On-Line Restaurant Insurance Quote Form Complete our Minnesota restaurant insurance information form and we will be in touch soon. Company Information Enter your full name: Bar or Restaurant Name: Mailing Address: City: State: Zip Code: Email: Email (again for accuracy): Phone: Fax: Bar and Restaurant Information: Business Type: (sole proprietorship, corporation, LLC, etc.)---Sole ProprietorshipCorporationLLCPartnershipOther Restaurant Type:---Fine DiningCasualPizza (Delivery)Pizza (No Delivery)Fast FoodBar / Tavern (Food)Bar / Tavern (No Food)Nightclub (Live Entertainment)Nightclub (No Entertainment)Gentlemen's ClubOther Current Insurance Company: Renewal Date: Current Cost: Any Claims in the Last 3 Years? ---YesNo Liquor Liability Included in Current Coverage?---YesNo Building Coverage:---YesNo Age of Building: Business Property Amount: Ansul Type: Deductible: Catering?---YesNo Patio?---YesNo Live Music?---YesNo DJ?---YesNo Total Square Footage: Public Access Sq. Ft.: Approximate Gross Sales: Food Sale %: Alcohol Sale %: Number of Employees: Comments / Remarks: Send my insurance quotation via :EmailFaxRegular MailCall me by phone Thank you for filling out this form completely. We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy. Yes, I agree. Please send me a restaurant / bar Insurance quote now.
