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Asia Insurance Business Restaurant Quote

Customer Information
Business Name
First Name	Middle Initial	Last Name
Street #	Street Name	Apt or Unit
City	State	Zip	-
Home Phone	Work Phone	Email

Number of years In business under current ownership?			At this location?
Has the owner ever been involved in a bankruptcy or business failure?		Yes No
lf needed, will financial statements be provided prior to banding?		Yes No
What are the gross sales for past 3 years?
Year	Food	$	Liquor	$
Year	Food	$	Liquor	$
Year	Food	$	Liquor	$
What are the hours of operation?
Is the business seasonal?	Yes No	Months of operation	to
Is there a bar or lounge?	Yes No	If yes, describe
Happy Hour?	Yes No
If liquor is served, describe the training protocol for liquor servers
Is there live entertainment?	Yes No	If yes, describe In Comments section (type, nights per week, hours, etc.)
Is there a dance floor(s)?	Yes No	If yes, what is its size?
Are there any operations away from the premises, such as catering?	Yes No	If yes, explain in Comments section
Any tableside cooking or food preparation?	Yes No
Was the building originally built as a restaurant?	Yes No
If no, has wiring, etc., been updated for restaurant occupancy?	Yes No	When?
Which floor ls the restaurant located on?		Is there emergency lighting?		Yes No
Maximum seating capacity of restaurant		Maximum seating capacity of lounge
Number of exits		Are all exits free of obstruction, lighted and marked with exit signs?		Yes No
Has insured ever been cited by Board of Health?	Yes No	If yes, explain
Housekeeping	Excellent	Good	Fair	Poor
Valet Parking?	Yes No	Is there a coat check room?	Yes No
Are all areas over ranges grills, fryers, and all other cooking surfaces, and hoods and ducts protected by a ULB00-compliant automatic fire extinguishing system?			Yes No
Is there a maintenance agreement to regularly inspect and service the system?	Yes No	No Times per year
Are the employees trained in the use of the automatic extinguishing system and portable fire extinguishers?			Yes No
Is there a maintenance agreement with an outside firm to clean the hood and duct system?	Yes No	No Times per year
If no, explain
How often are the grease filters cleaned by the employees?

Please use the space below to add comments regarding any special circumstances or coverage needs

Disclosure

Where permitted by law, the insurance companies we quote will individually confirm your information through consumer reports, which may include credit reports. Each company will provide the source of the report if you are interested. Your information may be shared with the quoting company's affiliated underwriting companies, independent representatives or other insurance partners.

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