8215 SW Tualatin Sherwood Rd #200
Tualatin, OR 97062
Phone: 503-443-1780
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Car Insurance
Information I need to give you a quote
  • Auto Insurance
  • Name (I need names of all the drivers in the house hold)
  • Address (Garaging address)
  • Telephone number
  • Date of birth
  • Social Security number
  • Driver License number
  • Issued State
  • How long you have been driving in the United State with Insurance
  • Do you have any accidents or citations for last 3 years?
  • Vehicle Identification Number
  • Insurance company that you are currently with. Please email me or Fax me the copy
Homeowner’s insurance
Information I need to give you a quote
  • Address
  • Year built
  • Squire footage
  • 1 story house or 2 stories
  • Do you have basement
  • What type of Life insurance are you looking for? Term or Permanent?
  • How much face amount are you looking for?
  • Age of applicant (Date of birth)
  • Do you smoke cigarette or chew tobacco? If you quit, how long has it been?
Commercial Insurance
Please send me a copy of current policy by email or fax. I will prepare for your quote and call you
  • Your name, company name, and telephone number
  • Medical insurance
  • Age of all applicants
  • Name and address
  • Phone number