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Your Name *
Your Name
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Phone
Phone
general information
2. Does your company operate as a *
please check all that apply
A. Current Year (projected YE) B. Past Year C. Next Year (projected)
A. Produced by you under your label(s):
B. Produced by others for you:
C. Produced by you for others:
D. Total:
premises/operations
2. Do you produce or sell any other alcoholic beverages (cider, liquor, wine, etc.)? *
4. Do you clean daily *
7. Is your facility fully protected by a smoke detection system that rings to a central station? *
8. Is your facility fully protected by an automatic sprinkler system? *
9. Do you have a tasting room? *
A. Number of seats B. Number of drinks or samples offered C. Size of drinks or samples served(oz) D. Who serves the tasting room samples
10. Do you have a tasting room (onsite or another location)? *
A. What are the hours of operation and days open B. How many servers/bartenders C. Are the servers/bartenders TIPS (or equivalent) trained D. Do you have live entertainment? (If yes, How many times a week/Describe type of music)
11. Do you offer brewery tours? *
A. How often? B. Are brewery tours supervised by employees? (Y/N) C. Are the tours allowed on the production floor during production? (Y/N) D. What safety precautions do you take to help prevent slips, trips, and falls?
12. Do you operate a Restaurant/Brew Pub? *
13. Do you batch test your beer at every stage in the process? *
15. Do you import any ingredients? *
products recall
Complete if requesting coverage
1. Is there a recall or market withdrawal plan in place that's compliant with FDA guidelines? *
2. Were FDA inspections completed regularly over the past 5 years? *
3. Does the applicant keep detailed records of products distribution processes? *
4. Is there a formal compliant handling process in place? *
5. Have you recalled any beer in the last 5 years? *
packaging and transportation exposures
A. Bulk (%), B. Keg (%), C. Bottle (%), D. Can (%), E. Other (%)
2. Do you hire others to transport your products? *
Does the company assume liability during the shipping process? *
Do you require certificates of liability insurance annually from this firm? *
3. Do you directly distribute any product yourself? *
for your fleet:
1. Do you have a driver selection process that includes reference and MVR checks? *
2. Do you have a formal safety policy for Driver Training? *
A. Vehicle Safety and Maintenance? *
B. Personal Use of Company Owned Vehicles? *
C. Distracted Driving (Cellphone use and Texting)? *