BWD Survey - Hutch

BWD Survey – Hutch

Business

Business name:

Legal entity:

Number of employees:

Contact name:

First Last

Phone:

Address:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Other location(s):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email:

Website / Social Media:

Annual sales:

Annual payroll:

Federal tax ID number:

Franchise:

Current carrier:

Years with current carrier:

Policy expiration date:

Number of claims:

Claim(s) details:

Years in operation:

Number of employees:

Seating capacity:

Square feet:

Hours of operation on Sunday:

Hours of operation on Monday:

Hours of operation on Tuesday:

Hours of operation on Wednesday:

Hours of operation on Thursday:

Hours of operation on Friday:

Hours of operation on Saturday:

Identify products:

Wine

Beer

Distilled Spirit

Years of experience on Winemaker:

Years of experience on Brew Master:

Years of experience on Distiller / Blender:

What experience and accreditation do Vintner / Winemaker / Brew Master / Distiller / Blender and assistants have?

Annual sales of Retail / Wholesale / Internet:

Annual sales of Bottles / Barrels / Cases:

Annual sales of your manufactured alcohol:

Annual sales of other alcohol:

Annual sales of Food receipts:

Annual sales of Gift Shop / Merchandise:

Annual sales of Hospitality / Lodging:

What percentage of your total alcohol sales are sold “retail” to be consumed on-site or off-site?

What percentage of your total alcohol sales are sold wholesale, through a distributor or self-distributed to a grocery, convenience, or other hospitality outlet such as a restaurant or hotel?

Property

Blanket

Building:

Contents:

Deductible:

Inventory value:

Equipment value:

Is equipment covered by a service agreement?

Additional Property (signs, lights, clocks, fences, playgrounds, etc.)

Construction type:

Protection class:

Year built:

Building square footage:

Applicant square footage:

Number of stories:

Is there a fire alarm?

If yes, central or local?

Security cameras on premises?

Length of time footage is kept:

Carbon Dioxide monitoring and ventilation?

List other tenants:

Building designed for current use?

Sewer / Drain:

General Liability Limit

Select one:

Umbrella?

Rating basis:

Sales / Receipts:

Payroll:

Data Breach liability:

Employee benefit liability:

Employment practices liability:

Deductible:

Number of Employees (full-time):

Number of Employees (part-time):

Third-party coverage?

Underwriting

Has the Applicant ever been canceled (incl. nonpay) or refused insurance of any kind by ERIE or any other insurance carrier?

If yes, please explain:

Has the Applicant filed for bankruptcy in the past 5 years?

If yes, please explain:

Claims History:

(Provide 3-5 years Loss Run)

General Information

Do you conduct wine / beer / distillery tours?

Are they guided by staff?

Are samples offered?

What are product sampling and testing procedures?

Are documentation records kept?

Are IDs checked?

Do you host weddings / showers / conferences / misc. events?

If yes, explain:

If yes, do you supply bartenders / servers for events?

Do you participate in special events OFF your premises, including Wine / Beer / Distillery festivals?

What states will you travel to?

Maximum size:

Explain how tastings are monitored / controlled:

Are there bouncers, security guards, or doormen?

Do you have a cover charge on any night?

Entertainment:

Happy hour

Drink specials

Flaming drinks

Live Band

Dance floor

Yoga / Sport Events

Painting / Art events

None

(check all that apply)

How many per year?

Average attendance per event?

If conducting Happy Hour explain:

Formal Quality Control Program in place?

Formal Product Recall plan?

Have you ever had to recall a batch?

Kitchen Protection

Do you own a Food Truck?

Are all commercial cooking surfaces and deep fryers protected by a UL3000 automatic chemical extinguishing system?

Is there a written contract for commercial cleaning of the exhaust hood, including ductwork and filters?

If yes, what is the date of last inspection?

Are all commercial cooking surfaces and deep fryers protected by a Wet automatic chemical extinguishing system?

Is the automatic extinguishing system(s) serviced under a written maintenance contract at least every 6 months?

If yes, what is the date of last inspection?

Are the filters, hood, rear wall and appliances free of grease accumulation?

Are there any open pits, hearths or open flame grills?

If yes, please describe in detail:

Are there Class K fire extinguishers and are they serviced annually?

Sales & Distribution

How are your products distributed?

What is your distribution area?

Do you do any mail order distribution?

Do you export any products?

Do you transport your own product?

Do you use a common carrier?

If yes, what is the split?

Do you ever transport for others?

Liquor Liability

Limits of liability requested:

Each Common Cause:

Policy Aggregate:

Name on Liquor License:

Date issued:

Has the Applicant submitted any claims in the past 5 years regarding liquor liability coverage or had any incidents that might give rise to a claim?

If yes, provide details:

Has the Applicant been cited or fined by a government agency for any liquor violations:

If yes, provide details:

Has the Applicant ever had their liquor license suspended or revoked?

Has liquor liability coverage ever been canceled, non-renewed or denied in the past?

If yes, provide details:

Has the Applicant been cited or fined by a government agency for any liquor violations:

Does the business have a formal alcohol awareness training program?

Does the business supply the bartender / servers for catered events?

Winery, Brewery, and Distillery Specific Questions

What is the age of your tank / vessel system?

What is your maximum leakage exposure from one tank / vessel at one time?

What is your maximum value per gallon from tank / vessel leakage?

Do you own barrels?

If yes, how many?

Number of taps:

Your product:

Host beer taps:

Crowler / Growler sales?

What is the percentage of sales for Crowler?

What is the percentage of sales for Growler?

Are brewing operations automated?

Canning/ Bottling on site?

Type of still used?

Are there flow controls in the event of a breakage?

Is any grinding done on site?

Controls in place to reduce fire / explosion?

Separation walls for storage / manufacturing / bottling?

Static buildup controls?

Combustible dust controls

Is there electrical wiring designed for flammable liquids?

Workers’ Compensation

Expert modification factor:

Expert modification date:

Sole proprietor / Partners coverage?

Corporate officer coverage?

List

Class code #:

Payroll =

Average length of employment:

Safety:

Safety meetings

Lifting training

Forklift training

PPE training

(check all that apply)

Eye washing stations?

Autos

Auto used in business?

Autos titled to?

Hired / Non-owned?

Do your corporate officers maintain a personal auto policy?

If no, consider adding the corporate officers named coverage endorsement.

Included at direct primary

Limit is actual loss

Liability

Med Pay

Um / Uim

Comp

Coll

List

Year

Make

Model

VIN

Documents

Check each box when complete:

Exterior photos of front and back

Loss runs

BWD Survey – Hutch

Business

Property

General Liability Limit

Underwriting

General Information

Kitchen Protection

Sales & Distribution

Liquor Liability

Winery, Brewery, and Distillery Specific Questions

Workers’ Compensation

Autos

Documents

Company

Follow Stakwise