Liquor Liability
Liquor Liability
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This form is required only when it is requested on the customers order.
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Is this policy for a special event?
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Yes
No
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Are the facilities available for banquets, receptions, and/or private affairs?
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Yes
No
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{"Yes":["287","288"]}
Number of annual functions:
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What type of functions do they have?
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Does the insured have more than one business operation at this location?
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Yes
No
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{"Yes":["290"]}
Describe in detail the business operations?
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What type of food service do they provide?
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-- Please Select--
On premises
Off premises
None
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{"On premises ":["294"]," Off premises ":["294"]}
What type of alcohol service do they provide?
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-- Please Select--
On premises
Off premises
On and off premises
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{}
Provide breakdown of receipts for each that apply include a 0 for none.
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Food sales $:
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Alcohol sales $:
*
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What types of entertainment are on the premises?
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Band
Comedian
DJ
Exotic dancing
Jukebox
Karaoke
Other
Solo vocalist
Stage/Floor Show
None
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{" Other":["38"]}
Describe other type of entertainment:
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What types of music do they play?
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Alternative
Classic rock
Country
Hard rock
Jazz
R&B
Rap
Soft rock
Top 40
No music
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Do they have a valid liquor license?
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Yes
No
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{"Yes":["299","300"]}
What is the exact name on the license?
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License number:
*
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Are employees allowed to consume alcohol during their hours of employment?
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Yes
No
No employees
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Is the property within 5 miles of a college/university?
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Yes
No
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What is the average age of the patrons?
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-- Please Select--
Under 21
21-25
26-30
31+
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Do they offer drink incentives?
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Yes
No
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Are persons under the legal drinking age allowed on the premises after 10:00 pm?
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Yes
No
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Do they have bouncers or door persons?
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Yes
No
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{"Yes":["307"]}
Are the bouncers and/or door persons employees or contract?
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Employees
Contracted
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Are guns permitted or kept on premises?
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Yes
No
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Do they allow BYOB or setups?
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Yes
No
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{"Yes":["310"]}
Describe BYOB and/or setups:
*
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Do they have bartenders?
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Yes
No
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{"Yes":["312","315"]}
Are the bartenders full time and/or part time?
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-- Please Select--
Full time
Part time
Full time and part time
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{"Full time":["313"]," Part time":["314"]," Full time and part time":["313","314"]}
Number of full time bartender(s):
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Number of part time bartender(s):
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Are all bartenders that serve alcohol certified in a TABC, TIPS, or another type of training course?
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Yes
No
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Within the last 5 years have they been fined or cited for violations related to illegal activities or sale of alcohol?
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Yes
No
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{"Yes":["317"]}
Describe the fines and/or citations in detail:
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Have they had any liquor liability claims in the past 5 years?
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Yes
No
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{"Yes":["319"]}
Describe the liquor claim(s) from the past 5 years:
*
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{}