Contact Information Contact Person's Name: * Phone * (###) ### #### Email * Business Filed As: * Individual Limited Liability Company Corporation Partnership Joint Venture Other (Specify) Address to the Restaurant * Address 1 Address 2 City State/Province Zip/Postal Code Country Is the property address the same as the mailing address? * Yes No Square Footage Website Address http:// Requested Effective Date MM DD YYYY Type of Establishment * Check all that Applies Coffee Shop Boba / Dessert Spot Banquet Facility Bring Your Own Bottle Deli / Bakery Fine Dining Gentlemen's/Strip Club Night Club Fast Food Annual Gross Sales * Food Sales Alcohol Sales Number of Employees * Hours of Operations * Are there any catering services available No Yes Are facilities available for use or rent for private parties, receptions, banquets or similar affairs? No Yes Does applicant advertise or promote "happy hour" or other events when drinks are sold at a lower price than usual? No Yes Does application subscribe to a taxi or other service providing transportation home to apparently intoxicated persons? No Yes Thank you! Restaurant InsurancePlease enter as much details as you can to expedite your insurance needs.
