Restaurant Application

Quote Request – Restaurant, Bar, Tavern

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Owner/Shareholder Information

Owner Information (List additional owners/shareholders in notes below)(Required)
Email(Required)

Business Information

Business Address(Required)
Mailing Address
If different from Business Address
Please select the coverages you are interested in(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Has your current coverage been Cancelled or Non-Renewed?(Required)

Operations Information

Open(Required)
:
Days(Required)
Close(Required)
:
Open
:
Days
Close
:

Building Information

Do you own the building(Required)
If unowned, are you required by lease to insure the building?
Other Occupants(Required)

Kitchen Information

Fire Protection(Required)
Automatic Cooking Shutoffs(Required)
Hoods and Ducts over ALL cooking Equipment(Required)
Hoods and Filters Cleaned Weekly by Staff(Required)
MM slash DD slash YYYY

Entertainment

Do you have entertainment?(Required)
Nights with Entertainment
Type of Entertainment
Jukebox(Required)
Dance Floor(Required)
Dancing Permitted?(Required)
Cover Charges?(Required)
Bouncers?(Required)

Liquor Legal Liability

Alcohol Service(Required)
Liquor License(Required)
Happy Hour
Last Call
Written Policy for Alcohol Service Standards
Incident Log Kept
Management Notified when Shutting off Patrons

Staffing

Alcohol Server Training

Receipts

Coverage

Value of all furniture and equipment not permanently fixated to the structure
Drop files here or
Accepted file types: pdf, Max. file size: 50 MB.
    While it is not required to upload these documents, it does streamline the process and makes quoting easier.