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Restaurant Questionnaire
Call Us Today At
(281) 550-5864
Restaurant Questionnaire
Legal Name of Business
DBA
Owner Name
Main Contact Name
Red Tax I.D.
Legal Entity
Individual / Sole Proprietor
Corporation
Partnership
Limited Liability
Physical Address (Street, City, State, ZIP)
Mailing Address (Street, City, State, ZIP)
Garaging Address (Street, City, State, ZIP)
Phone
Fax
Email
Business Information
Applicant is a:
Restaurant
Diner
Tavern
Night Club
Banquet Hall
Fine Dining
Other
If Other, Please Specify
# of Years at this Location
# of Years in Restaurant Business
If less than 3 years at this Location, list previous experience
Property Section
Multiple Occupancies?
If so, Please List:
Receipts
Food
Liquor
Other
Total
Square Footage
Total
Restaurant
Building Off Premise Parking
Yes
No
If "Yes", list address and square footage
On or Off Premise Catering / Banquet
Yes
No
If "Yes", % of total Receipts
Describe Catering Operation
Valet Parking?
Yes
No
If "Yes", is Garage Keeper Liability Required
Yes
No
If "Yes"
Limit
Deductible
Any Elevators or Stairs on Premise?
Yes
No
Any Tableside Cooking?
Yes
No
Legal Liability Section
Does Applicant Serve Alcohol?
Yes
No
Does Applicant Have Liquor License
Yes
No
If "Yes", Type and #
Does Applicant Sell Package Goods
Yes
No
If "Yes", % of Liquor Receipts
# of Bartenders
# of Waiters/Waitresses
Avg Length of Employment
Are Employees Given Liquor Training
Yes
No
Explain Type and When Trained
Does Applicant Have Written Policy on Serving Alcohol for Employees & Customers
Yes
No
Is Management Notified Prior to Shutting Off Patrons
Yes
No
Is Documentation Kept on Each Incident
Yes
No
Service Bar Only?
Yes
No
# of Bars on Premises
Is There a Steady Bar Clientele
Yes
No
Is There a Happy Hour
Yes
No
Are Shots Given
Yes
No
Shots Specials / Shooter Girls
Yes
No
Have There Been Any Liquor Board Violations
Yes
No
If "Yes", List ALL Violations
Entertainment Section
Entertainment on Premises?
Yes
No
Nights of Week
Age of Clientele
Type of Entertainment
Rock Group
DJ
Band (Any Kind)
Go-Go
Other
If "Other", Please Describe
Does a Dance Floor Exist
Yes
No
If "Yes", Square Footage Is Dancing Permitted
Bouncers or Doormen
Yes
No
If "Yes", Explain Why
Amusement Devices (Pool Tables, Video Games, TVs, etc)
Yes
No
If "Yes", # and Description
Operations Section
Is Applicant Open Now
Yes
No
If "No", Explain
Hours of Operation
From
To
# of Days per Week
Is Applicant a Seasonal Operation
Yes
No
If "Yes", Explain
Distance to Ocean or Nearest Body of Water
Physical Plant Section
Age of Building
Construction
# of Stories
Age of:
Wiring
Plumbing
Heating
Roofing
Smoke Detectors
Yes
No
If "Yes", Electric or Battery Power
Fire Alarm
Yes
No
If "Yes", Type
Burglar Alarm
Yes
No
If "Yes", Electric or Battery Power
Sprinkler System
Yes
No
If "Yes", Age and Type
Kitchen Fire Protection:
UL-300 Wet Chemical Extinguishing System Serviced every 6mos.
Yes
No
Above System Covering All Cooking Surfaces
Yes
No
Name of System
Automatic Gas or Electric Shut Offs for Cooking
Yes
No
Hood and Filters Cleaned Weekly By Staff
Yes
No
BC Extinguisher Available in Kitchen
Yes
No
Hoods and Ducts Over All Cooking Equipment
Yes
No
Hoods and Ducts Maintenance Contract Schedule
Yes
No
# Month
Δ
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