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Restaurant Insurance
* = Required Information
This is not an instant quote website; our prices are too low to list online. Please fill out the quote form to obtain a Restaurant insurance quote, and an insurance specialist will contact you shortly. Please understand this is not an application for insurance. An application will be sent to you if coverage is desired.
 
Proper Protection Fact Finding Questions
Of the following, what is the primary reason for a quote request? Requesting More Information 
Landlord Required 
Replace Investment 
Liability Protection 
In the order of importance, what is most important to you? Price 
Service 
Proper Coverage 
Approximately when was the last time you did a review with your agent? Within the year 
Over 2 years ago 
Over 5 years ago 
Never 
Would you be interested in going to higher deductibles to reduce your premium? Yes 
No 
In the event of a lawsuit, accident, or judgment would you want to: Maximize Protection 
Assume Some Risk 
In the event of an untimely death, is it important to you that you're surviving spouse and/or children maintain the quality of life you currently have together without debt? Yes 
No 
Would you be interested in combining your commercial insurance for additional savings? Yes 
No 
If health insurance is provided for employees, would you like to save money? Yes 
No 
Requesting More Information 
Has your current company/agent failed to meet your expectations in any way? Yes 
No 
What else must I do to earn your business?
Contact Information
First Name
Business Name
Gender Male     Female 
Date of Birth
Occupation
Business Address
Zip Code
The Best Time to Call?
Best Phone Number to Reach You
Fax
Email Address *
Business Information
Business License Number
License Type
Years in Business
Policy Information
Current Policy Expiry
Current Insurance Company
Annual Premium
Losses and Claims for the Last 5 years
If yes, what is the date, amount paid and description of each loss or claim?
What is the Building Coverage Requested?
Contents Property Coverage Requested?
Premise Liability
Policy Deductible
Building Information
Total Square Footage of Business Building
Total Square Footage of Business Only
Square Footage of Customer Area
How many stories?
Construction Type
What Type Roof Covering?
Has the Roof Been Updated? Yes     No
If Yes, what year?
Fire & Burglary Alarm Yes     No
Distance of the Property to the Closest Fire Department
Is the Business in the Brush Area? Yes     No
Do you Have a Storage Area More than 1500 Sq. Ft.? Yes     No
Is there a Smoke Alarm? Yes     No
Is there a Fire Extinguisher? Yes     No
Are there Deadbolts? Yes     No
Is the Electrical Updated? Yes     No
Are there Circuit Breakers? Yes     No
Is the Heating / Air Conditioning Thermostatically Controlled? Yes     No
Has the Plumbing Been Updated? Yes     No
Is the Plumbing Copper? Yes     No
Is there a Theft Alarm? Yes     No
Are There any Restaurants in the Building Next to Your Business? Yes     No
Underwriting Information
Number of Stories
Number of Employees
Payroll of Owners
Payroll of Employees
Annual Gross Receipts
Hard Liquor Receipts
Beer and Wine Receipts
Food Receipts
Open 24 Hours Yes     No
Propane Tank Filling Yes     No
Describe the Nature of Your Business and Any Unusual Exposures.
Entertainment Information
Is There Entertainment? Yes     No
If yes, Please Describe
Is There Live Music? Yes     No
If yes, what size is the dance floor and how many nights per week is there dancing
Are there any Coin Operated Amusement Devices? Yes     No
If yes, how many and are they coin operated
Are there any Pool Tables? Yes     No
If yes, Please Describe
Are there any Bouncers, Doormen, ID checkers, Armed or Security Guards? Yes     No
If yes, how many of each? (list their job duties and employer)
Are there any Contests or Exhibition? Yes     No
If yes, Describe Events
Are there any Audience Participation Events? Yes     No
If yes, Describe Events
Do you have any other type of entertainment? Yes     No
If yes, Describe Events
Cooking Information
Describe the Cooking Devices at Your Business
Is there Tableside Cooking? Yes     No
Is there an Automatic Suppression System? Yes     No
If yes, do they Protect all Hoods, Ducts and Griddles? Yes     No
Is there any Deep Frying? Yes     No
If yes, is there a High Limit Shutoff? Yes     No
Do you have an Outside Cleaning Service for the Hoods and Duct System? Yes     No
How Often are Hood and Duct Cleaned?
Is there any Manufacturing, Mixing, Re-Labeling or Repackaging of Products? Yes     No
Is there any Delivery Service? Yes     No
Is there any Catering Service? Yes     No
Additional Information