Bar, Tavern & Restaurant Insurance Quote
Applicant Name:
Premises Name:
Premises Address:
Business Phone:
Premises Website:
Contact Email Address:
Requested Effective Date:
1. Are the insured's operations currently open or will they be open within the next 60 days?
-- Select --
Yes
No
If no, please provide details regarding the insured's plans to be open for business:
2. 3+ years of restaurant/bar ownership in past 5 years?
-- Select --
Yes
No
If no, please provide details regarding the insured's prior related experience:
3. Business closing time:
4. Square footage:
5. Number of employees:
6. Is this a fine dining restaurant?
-- Select --
Yes
No
7. Does the insured offer counter service?
-- Select --
Yes
No
8. Does the insured manufacture alcohol?
-- Select --
Yes
No
If yes, is >25% consumed on premises?
-- Select --
Yes
No
9. Annual Receipts:
10. 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
11. Cannabis infusion?
-- Select --
Yes
No
12. Solid fuel cooking structures within 10 feet of the building?
-- Select --
Yes
No
13. Any cooking surfaces not protected by UL300 fire suppression?
-- Select --
Yes
No
14. Any other entertainment besides: Karaoke or Trivia?
-- Select --
Yes
No
If yes, describe:
15. Other activities besides, darts, bag toss, pool tables (5 or less), horseshoes, volleyball?
-- Select --
Yes
No
If yes, describe:
16. 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
17. Offer delivery?
-- 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
If yes, please explain:
Is the delivery radius greater than 5 miles?
-- Select --
Yes
No
If yes, please explain:
Do the delivery hours extend past 10 PM?
-- Select --
Yes
No
If yes, please explain:
18. If auto coverage is rated:
Does the insured's business provide shuttle services?
-- Select --
Yes
No
Are there any additional auto policies in force that would provide coverage for the named insured(s)?
-- Select --
Yes
No
19. Liquor law violations?
-- Select --
Yes
No
If yes, please provide the number of violations and a description of each liquor violation:
How many total claims in the last 3 years?
-- Select --
Zero
2 or less
3 or more
List any Additional Insureds – Name, Address & Contact Info:
Payment Plan:
Monthly
Annual
Submit
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