Restaurant Insurance Application
Submission of this information does not represent a binding of any insurance contract or agreement. Additional information may be required in order to get an accurate quote of insurance
Legal Name of Restaurant
Your Contact Number
Website of Restaurant
Years in Business or Years Experience in Hospitality Industry (if no prior years in business please describe your past managerial experience in hospitality industry)
Has The Restaurant Business Ever Had an Insurance Claim?
YES: Date, Description of Loss and Amount of Loss ($)
Current Insurance Company
Address of Restaurant
Newfoundland and Labrador
Prince Edward Island
Building Year Built
Total Square Footage Restaurant Occupies
How Many Stories
Is There A Basement?
Is The Building More Than 80% Sprinklered ?
Frame / Wood Construction
Fire Restive / Concrete + Steel Beam
Masonry + Wood Beam
Wood - Ashphalt Shingle
Steel - Tar & Gravel / Membrane
PEX / COPPER / PVC
COPPER / PVC
GALVANIZED STEEL / CAST IRON / PVC
Electrical - WIRING
Mix - Copper / Aluminum
Electrical - Panel
Breakers & Fuses
Electrical - AMPs
Less than 100 AMP
200 AMP +
Gas - Furnace / Radiator
Electrical - Furnace / Baseboard / Radiator
Type of Restaurant
Annual Revenue from Food ($)
Annual Revenue from Alcohol($)
Is There Any Other Revenue Other Than From Food & Alcohol
Other Revenue ($)
Other - Describe Service or Goods Sold
In The Premises Is There A WETT Extinguishing System Which is ULC Compliant Fixed Fire Suppression System on Semi-Annual Maintenance Contract?
K-Type Fire Extinguisher Located in Kitchen ?
Is There Deep Fat Frying
Range, Hood, Ventilating Duct Work, Exhaust Fans and Filter Screens Steam Cleaned by Professional Company Semi-Annually ?
Do you Attend Any Fairs/Festivals/Events ?
Is The Premises Monitored by Central Alarm System?
Hours of Operation + Days Open Per Week
Number of Seats Inside
Number of Seats Outside
Number of Full Time Staff
Number of Part Time Staff
Any Deleveries Done?
Sales from Delivery $
Delivery Done By Employees or Third Party ?
Any Live Entertainment
Live Entertainment - YES - Please Describe: