General Information

Name of distillery:

Location Address

Name*

Email*

Phone*

Website:

TTB Permit #:

Property

Building Replacement Cost

Full replacement cost of building contents (materials, equipment, furniture and fixtures, etc):

Value of stock (Aging Spirits):

Age of distilling equipment:

Length your product is aged/stored:

Confirm type of barrels used for storage:

Do grain handling areas have proper ventilation?

Yes
No

Are grain storage and handling areas, production, and storage areas each situated in a separate fire division?

Yes
No

Building details

Are you the only tenant?

We are sole tenant
The building has other tenants

Please describe the other tenants

Number of stories:

Type of construction

Square footage of building

Square footage you occupy

Year built

Describe the following:

Type of heating system

Year Updated

Type of roof

Year updated

Type of plumbing

Year updated

Electrical AMPS

Year updated

Sprinkler Protection type (if any)

Percentage of Building Covered by Sprinklers?

Operations Information

Number of years operating under current ownership:

If this is a new operation, please describe your prior experience in this type of business:

Number of years at this location:

Estimated Total Annual Receipts:

Estimated Annual receipts for gift shops sales:

Estimated Tasting room/restaurant annual receipts including liquor:

Describe the type of distilled products are you manufacturing:

Do you offer distillery tours?

Yes
No

Gross sales of tours:*

Are tour guests required to sign waivers?

Yes
No

Describe any planned new products or services not currently advertised on your website:

Have you suffered any losses in the last 5 years?

Yes
No

Please provide details:

Safety Program and Organization

Is the owner active in daily operations?

Yes
No

Do you have a formal safety program?

Yes
No

Do you have a testing program in place?

Yes
No

Liquor Liability

What type of liquor training is given to servers?

Is there a policy for serving alcohol to employees?

Yes
No

Please describe your policy for serving alcohol to employees?

Do you hold any special events?

Yes
No

What type(s) of event(s)?*

Expected number of participants*

How often are they held?*

Gross revenue from events*

Do you have a tasting room?

Yes
No

Number of seats:

Hours of operation:

Gross revenue from alcohol served on premises:

*The information provided from this application will allow us to provide an insurance premium indication only. More information will be required for a final quotation.

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