Applicant Information

First Name:

Last Name:




Zip Code:

Daytime Phone:

Cell Phone:

Email:  (Required)

How Best To Contact You:

Currently Insured:

Boat Information

Boat Builder:

Boat Model:

Boat Year:

Boat Length:

Boat Type:

Engine Information

Engine Year:

Engine Builder:

Engine HP:

Engine Type:

Number of Engines:

Boat Trailer Information

Trailer Builder:

Trailer Model:

Trailer Year:

Trailer Value:

Mooring/Storage Location

Boat Mooring:

Types of Safety Equipment on Boat
(check as many boxes as appropriate)
Depth Finder
Auto Halon
Loran Insurance
Fume Detector

Value of Waterskiing and/or Fishing Equipment:

Boat used on any private lakes:

Boat used in bay and/or coastal waters:

Boat used outside U.S. coastal waters:

Is this a promotional/Memo boat:

Boat used for guide service or charters:

Boat used for waterskiing:

Boat used for residence:

Primary Boat Driver Information

Is your driving record accident
and violation free during the
past 5 years?

If No, how many accidents?

If No, how many violations?

Boating safety education courses completed

Any boating claims of losses to boat
from liability in the past 5 years.

Description of losses, including
amount paid on each accident.

Boat Insurance Coverage Desired For
(check as many boxes as appropriate)
Insure Boat(s)
Insure Motor(s)
Insure Equipment(s)
Insure Trailer(s)

Choose Coverage Limits

Boat Liability Limit:

Boat Uninsured Limit::

Boat Medical Limit:

Choose Deductibles

Collision Deductible:

Comprehensive Deductible:

Question or Message:

Click the "Submit Quote Request"
button below to send your North
Carolina Boat Insurance request
to Ed Moore & Associates.

***By submitting this request you
acknowledge that this is neither
an offer to insure nor a guarantee
of insurance.***

We are a Cary, NC insurance agency
offering North Carolina boat insurance
quotes in the following towns, cities,
and counties in central North Carolina:
Raleigh, Morrisville, Cedar Fork, Apex,
Garner, Swift Creek, Green Level,
New Hope, Neuse, Bayleaf, Falls,
Wake Forest, Forestville, Bethesda,
Carpenter, Lowes Grove, Auburn,
Holly Springs, Chapel Hill, Durham,
Oak Grove, Knightdale, Macedonia,
New Hill, Brentwood, McCullers,
Farrington, Leesville, Durham County,
Orange County, Chatham County, and
Wake County, NC.

Ed Moore & Associates, Inc.
103-B Kilmayne Drive
Cary, North Carolina 27511
Wake County, NC
North Carolina
Boat Insurance Quote
Wake County, NC Area
Ed Moore & Associates, Inc.
© 2011, All Rights Reserved
Since 1971
Always here when you need us. Protecting
hundreds of North Carolina families and businesses.
& Associates, Inc.