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Restaurant Submission Form
Shaun Ryan
2015-06-02T14:47:43+00:00
If you are a human and are seeing this field, please leave it blank.
Fields marked with an
*
are required
Name of Restaurant
Type
Restaurant
Café
Coffee Shop
Take Away
Address
Does Your Establishing Use A Deep Fryer?
Yes
No
What Is Your Establishment's Capacity?
Is Your Establishment Licenced?
Yes
No
Wall Construction
Brick
Timber
Cladding
Concrete
EPS
Metal
Roof Construction
Tiles
Iron
Timber
EPS
Other
Floor Constructions
Concrete
Timber
Fire Protection
Hoses
Sprinklers
Alarms
Security Protection
Deadlock on doors?
Window locks/ bars?
Alarm?
Alarm (Only if Alarm is selected from above)
Monitored Alarm
Local Alarm
Number Of Seats
Property To Be Insured
Contents
Stock
Building
Enter amount of the selected above
Business Interruption Sum Insured
Theft Sum Insured
Money Sum Insured
Glass Cover Required?
Yes
No
Machinery Breakdown Required?
How Many Pieces Of Machinery?
Sum Insured Required?
Electronic Equipment
Do You Require Electronic Equipment Cover?
Yes
No
Computer And Electronic Office Equipment Sum Insured:
Laptops Sum Insured
Liability
How Many Employees Do You Have?
Annual Turnover
If You Use Subcontractors, What Are Your Payments To Your Subcontractors Per Year?
Limit Of Liability Required
Upload File
What is 20-12?
*
