Georgia insurance

"Experience GA, TN, SC, & MO Residents & Businesses Can Count On."
Georgia auto insurance
Georgia auto insurance
Home Insurance | Auto Insurance | Life Insurance | Renters Insurance | Landlord Liability | Builders Risk
Georgia auto insurance
 
Call Us Now!
No Down Payment &
Save 20% on Your
Auto Insurance!
770-434-6691


 
GA homeowners insurance

    Homeowners Insurance Quote
    Condominium Insurance Quote
    Renters Insurance Quote
    Builder's Risk Quote
    Landlord Liability Quote

GA auto insurance

    Auto Insurance Quote

Free Georgia insurance quotes

    Life Insurance Quote
    Commercial Insurance
    Mortgage Brokers/Realtors
    Superheroes Foundation

    Service to Your Account
    Learn More About Our Agency
    Mel Clemmons - Personal Bio
    Protecting Your Privacy


New to Georgia? Click Here!

5 Reasons Why You Should Use Our Insurance Services:

1. Excellent coverage at very competitive prices.

2. FAST online quotations for auto, homeowners, and life, and INSTANT quotes by phone.

3. Low down payment & Easy monthly installments on most policies.

4. Our service is second to none. Call us and get an agent who really CARES!

5. We offer a satisfaction guarantee. We know our top quality coverages and service will SATISFY you!

Remember...
"All Our Policies Come With an Agent!"

Clemmons Insurance Agencies has helped thousands of Georgia, Tennessee, South Carolina, and Missouri residents and businesses find the lowest rates available and the best insurance plans to protect their cars, homes, businesses, and families. Let us do the same for YOU! Our office includes a state-of-the-art computer system for policy services, claim servicing and accounting so that quality service is GUARANTEED. Your needs will be addressed, phone calls returned, and coverage issues responded to, and claim matters will be addressed...WITHIN 24 HOURS!

   © 2014 Design by Insurance Web Sales

 

 
On-Line Automobile
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data

Your Name:
Street Address:
City:
State:
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
Primary Insured's Occupation:
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type N/C)


DRIVER INFORMATION #1
Name: Birthdate:
Sex (M/F): # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations, and approximate DATES of each in the fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No If YES to SR22 filing, why needed?
(list accident/cite)
Give details on all violations or accidents:


DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?
Give details on all violations or accidents:
ADDITIONAL DRIVERS:
If More than 2 Drivers, list Additional Drivers' Names, Birthdates, and driving record history here:


VEHICLE #1 INFORMATION
(if "Non-Owners", type "NON-OWNER" in "YEAR" Field)
Year of vehicle: Make & Model:
Vehicle ID# (for rating accuracy):
Annual Mileage: Used in business?
(Explain, if yes):
VEHICLE #1 COVERAGES:
Select Liability Limits
 
Select Comprehensive Deductible:
 
Select Collision Deductible:
 
Rental Car &
Towing Coverage?
YES NO
 
Uninsured Motorists
Coverage?
YES NO
 
Medical and/or
PIP Coverage?
YES NO
 
 
VEHICLE #2 INFORMATION (if none, leave blank)
Year of vehicle: Make & Model:
Vehicle ID# (for rating accuracy):
Annual Mileage: Used in business?
(Explain, if yes):
VEHICLE #2 COVERAGES:
Select Liability Limits - - - Liability Limits Must
Match Vehicle #1 - - -
 
Select Comprehensive Deductible:
 
Select Collision Deductible:
 
Rental Car &
Towing Coverage?
YES NO
 
Uninsured Motorists
Coverage?
YES NO
 
Medical and/or
PIP Coverage?
YES NO
 
Comments or Remarks:
(List additional drivers, autos, etc. here)
ADDITIONAL VEHICLES: If More than 2 Vehicles, list Additional Vehicles Year, Makes, and Models here:


Send my quotation via: E-Mail Fax
Regular Mail
Call me by Phone!

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me an Auto Quote NOW!


Help Us Fight SPAM! Please enter the code#
below in the box, to show you are human!

CAPTCHA Image
Reload Image

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!


GA auto insurance
 
Please contact our agency at the address and phone numbers below for a free quotation today. We have the service you are looking for!

Clemmons Insurance Agencies - Smyrna, GA Office
1326 Concord Road, Smyrna, GA 30080
Phone: 770-434-6691
Fax: 770-434-6779
Email: Click Here to Email Us | Click for Map/Directions

Agents, Join Our Insurance Family!
Click Here for Career Opportunities & Sales Positions.