Restaurant-Bars-Nightclubs-Food Trucks

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Restaurant-Bars-Nightclubs-Food Trucks

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Your Name *
Your Organizations Name *
Street Address (no POB)*
Your City*	Your State*	Your Zip Code *
Your Phone Number *	Your Email Address*	Your Web Address*
Federal Employer Number (FEIN)*	Start Date of the Business*	Years Experience in this Industry*
SQFT of Your Work Space *	Value of Supplies / Equipment (no vehicles)*	Legal Structure (individual, LLC, corp,etc)*
Number of Business Locations*	Projected Annual Revenues *	Projected Annual Payroll*
# of Full Time Employees*	# of Part Time Employees*	# of 1099 Sub Contracted Employees*
Annual Payroll for FT Employees*	Annual Payroll for PT Employees*	Annual Payroll for 1099 Employees*
Any owner / director been convicted of a felony?* yes no	Is the above address also your mailing address?* yes no	Are you buying or leasing your work space?* yes no

Any material or equipment in storage off site?* yes no	Do you use subcontractors?* yes no	Do you move supplies form place to place?* yes no

Does the business own any vehicles?* yes no	Do your clients sign your standard contract?* yes no	Ever operated under another name ?* yes no

Tell us about your work space location * home office office building office park industrial park warehouse church shopping center medical center truck or train airport converted home residential area manufacturing center distribution center factory / plant school / university government / military facility beach front / water front near a college other	Work safety and security (check all applies)* we have a ADT type system we have video cameras our space in fenced in we have security guards we have armed security guards we have automatic sprinkler system we have smoke detectors we have exit signs over our doors we have no safety or security features system tied to a central alarm system we have a firextinguishers some employees are armed some owners are armed we have a bouncer we check ID's at the door our space has two or more exits other non applicable We use an 3rd party vendor for security	Employee per-employee procedures (check all that apply)* applicants complete an application drug test driving test credit check criminal background check MVR reports prior employment confirmation finger print check polygraph test personal references check other non applicable
Describe your business (check all that apply)* restaurant bar / tavern sports bar comedy club nightclub piano / martini bar adult club jazz / blues club food truck catering other	Types of cooking (check all that apply)* no cooking done on premises microwave only wood burning stoves fireplace deep fryer barbecue open broiling smokehouse solid fuel (wood / charcoal) gas / electric stove roasting grilling tableside all cooking is preformed inside the premises	We have or offer the following (check all that apply)* video games swimming pools pool tables dart boards TV's punching bags apartments trampolines boat docks mechanicals bulls volleyball inflatables climbing walls athletic courts horseshoes dunk tanks sauna, hot tubs, showers children playground equipment radio / TV broadcasting stations bathhouse roof top bar balconies none of the above
Do you have a safe on the premises?* yes no	Have you ever filed for bankruptcy?* yes no	Is your business seasonal?* yes no
Do you have an active liquor license? no yes for beer yes for wine yes for mixed drinks yes for a brewers premit yes for a package store yes as a private club yes as a wholesaler BYOB Service we have applied for one	Alcohol Operations (check all that apply)* staff is trained on serving alcohol we have never violated any alcohol laws we have drink specials we sell alcohol away from premises we have written guidelines on alcohol sales we allow drinking games we offer "open bars" we utilize Tyvek wristbands none of the above non applicable	Latest closing time* 11:00 PM or eariler 11:00 PM to 2:00 AM after 2:00 AM open 24 hours a day
Projected Total Food Receipts *	Projected Total Alcohol Receipts*	Total Receipts from Live Music Sales*
Total Receipts from Banquet / Catering *	Total Expenses Paid to Bands*	Total Expenses for Comp Liquor or Admissions*
What is the average price of a meal?*	Do you have a dress code?*	Ever been cited by the Board of Health?*
Entertainment Operations (check all that apply)* we have a dance floor we attract crowds over 250 people we host special events we have nude or topless dancing we have DJ's we live music we have Raves we have foam parties we have karaoke we have boxing / tough man contents we comedy acts we live Mic or poetry night we have fashion shows none of the above non applicable	We rent our space out to others* yes no	Maintenance (check all that apply)* we do our own cleaning we use an outside firm for maintenance a vendor cleans our hoods, ducts and vents cooking equipment fitted with auto shut off we have a fire suppression system none of the above non applicable
Work space roof age* young than 30 years older than 30 years non applicable	Work space HVAC age * younger than 30 years older than 30 years non applicable	Work space circuit breaker age* younger than 30 years older than 30 years non applicable

# of parking spaces on the premises*	Your business ever had an insurance claim*	Is you business insured now?*


























































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