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