Motorcycle Insurance - Stratum Insurance Agency LLC

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Tell us About your Ride*

Is your vehicle Street Legal or Offroad?*

Name*

First Last

Email*

Enter Email Confirm Email

Address where you keep your Motorcycle / ATV / UTV / Side By Side / Trike*

Street Address Address Line 2 City State ZIP Code

Do you have a separate mailing address?

No
Yes - I have another mailing address

Mailing Address - enter only your mailing address here

When is your birthday?*

Phone*

Marital Status

What is your profession? ** Discount

Many professions can earn discounts. Tell us what you do and we will work to find you a discount.

How many years of motorcycle or ATV/UTV experience do you have?

Please enter a number from 0 to 100.

What is your highest level of Education ** DISCOUNT

What is your spouse's name and birthdate?

If you are married, we need to INCLUDE or EXCLUDE your spouse on the quote. This means that his or her name must be listed on the policy. This does not mean that it affects the price, but it is a requirement from most companies to list the spouse.

Driving Record

Clean Record for the last 3 years
Ticket(s) in the last 3 years
Accidents(s) in the last 3 years

Are you able to tell us what tickets or accidents you have in the last 3 years? If you know the type of ticket and/or the date, it helps us to get a more accurate quote.

Do you have a DUI?

Do you have insurance now on this vehicle / watercraft? **** DISCOUNT

About Your Motorcycle / LSV / Golf Cart / ATV / UTV / Side By Side / Trike / Watercraft / Dune Buggy

Year*

Make*

Model*

Tell us as much as you can. Example: Artic Cat M8 LTD edition

CCs (if you know the answer)

VIN (not required, but very helpful to get a quote)

If you know your 17 digit VIN for a car (or other ID number for a golf cart/LSV), it helps us get an accurate quote. If you do not provide the VIN, then the quote is even more of an estimate.

What kind of vehicle do you have?

Is it street legal?*

To obtain a street legal dune buggy or sand rail quote, we need to quote at least one (or all) of the other vehicles registered in your household. We do not quote stand-alone street legal buggies as of September 1, 2016. Please provide the year, make, and model of your other vehicles in the box below.*

If you only provide the details of your street legal dune buggy, then we will not be able to send you a quote.

Discounts - Check all that Apply

Do you need to add any other riders? Remember, you must disclose all people of driving age in your household.

NO - no other people of driving age in my household
YES - I will add more drivers

Please tell us the NAME, Birthdate, and relationship to you of others riders that you are adding.

Do you need to add another Motorcycle / ATV / UTV / Side By Side / Trike / Dune Buggy?

No
Yes

Tell us the Year/Make/Model of your other Motorcycle / ATV / UTV / Side By Side / Trike

If you have the VIN, please tell us here. If you are adding a second rider, please include a name and birthdate.

Do you want to send us a picture of your ride? You can include it here.

Do you authorize us to send you a text (SMS) about your quote or policy, if you purchase one?

Yes
No

Watercraft Section

Are you the original owner of the watercraft?*

Year*

Make*

Model*

Top Speed*

Engine Size in total number of CCs*

How many years of watercraft experience do you have?*

Do you know the VIN or Hull ID?

The HIN consists of twelve characters, uninterrupted by slashes, hyphens, or spaces. HIN's are typically found on the boat registration and are embossed on the stern right quarter of the boat.

What is the hull material*

Engine Type*

Does the Boat/PWC have an exposed engine?*

A watercraft equipped with an engine that is not contained within an original equipment manufacturer designed cover and/or insulation.

Would you like to insure your trailer? If so, please provide the market value of the trailer.

Storage/Mooring ZIP code*

Does the watercraft have multiple owners?*

Multiple owners that do not live in the same household. More than two owners is not acceptable.

Where is Boat/PWC kept during boating season?*

Total Horsepower (of all engines)

Engine/outdrive modified to enhance performance

Answer 'yes' if the watercraft has any engine or outdrive components installed to enhance performance beyond hull and/or engine manufacturer stock configurations (i.e. blowers, performance outdrives, performance props, surface drive/mud motors, superchargers, etc.).

Comments and Notes

Provide additional information here

FLORIDA SECTION

Is your vehicle registered in Florida?*

Do you have ANY other cars or Low Speed Vehicles registered in Florida at the same address?*

If you keep you have your vehicle registered in Florida and you have ANY other cars registered in Florida, the insurance carrier requires that you write all vehicles registered at your household in Florida with them. We will quote your other vehicles too. Please provide either the VIN or the year/make/model of your other vehicles.*

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About Your Motorcycle / LSV / Golf Cart / ATV / UTV / Side By Side / Trike / Watercraft / Dune Buggy

Watercraft Section

FLORIDA SECTION