Connecticut homeowners, automobile and life insurance for CT residents. Free CT insurance quotes.
UNDERWRITING INFORMATION
Insured Name:
Birthdate:
Insured Height:
Insured Weight:
Insured Occupation:
Hazardous Activities? (if yes, describe):
Sex (M/F):
List children's ages to be covered
Be as specific as you can on the underwriting questions below so we may find the most competitive product for you!
Do You use tobacco?
Yes
No
Describe usage (cigar, cigarettes, etc.)
Any Pre-existing Health Conditions?
(If yes, descibe in detail, and to which of the insured persons they apply.)
Any Covered Persons Currently Taking Medication of Any Kind?
(If yes, descibe in detail, and to which of the insured persons they apply.)
COVERAGE INFORMATION
Check the Kind(s) of Plans You Are considering:
Retirement Plan
401K Plan
IRA (Retirement) Plan
Annuity Savings Plan
Other Type of Pension Plan (describe in remarks)
How Much do Your have to Invest Monthly? (so we may present to you the best investment options.)
$ per month.
Tell Us What You Want MOST in your Retirement or Pension Plan, 401K, or Annuity Plan, or list any other Remarks here:
Send my quotation via:
E-Mail Fax Regular Mail
Call me by Phone!
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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.
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More About The Adinolfi Group, Inc.
Agency Owner, Advisor Rich Adinolfi
Thanks for visiting! I'm Rich Adinolfi, Agency Owner of The Adinolfi Agency. We have been providing Connecticut residents with quality customer service for more than 20 years and want the chance to show you our outstanding online service and pricing!
We would like to speak with you personally about your Connecticut insurance needs. Please phone me, M-F 9am - 5:30pm (EST), or if you prefer, request quotes online using our convenient website forms. We promise to be responsive and informative, whether by phone or online.
My staff and I look forward to serving you.
Our agency specializes in your commercial vehicle insurance. Whether you have a car you use in business, or a contractor using your truck in your operations, we can help.
Agency Owner, Advisor
