line)
Vehicle(s) year, make, model, body type and VIN#: (One per line)
Annual miles per vehicle:
Vehicle(s) use (personal or business):
Number of miles to and from work/school each way:
Current coverage limits:
Comprehensive deductible:
Collision deductible:
Current company:
Expiration date:
Has any driver shown above been convicted of a moving violation in the last 3 years? If so, please explain:
Any claims in the last 3 years?:
Phone Number
E-mail address