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Auto Quote


Thank you for your interest in an auto insurance quote from Salzberg Insurance Agency. Please fill out the form below and one of our agents will respond to your request in a timely manner. Please provide as much information as possible so we can provide you with an accurate quote.

First Name
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Last Name
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Street Address
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ZIP / Postal Code
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Primary Phone Number
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E-Mail Address
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Date of Birth
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License Number
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License State
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Gender
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Marital Status
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Spouse First Name
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Spouse Last Name
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Spouse Date of Birth
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Spouse License Number
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Spouse License State
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Does this driver have any major violations or claims in the last five years?
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Do you rent or own your home?
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Do you currently have insurance?
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Current Insurance Provider
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Coverage Period
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Current Policy End Date
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Bodily Injury Liability
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Property Damage Liability
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Underinsured Motorist - Bodily Injury Limits
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Underinsured Motorist - Property Damage Limits
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Comprehensive Deductible
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Collision Deductible
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Towing
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Rental
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Vehicle 1 Year Model
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Vehicle 1 Make
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Vehicle 1 Model
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Vehicle 1 VIN
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Vehicle 2 Year
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Vehicle 2 Make
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Vehicle 2 Model
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Vehicle 2 VIN
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If you have additional vehicles or drivers, please enter info
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How did you hear about us?
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
Our Contact Info

Salzberg Insurance Agency
249 East Little Creek Rd.
Norfolk, VA 23505-0649

Local: (757) 583-1828
Fax: (757) 587-7735
info@salzberginsurance.com
Monday - Friday 9am - 5pm
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Five Star Professional