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Home
About Us
Policies
Medical Travel Insurance
Business Insurance
Business Owner’s Policy
Intellectual Property
Product Liability
Workers Compensation
Property Insurance
Commercial Earthquake
Employment Practices & Liability
Professional Liability Insurance
Nursing
Property Management
Architects & Engineers
Fitness & Wellness
Healthcare
CPA
Entertainment Insurance
Personal Lines Insurance
Auto Insurance
Homeowners Insurance
Health Insurance
Life Insurance
Wedding & Wedding Reception Insurance
LegalShield Pre-Paid Legal Services
Forms
Payments
Contact Us
get a quote
Forms
Commercial – Liquor Liability Supplemental Application
Get started by filling out this form and someone from our team will contact you shortly!
Commercial - Liquor Liability Supplemental Application
Legal Name of Insured
*
The individual or company name that the policy will be under.
dba (if applicable)
Please list the dba that your company is listed as doing business as, i.e. Frankel & Associates dba Filmins.com
Does your organization own or lease LONG-TERM vehicles?
*
Yes
No
Long term rental/leases are 6 months or more a year.
Do employees or volunteers regularly use their autos for company business?
*
Yes
No
This is not commuting back and forth to work. This includes driving specifically for work purposes during working hours.
Please explain this vehicle usage in detail.
*
Do you verify that insurance is in place with limits of at least $300,000 before employees or volunteers can use their vehicles?
*
Yes
No
How many volunteers do you have driving personal autos for work purposes?
*
What is your total number of employees?
*
HIRED AUTO LIABILITY
Do you hire or rent vehicles during your fairs/festivals/events?
*
Yes
No
What types of vehicles do you rent?
*
How many vehicles do you estimate that you rent per year?
*
What is the avarage duration of these rental vehicles?
*
Please explain the usge of these vehicles for your business operations.
*
Are any of these vehicles 12 or 15 passenger vans?
*
Yes
No
How many of these vehicles are 12 or 15 passenger vans?
*
Are any vehicles provided/donated for your use as part of a sponsorship or promotional agreement?
*
Yes
No
Please provide a copy of the rental agreement and include a description of vehicle types, estimated number, duration and usage of these vehicles.
*
Drop files here or
Select files
Accepted file types: doc, docx, pdf, xls, xlsx, jpg, gif, giff, Max. file size: 50 MB, Max. files: 5.
This information is required to determine the relationship between the sponsored/promotional company and your business operations by the underwriter.
Do either the volunteer/employees or sponsored/promotional companies require that you have primary liability?
*
Yes
No
Please provide the names of the owners of these vehicles that require you to carry primary auto liability coverage.
*
Please provide your email address for correspondance.
*
Enter Email
Confirm Email
Email
This field is for validation purposes and should be left unchanged.