Combine Policies & Save Money

Phone: (802) 442-5414
Fax: (802) 442-1131
Email: kmahar@willsinsurance.com

Mailing Address:
116 South Street
Bennington, Vermont 05201

At Wills Insurance, we understand you have many facets of your life to protect -- home, auto, and family. If you haven't considered combining insurance policies before, you should. Not only will you reduce your monthly premiums, you'll pay one carrier instead of multiple ones and have less hassle and paperwork. Tell us below how you want to combine and save and a qualified Wills Insurance agent will contact you within 24 hours.

Personal Information

In order to protect your privacy, do not send us your confidential personal information via email.

*Full Name

Address

City

State

Zip

Phone

Best Time To Call

*Email Address

Date of Birth -(mm/dd/yy)

Occupation

How long at Current Job

Current Auto Insurance

Company Name*-(not agency)

Policy Expiration Date -(mm/dd/yy)

Premium Amount ($)

Years Insured

Vehicle Information

(all cars you or your family members own or lease)

Car 1:

Year

Make

Model

VIN

Car 2:

Year

Make

Model

VIN

Car 3:

Year

Make

Model

VIN

Car 4:

Year

Make

Model

VIN

Liability Limit For All Cars

Choose Either Bodily Injury AND Property Damage or Singe Limit

Bodily Injury

Property Damage

Single Limit

Deductibles

Car 1:

Comprehensive

Collision

Towing Yes

Rental Reimbursement Yes

Car 2:

Comprehensive

Collision

Towing Yes

Rental Reimbursement Yes

Car 3:

Comprehensive

Collision

Towing Yes

Rental Reimbursement Yes

Car 4:

Comprehensive

Collision

Towing Yes

Rental Reimbursement Yes

Driver Information

Driver 1:

Relationship

Years Driving

Date of Birth -(mm/dd/yy)

Sex

Male

Female

Marital Status

Married

Single

Driver 2:

Relationship

Years Driving

Date of Birth -(mm/dd/yy)

Sex

Male

Female

Marital Status

Married

Single

Driver 3:

Relationship

Years Driving

Date of Birth -(mm/dd/yy)

Sex

Male

Female

Marital Status

Married

Single

Driver 4

Relationship

Years Driving

Date of Birth -(mm/dd/yy)

Sex

Male

Female

Marital Status

Married

Single

Claims and Accidents in the past 3 years - (include date, amount paid, description of event)

Excess Liability

Personal Umbrella Coverage Yes No

Amount

Current Homeowners Insurance

Company Name*-(not agency)

Policy Expiration Date -(mm/dd/yy)

Years Insured

Dwelling Coverage -(Replacement Cost)

Premium Amount ($)

Deductible

Dwelling Information

Year Building Built

Square Footage

Construction Type

Heating Type

Year Heat Updated

Year Plumbing Updated

Year Roof Updated

Year Electric Updated

Do You Have An Alarm System?

Yes

Do You Have Any Claims?

Yes

If Yes Please Explain

Do You Have High Value Items?

Jewelry ($)

Silver ($)

Furs ($)

Fine Arts ($)

Cameras ($)

Other ($)

How Did You Hear About Us?

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If other

Comments or Questions

Code:

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