Restaurant Insurance Quote Request

Application Information :
Full Named Insured :
Telephone Number :
Location :
                
Year Established :      If less than three (3) years, please detail prior experience below :

Premises Information :
Fire Alarm : No Yes Yes-Centralized            Burglar Alarm : No Yes Yes-Centralized            Sprinklers : No Yes Yes-Centralized
Auto Fuel Shutoff : No Yes Yes-Centralized            Delivery Service : No Yes
Auto Extinguishing System : No Yes
If NOT protected by A.E.S., list cooking equipment :
          

Frequency of Service/Cleaning of Hood, Duct & A.E.S. : months
(We will require: Outside qualified contractor to clean/service above system on a maximum six-month basis.)

Total square feet of building :            Area occupied by applicant :            Area occupied of each floor :
Area occupied as banquet halls :            Storage / Office :
Area of parking (in square feet) :
Responsibility of parking lot : Applicant Building Owner

Application Information :
Gross Receipts :
   Food :
   Alcohol :
   Admission/Membership :
   Off-Premises Catering :
   Payroll :
   All Other :
   Describe :
         

Hours of operation (weekdays):
Hours of operation (weekends):
Does bar continue to serve liquor after kitchen closes ?
No
Yes     If yes, what days and until what time :

Email Address :
Enter Additional Comments Below :