subject_line
Restaurant Form
Name of Business:
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Mailing Address:
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City:
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State:
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Zip Code:
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Phone:
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Fax Number:
*
Contact Name:
*
Email Address:
*
Physical Address (if different from mailing address):
City:
*
State:
*
Zip Code:
*
Federal ID #:
*
Years in Business:
*
If new venture - # of years experience in industry:
*
Type of Restaurant:
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Seating Capacity in Restaurant:
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Seating Capacity at Bar:
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Gross Receipts
Catering:
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Food:
*
Alcohol:
*
Hours/Days of Operation
Hours & Days of Operation
Hours:
Days:
Hours:
Sunday
Hours:
Monday
Hours:
Tuesday
Hours:
Wednesday
Hours:
Thursday
Hours:
Friday
Hours:
Saturday
Hours:
Entertainment
Entertainment:
*
DJ
Live Band
Dance Floor
How many nights per week:
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Hours:
*
Special Offered:
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Number olf Bartenders and/or Waitresses:
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Building Specifications
Square Footage:
*
Year Built:
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Construction Type:
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Building Updates If Over 25 Years Old:
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Fire Protection
Smoke Detectors
Central Alarm
Alarm System:
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Local
Central Alarm
Business Personal Property Limit (including inventory):
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Cooking
What type is done on premises?
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Automatic Extinguishing System?
*
No
Yes
If yes:
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Wet
Dry System
Cleaning Agreement for Hood & Duct Work?
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No
Yes
Name of Service Contrator:
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Frequency of Cleaning:
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Signage
Are signs:
*
Attached
Detached
Value:
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Crime
Amount of Money Kept on Premises:
*
Workers Compensation Payroll
Owners
*
Included
Excluded
Number of Full-Time Employees:
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Number of Part-Time Employees:
*