commercial property and casualty insurance

EXCLUSIVE INSURANCE PROGRAM

To make this program a reality, we need your help by providing essential underwriting information.

YOUR INFORMATION

tell us who you are

First name*

Last name*

Email*

BUSINESS INFORMATION

tell us a little about your establishment

Business Name*

Street address*

Street address 2

City*

State/Region*

Postal code*

Restaurant Concept*

Entertainment*

Yes

Estimated Annual Receipts*

Estimated Alcohol Receipts (if applicable)

DOCUMENTATION

insurance policies and loss information

Please provided copies of your current property/liability insurance policies and the past three, ideally five years of loss information.*

Yes, I have my documents.

No, I do not have my documents. I will provide the “name, phone and email address” of the individual who will be sending over the documentation. For example, this could be your “insurance broker”.

I agree and understand that by clicking submit below, I consent to allow the California Restaurant Association to store and process the personal information submitted above. I understand my information will remain confidential and will only be shared with the companies involved in the development/process of the insurance program.*