Bar, Tavern & Restaurant Insurance Quote
Applicant Name:
Premises Name:
Premises Address:
City:
State:
Zip:
Type of Organization:
Corporation
LLC
Individual
Business Phone:
Premises Website:
Contact Email Address:
Requested Effective Date:
1. Are you currently open or will be within 60 days?
-- Select --
Yes
No
Please provide details regarding the insured's plans to be open for business:
2. 3+ years of restaurant/bar ownership/management in past 5 years?
-- Select --
Yes
No
Please describe that experience:
Please describe that experience:
3. Business Personal Property in $ (movable items owned, equipment, inventory, furniture):
4. Square footage:
5. Construction Type:
Frame
Joist Masonry
Masonry
6. Year Built:
7. Number of Floors:
8. Automatic Sprinkler:
-- Select --
Yes
No
9. Number of employees:
10. Business closing time:
11. Is this a fine dining restaurant?
-- Select --
Yes
No
12. Does the insured offer counter service?
-- Select --
Yes
No
13. Does the insured manufacture alcohol?
-- Select --
Yes
No
Is >25% consumed on premises?
-- Select --
Yes
No
14. Annual Receipts:
15. What is the level of cooking on premises?
Full cooking - Cooking equipment that can produce grease laden vapors such as deep fryers, grills, flat tops, char-broilers, etc.
Limited cooking - Cooking equipment that does not produce grease laden vapors such as ovens, microwaves, sous vides, panini presses, etc.
No cooking
16. Cannabis infusion?
-- Select --
Yes
No
17. Do you have a non-gas Smoker/Grill (wood, pellets, etc) structure within 10 feet of the Building?
-- Select --
Yes
No
Is the equipment Professionally installed?
-- Select --
Yes
No
Is it regularly maintained?
-- Select --
Yes
No
Cleaned and Scraped weekly
Vent or Exhaust system inspected and cleaned monthly
Ashes Removed Daily
Other than the days supply, Do you store Wood, Pellets, etc more than 10 feet away from device?
-- Select --
Yes
No
Do you have a Hood System and a UL 300 extinguishing system in place?
-- Select --
Yes
No
Do you have a Class K or 2A fire extinguisher with 20 feet of each device?
-- Select --
Yes
No
18. Any cooking surfaces not protected by a UL300 fire suppression?
-- Select --
Yes
No
19. Any other entertainment besides: Karaoke or Trivia?
-- Select --
Yes
No
Describe the entertainment:
20. Other activities besides, darts, bag toss, pool tables (5 or less), horseshoes, volleyball?
-- Select --
Yes
No
Describe the activities:
21. Security or bouncers?
-- Select --
Yes
No
Are background checks performed on bouncers and security personnel?
-- Select --
Yes
No
Are the bouncers and security personnel armed?
-- Select --
Yes
No
Are the bouncers and security personnel trained in conflict resolution?
-- Select --
Yes
No
22. Do you Deliver (not including UberEats, DoorDash, etc)?
-- Select --
Yes
No
Are insured owned autos used for delivery?
-- Select --
Yes
No
Are employee owned autos used for delivery?
-- Select --
Yes
No
Are third party delivery services used for delivery?
-- Select --
Yes
No
Delivery Sales Completed Using Insured Owned or Employee Owned Autos:
Do the delivery sales at any one location exceed 20% of the total sales from its/their respective location(s)?
-- Select --
Yes
No
Please explain:
Is the delivery radius greater than 5 miles?
-- Select --
Yes
No
Please explain:
Do the delivery hours extend past 10 PM?
-- Select --
Yes
No
Please explain:
23. Does the insured's business provide shuttle services?
-- Select --
Yes
No
If Yes, please explain:
Are there any additional auto policies in force that would provide coverage for the named insured(s)?
-- Select --
Yes
No
24. Do you have any liquor law violations?
-- Select --
Yes
No
Please provide the number of violations and a description of each violation:
How many total claims in the last 3 years?
-- Select --
Zero
2 or less
3 or more
Please describe the claim and include the date and amount paid:
Please describe the claim and include the date and amount paid:
Do you own the building and would you like a quote for the building?
-- Select --
Yes
No
Would you like a Workers Comp Quote?
-- Select --
Yes
No
Bar/Tavern
Restaurant
# of Employee FT:
# of Employee PT:
Est Annual Payroll:
Do you have any Additional Insureds?
-- Select --
Yes
No
Loss Payee
Lienholder
Mortgagee
Additional Insured
Name:
Address:
City:
State:
Zip:
Do you have additional Names?
-- Select --
Yes
No
Loss Payee
Lienholder
Mortgagee
Additional Insured
Name:
Address:
City:
State:
Zip:
Payment Plan:
Monthly
Annual
Submit
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