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Brownell Insurance Center, Inc.
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Welcome to Your Ballpark Insurance Quote

This estimate is based on but not limited to the following major factors:

  1. A combination of information you enter, please be as complete as possible.
  2. Proof of prior insurance.
  3. Your insurance score …
    1.  There are many factors used to determine your score. Some of the more common factors are:
      1. Payment history (delinquencies or late payments)
      2. Length of time of credit history (when was your credit
         history established?)
      3. Type(s) of credit (credit cards, finance company installments, etc.)
    2. When determining your score, gender, marital status, age, ethnicity, address and income are not considered.
  1. The VIN (Vehicle Identification Numbers) of your vehicles.
  2. The driving records of all drivers in the household.
  3. Age or driving experience of drivers.
  4. The usage of your vehicles.
  5. Claim history.
  6. Garaging location of vehicles.
  7. Homeownership and the availability to package home and auto insurance together for added discounts.

Please note: Completing this quote form you are giving the Brownell Insurance Center the authority to secure the necessary reports required by our companies to secure a quote.

You will be called in 1 to 2 business days by one of our agents.




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Auto Quote Form

* Required Information

Current Insurance Coverage

Have any drivers had any speeding tickets or accidents in the last 5 years?

Driver #1 Information

Driver #2 Information

Additonal Drivers

Vehicle #1 Information

Vehicle #2 Information

Vehicle #3 Information


*This form is for information only and does not afford any coverage.  Coverage must be submitted or bound by one of our authorized insurance agents and initial premium paid before any insurance is in force.


Brownell Insurance Center, Inc. • 5 Nashua Road, Londonderry, NH 03053
Phone: 603.437.1992 • Fax: 603.437.4846 •


Hampton Office • 860 Lafayette Road, Unit 2, Hampton, NH 03842
Phone: 603.296.0077 • Fax: 603.296.0079

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