Restaurant Businessowner's Quote
Location Information Location Number
1) Type of Restaurant: o Fast Food o Casual Dinning o Fine Dining o Restaurants – No Cooking/No Frying and Limited Seating o Restaurants – WITH Cooking and Limited Seating o Other than shown
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2) Is the restaurant a franchise? o Yes o No
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3) What is the primary type of cuisine?
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4) Does the restaurant regularly provide meal/food delivery? o Yes o No
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5) What is the year the business was established or acquired at this location?
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6) How many years management/ownership experience does applicant have in this industry?
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7) Total annual gross receipts at this location $
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8) Catering receipts at this location: $
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9) What are the total annual receipts generated from serving alcohol at this location? $
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10) Indicate the location type: o Stand-alone building o Located in a strip shopping center o Attached or within buildings with residential apartments or condos o Attached to or within office buildings o Attached to or within a mixed occupancy bldg without residential exposures o Attached to or within a hotel/motel Located in an enclosed mall o Other than described above
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11) Hours of operation at this location: Open:
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Close:
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12) Total square footage occupied by the applicant:
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13) Total square footage of the public area: NOTE: Public Area is defined as the total square footage
of all areas where the public is permitted to go, such as dining areas & lounges, hallways, stairs, rest rooms, waiting areas & dance floors. Public area does not include kitchens, storage, behind the counter or bar & outside driveways for drive thru service. Please contact your underwriter if you have questions regarding public area.
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14) Seating Capacity: Note: Seating capacity is the number of seats available for restaurant patrons.
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15) Indicate the type of entertainment provided at this location: o NONE o Live Band or DJ o Mechanical Rides
- Dartboards Number of video games Number of Televisions Number of Pool or Gaming Tables
- Other than listed _____________
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16) Is there a video surveillance system at this location? o Yes o No
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17) Is the restaurant responsible for the parking lot? o Yes o No
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18) Is there a drive-through at this location? o Yes o No
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19) Are there any playgrounds at this location? o Yes o No
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20) What percentage of the building does the restaurant occupy?
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21) If less than 100%, what percentage is occupied by the following types of operations: % Habitation/Apartment
% Auto Service/Repair % Bars/Pubs/Taverns % Grocery Store % Offices
% Other Restaurants % Retail stores % Other than above
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22) What percentage of the building is vacant or unoccupied? %
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Cooking Operations Complete if applicable
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23) Indicate the type of fully operational automatic fire extinguishing system covering all hoods, ducts and cooking equipment: (circle one)
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Dry Chemical
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UL 300 Wet Chemical
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Water Spray
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Other
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None
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24) How often is the automatic fire extinguishing system inspected and serviced by a contracted outside firm? (Circle one)
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Monthly
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Quarterly
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Semi-Annual
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Annual
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Never
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25) How often are flues and ducts inspected and cleaned by a contracted outside firm? (Circle one)
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Monthly
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Quarterly
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Semi-Annual
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Annual
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Never
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26) How often is cooking equipment exhaust filters cleaned? (Circle one)
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Daily
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Weekly
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Monthly
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Quarterly
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Semi-Annual
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Annual
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Never
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27) Is any table-side service provided which involved open flames?
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28) Are they any deep fat fryers on the premises? o Yes o No
a. If yes, do the fryers have thermostats, fuel cut-offs and proper ventilation? o Yes o No
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Liquor Liability Complete if applicable
29) Liquor License? o Yes o No
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If yes, license number:
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30) Is there a separate bar area? o Yes o No
a) Does the bar area close later than the dining area? o Yes o No
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31) Are drink promotions, such as happy hours, 2-For-1 specials or ladies night offered? o Yes o No
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32) Does the restaurant allow patrons to bring their own (BYO)? o Yes o No
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33) Have there been any prior liquor citations? o Yes o No
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34) Has there been prior liquor liability coverage? o Yes o No
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35) Are all employees that serve alcohol given formal alcohol service training, such as TIPS? o Yes o No
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36) Does the restaurant have a written policy covering alcohol service guidelines? o Yes o No
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37) Are alcohol related incidents documented? o Yes o No
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Automobile Related Operations/Valet Parking Complete if applicable
38) Does the restaurant provide valet parking at this location? o Yes o No
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39) Do all valet parking attendants have a valid U.S. driver’s license and are they all over the age of 21? o Yes o No
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40) Do any of the valet parking attendants have any major driving violations? o Yes o No
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41) Have there been any valet parking losses? o Yes o No
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42) Are keys regularly left in the vehicles after they are parked? o Yes o No
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43) Are car wash, oil changes or other related services other than valet parking provided? o Yes o No
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