Texas Insurance Exchange
190 W Highway 114, Suite A
Southlake, TX 76092
817.410.2333

Free Texas Insurance Quotes for Car Insurance

Car insurance protects your automobile in the case of accident for both liability and/or physical damage.  We will help educate and advise as to what liability limits are prudent and what additional coverage is needed.  For instance, we do not recommend comprehension or collision on a vehicle that is over ten years old or the cost of this coverage is more than 10% of the vehicle.  Please take a moment to receive a prompt and professional evaluation for your automobile insurance.

 Texas Insurance Quotes for Car Insurance

Please complete the following secure form and click on the Submit button at the bottom of the page when you are finished.  We will provide you with a quote or contact you for additional information, by the next business day. 

 

Should you wish to complete the form off-line, you may fax it to 817-251-2424 or attach via e-mail to quote.request@txie.com.  The quote form is offered in both Microsoft Word or Adobe Acrobat.  Should your have any questions, Contact Us for a next day answer.

 

To view the our Quote Form, Acrobat Reader must be installed on your computer. To download, please cliAdobe Readerck on the Acrobat Reader icon to your right.  This will take you to Adobe's download page.  Read and follow the directions contained there for downloading Acrobat Reader.  Make sure you download the correct version for you operating system (ie, Windows 95, etc.).

Car Insurance Quote Form.doc

 

Car Insurance Quote Form.pdf

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Auto Insurance Form
Primary Driver:
Address:
City/State/Zip:
Email: Phone (wk):
Phone (hm): Phone (other):
 
Driver SIN Date of Birth Gender
M F
M F
M F
M F
M F
 
Vehicle Year/Annual Mileage Vehicle Make/Model VIN Number Purpose *
W/S B P
W/S B P
W/S B P
W/S B P
W/S B P
*To Work or School(w/s) For Business (b) For Pleasure (P)
 
Current Insurance Carrier:
Current Policy Number: Date Coverage Expires:
Limits of Coverage Desired:
Please list any claims you have made in the last 39 months. Include date and amount paid:
Please list any tickets or accidents for all of the above drivers in the last 39 months:
Please list any other information you feel is important and/or relevent to quoting your auto insurance:
 
 
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