Business Information

Business Name:

Premises Address:

City:

NORTH CAROLINA

Zip Code:

Years In Business:

Contact Name:

Phone:

Extension #:


Email:  (Required)


How Best To Contact You:



Federal Employer's ID #:

Description of Operations:


Number of Employees:


Payroll (not including owners):
$

Estimated Gross Receipts:
$



Business Liability Information
(Select all that apply to your business)

Operate or lease aircraft/watercraft
Work Underground
Work above 15 feet
Require out of state travel
Use Subcontractors
Delivery Service
Pre-employment physicals
Offer safety incentive programs
Store, treat, dispose, or transport hazardous waste
Work on vessels, docks, or bridges over water
Other



Recent Insurance Information

Insurance Expiration:


Any losses past 3 years?


Description of losses, including
amount paid on each accident.




Coverage Limits

General Aggregate Limit
(other than products completed):


Products/Completed Operations
Aggregate Limit:



Umbrella Insurance Amount Desired




Property Information

If you've already filled out
information on your buildings or
facilities in another insurance quote
form then skip the section below.


Building(s) Value:
$

Contents Value:
$

# of Buildings:


Year Built:


Total Building Area:


Building Construction Type:



Central Fire Alarm:


Sprinklered All Rooms:


Plumbing Renovation:


Plumbing Renovation Year:


Electrical Renovation Year:


Electrical Type:


Amps:


Heating Type:


Heating Renovation Year:


Roofing Renovation:


Roof Age:




List Neighboring Businesses

Name of Business to the Right:


Distance from Business Listed Above:



Name of Business to the Left:


Distance from Business Listed Above:



Name of Business to the Rear:


Distance from Business Listed Above:




Question or Message:



Click the "Submit Quote Request"
button below to send your North
Carolina Business Liability 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 business liability
insurance quotes in the following 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.
North Carolina
Business Liability
Insurance Quote
Wake County, NC Area
Ed Moore & Associates, Inc.
© 2011, All Rights Reserved
919-467-6339
Since 1971
Always here when you need us. Protecting
hundreds of North Carolina families and businesses.
ED MOORE
& Associates, Inc.