California Life Insurance Quote from Adams Avenue Insurance Agency

"Insurance Experience California Residents & Businesses Can Count On!"

Read What Our Satisfied
Customers Are Saying!

    Auto Insurance Quote
    DUI & SR22 Auto Insurance
    Motorcycle Insurance Quote
    Commercial Auto Quote
    Boat Insurance Quote

    Homeowers Insurance Quote
    Dwelling Fire Quote
    Commercial Property Quote

    Workers Compensation Quote
    Business Owners Insurance
    Commercial General Liability
    Life Insurance Quote
    Health Insurance Quote

    Service to Your Account
    FREE Disaster/Emergency Plans
    FREE Online Insurance E-Books
    Learn More About Our Agency
    Protecting Your Privacy

10 Reasons Why You Should Use Adams Avenue Insurance Agency:

1. The best coverage at the lowest price.

2. Instant phone quotes for most products.

3. Low down payments.

4. Easy monthly installments.

5. Internet quotes returned within 24 business hours.

6. We have carriers that will insure houses with prior claims and that are in brush areas.

7. Rates are shopped exclusively for you with 25+ auto and home insurance companies.

8. Huge discounts on ALL insurance products!

9. Our experience allows us to match you with the carrier that best meets your needs.

10. We have been saving our customers money on insurance since 1988.

On-Line Life Insurance Quotation Form One Simple Form - takes only 2-3 Minutes! Your Personal Data:

Your Name:
Street Address:
City:
State:	MUST be California!
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Marital Status: Single Married	Homeowner? Yes No

Currently Insured? (If yes, list carrier, and # of years continuous. If none, type N/C)

Unusual Activities? (If you engage in unusual activities such as scuba diving, airplane flying, rock climbing, etc., list them here.)

Underwriting Information:

Name of Insured: Birthdate:

Sex (M/F): Smoker or
Non-Smoker?:

Height: Weight:

Amount of Coverage Desired? $

Type of Coverage
(Term, Universal life, Other):

TERM = Pays death benefit only - This is lowest cost for coverage.
UNIVERSAL LIFE = Has savings aspect in addition to providing death benefit.
OTHER = Would be mortgage protection, whole life, etc.

If Term, list years of Level
Premium. (1yr., 5yr., 10yr., 20yr.):

List Any Health Problems:

Reason for Buying Life Insurance:

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 a
Life Insurance Quote NOW!

Click Button Below When Done

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

Adams Avenue Insurance
19895 Beach Blvd., Suite 103
Huntington Beach, CA 92648
Phone: 1-714-593-1914 / Fax: 1-866-832-4186
E-Mail us at: dave@adamsaveins.com