To start your Restaurant Owners Insurance Quote, just fill out the required information below. For a more accurate quote, you can fill out more information on the following secure pages.
Fill out as much information as you want. You may skip any of the following questions, but the more information you provide, the more accurate your quote will be.

Business Information

Full Legal Business Name:

DBA:

Entity:

Federal ID#:

Contact Name:

Mailing Address:

City:

State:

Zip:

Phone:

Fax:

Type of Restaurant:

Number Owners or Officers:

Number of Full Time Employees:

Number of Part Time Employees:

Estimated Monthly Payroll:

Number of Locations:

Years at present location:

Years in Business:

Gross Annual Sales:

Do you deliver?

If you provide entertaiment, describe types:

If Alcohol Sales

TAMS or TIPS certified?

Liquor License Class & Number:

Name on Liquor License:

Any Liquor Violations?

If You Cater

Do you use someone else's kitchen?

Do you prepare food on site?

Do you use your personal vehicle(s)?

Do you have a cargo van insured for commercial use?

Do you review employees who drive his/her motor vehicle report annually?

Do you serve alcohol?

Building Information

Approx Year Built:

Total Est. Square Footage:

Your Occupied Square Footage:

Do you own the building?

Is building free standing?

Is building located in a shopping center?

Do you have a free standing sign?

More than 1 free standing sign?

Indoor Sprinkler?

Building Construction

Hood Inspection Co. & Frequency:

Hood Duct Cleaning Co. & Frequency:

Did you make improvements?:

Contents/Equipment Limit:

Food Spoliage Limit:

Sign Limit:

Current Insurance

Current Carrier Name:

Current Policy Expiration:

Prior Year Carrier:

Do you know your worker compensation experience mod?:

Premium Amount:

Coverage Description:

Losses/Claims

Number of Losses Claimed

Additional Information

Agent Name (Optional):

How Did You Hear About Us?

Preferred Contact Method:

Additional Comments: