The Gerry Smith Insurance Agency
  Auto Quote
  Motorcycle Quote
  Boat Quote
  Personal Watercraft
  Snowmobile Quote
  Home Owners Quote
  Townhome Quote
  Renters Quote
  Life Quote
  Umbrella Quote
  Health Quote
  About Us
  Contact Us
  Gerry Smith Insurance Agency
12280 Nicollet Ave, Suite 104
Burnsville, MN 55337-1999

Ph  (952) 224-7029
Fax (952) 224-0400


Minnesota Renters Insurance Quote Inquiry Form
This inquiry form will allow us to provide you with a renters insurance cost and coverage summary, based on the information that you enter below. 

Note: This is not an application for insurance coverage.  

We recommend that you have a current copy of your insurance policy or declarations page to refer to as you are completing this form. When you have finished entering your information, click the 'Submit' button at the bottom of the page.


First Name   MI 
Last Name
Zip Code
Date of Birth  
Spouse's Date of Birth (if applicable)    

To provide an accurate quote we will ask you a series of questions, some of which we will confirm through consumer reports which may include credit information. This information will be available to our representatives only. For more information, see our Privacy Statement. Do you want to continue?

I have read the disclaimer and want to continue: Yes No



Personal Property $         Contents Replacement Cost
Loss of Use
Personal Liability $
Guest Medical $
Additional Coverage 1)          Amount  $
Additional Coverage 2)           Amount  $
Additional Coverage 3)           Amount  $
Deductible $
Current Insurance Company



Year Built               Number of Units in Bldg
Non-Smoker Yes   No
Protective Devices 1)
Protective Devices 2)

Claims (Last 3 Years)

Date (mo/yr)               Description

Claim #1


Claim #2


Claim #3




Preferred Method of Contact



Phone Number

Fax Number

Postal Mailing Address

Questions or Comments

Please press the Submit button.
Wait a few moments for an online acknowledgment.

© 2004-2017 Gerry Smith Insurance Agency. All Rights Reserved.