Restaurant, Tavern, Liquor Store

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Quote for Restaurant/ Tavern/ Liquor Stores

	By filling out the following questionnaire, you will enable us give you the most competitive rates available in the market today.
Corporate Name: (*)	Invalid Input
Federal ID#: (*)	Invalid Input
Name of Business: (*)	Invalid Input
UnEmp ID#:	Invalid Input
Address	Invalid Input
Contact Person: (*)	Invalid Input
County:	Invalid Input
Telephone:	Invalid Input
Fax:	Invalid Input
Web Site:	Invalid Input
E-mail: (*)	Invalid Input
Years experience in management:	Invalid Input
Years of ownership:	Invalid Input
	Building Information: Location #
Amount of Building Insured Value	Invalid Input
Business Income:	Invalid Input
Contents:	Invalid Input
Deductible:	Invalid Input
# of Stories:	Invalid Input
Total Sq Footage of Building:	Invalid Input
Rest Area Sq Footage:	Invalid Input
Bar Area Sq Footage:	Invalid Input
Seating Capacity Sq Footage:	Invalid Input
Type of Construction:	Invalid Input
Year Built:	Invalid Input
If older than 15 years, the dates of any renovations:	Invalid Input
What renovations did you do?	Invalid Input
Type of Ansul System:	Invalid Input
Must Be: UL-300 approved:	Invalid Input
Cleaning Contracts Provider:	Invalid Input
How often are the Systems Cleaned under contract:	Invalid Input
Service prodivders for Hoods:	Invalid Input
Service prodivders for Hoods Ansul System:	Invalid Input
Sprinklers:	Invalid Input
Digital Cameras:	Invalid Input
Alarm System:	Invalid Input
Alarm System Type:	Invalid Input
Safe:	Invalid Input
Safe type:	Invalid Input
Bank deposits taken daily:	Invalid Input
Dance floor:	Invalid Input
Dance floor sq ft of area:	Invalid Input
Is liquor served:	Invalid Input
Do you have happy hour:	Invalid Input
Happy hour times and types:	Invalid Input
Do you have live entertainment? If so, what are the times and types:	Invalid Input
Hours of operation:	Invalid Input
Money & Securities on premises:	Invalid Input
Money & Securities off premises:	Invalid Input
Employee dishonesty:	Invalid Input
No. of Employees Handling Money:	Invalid Input
	Auto coverage: list of Vehicle needed please attach. Age, VIN#, Cost New, Drivers List with license number.
Sign Coverage:	Invalid Input
Food Sales:	Invalid Input
Greens Fees:	Invalid Input
Gambling Sales:	Invalid Input
Liquor Sales:	Invalid Input
Golf Shop Sales:	Invalid Input
Bowling Sales:	Invalid Input
	Work Comp Info:
CLERICAL: How many Full-Time Employees do you have?	Invalid Input
CLERICAL: How many Part-Time Employees do you have?	Invalid Input
RESTAURANT: How many Full-Time Employees do you have?	Invalid Input
RESTAURANT: How many Part-Time Employees do you have?	Invalid Input
GOLF COURSE: How many Full-Time Employees do you have?	Invalid Input
GOLF COURSE: How many Part-Time Employees do you have?	Invalid Input
RETAIL: How many Full-Time Employees do you have?	Invalid Input
RETAIL: How many Part-Time Employees do you have?	Invalid Input
BOWLING: How many Full-Time Employees do you have?	Invalid Input
BOWLING: How many Part-Time Employees do you have?	Invalid Input
GAMBLING: How many Full-Time Employees do you have?	Invalid Input
GAMBLING: How many Part-Time Employees do you have?	Invalid Input
	Do not include the tips in the payroll.
Amount of Liability Coverage on current policy:	Invalid Input
Deductible:	Invalid Input
Amount of Umbrella Coverage on current policy:	Invalid Input
Amount of Automobile Coverage:	Invalid Input
Deductible:	Invalid Input
	Name of Current Carriers
Package Policy:	Invalid Input
Premium:	Invalid Input
Renewal Date:	Invalid Input

Workers Comp:	Invalid Input
Premium:	Invalid Input
Renewal Date:	Invalid Input
Experience Modification:	Invalid Input
Have you had any losses in the past 3 years?	Invalid Input
If yes, please describe:	Invalid Input
Liquor Liability:	Invalid Input
Premium:	Invalid Input
Renewal Date:	Invalid Input
Current Total Insurance Premiums:	Invalid Input
Have you had any losses in the past 3 years? If so, describe:	Invalid Input
	Please attach a brochure or photo if possible. Three years of loss runs are required. Please allow 20 to 60 days for rates. (Rush rates can be given if needed.)
	Invalid Input

Auto Insurance, Condo Insurance, Homeowners insurance – CacciatoreInsurance.com - Illinois / Indiana / Chicago

Building Information: Location #

Work Comp Info:

Do not include the tips in the payroll.

Name of Current Carriers

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