ACORD 185 Fillable PDF – Restaurant Insurance Application

ACORD 185 (2011/09)

RESTAURANT / TAVERN SUPPLEMENT

Form Number:

ACORD 185 (2011/09)

Category:

Supplement Form

Last Updated:

September 2011

Page Count:

04 Pages

File Format:

PDF, Fillable PDF

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ACORD 185

Running a restaurant comes with a variety of risks that require proper insurance protection. To help insurance providers assess these risks, the Acord 185, Restaurant Supplemental Application, is used alongside the Acord 125 (Commercial Insurance Application), providing a detailed view of your business operations. It collects important details related to food service, entertainment, safety measures, and cooking equipment. Completing and submitting it accurately ensures your business receives the right coverage at the right premium. Download, fill, and print the form to get started today.

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Benefits of The Restaurant Insurance Supplemental Application

Detailed Business Profile

The form provides a clear and detailed picture of your restaurant, including its legal name, address, licensing, and daily operations or services. It helps insurers to evaluate risks correctly.

Customized Coverage Support

Every business operates differently. This form allows insurers to make insurance policies according to your specific activities, whether you run a small family restaurant or hotel.

Improved Liability Protection

Since restaurants face higher risks, such as fire hazards and safety concerns, highlighting how your business manages these risks can strengthen liability protection.

Key Sections of Acord 185 Fillable Form

Business Information

This section describes the restaurant’s legal name, address, and license information.

Food Service Information

It includes the type of food offered, the average number of meals, operating hours, etc.

Entertainment

Indicate what you offer for entertainment purposes, such as live music, DJs, karaoke, etc.

Safety & Security Measures

Describes the number of employees or security staff, including how you manage safety.

Cooking / Kitchen Information

This section includes information on kitchen equipment, such as grills and open-flame cooking. It also includes fire protection precautions, such as hoods and an extinguishing system.

How To Complete The Restaurant Insurance Application?

  1. Agency Information: Provide the agency and carrier name, agency customer ID, and NAIC code.
  2. Applicant Information: Fill in the legal business name and policy number.
  3. General Rating / Underwriting: Provide the receipts of the last 3 years and fill in the accounts payable, notes payable, bank loans payable, total operating expense, restaurant type, net profit or loss, and valet parking details.
  4. Yes/No Questions: Explain all yes responses.
  5. Cooking / Kitchen Fire Protection: Indicate whether the kitchen has safety measures. Check all boxes that apply.
  6. Food Service Information: Provide food-related information, including type of food, hours of operation, number of meals served, and seating capacity.
  7. Remarks: Write any additional information, explanation, or remarks. Attach the Acord 101 (Additional Remarks Schedule) if more space is required.
  8. Signature(s): The applicant(s) must sign and date the form.
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Frequently Asked Questions

This is the Restaurant Supplement Application used alongside the Acord 125 to provide insurers with detailed information about a restaurant and its operations, such as business hours, safety concerns, food offered, etc., for insurance underwriting.

The form provides insurers a clear and complete view of your business, including sales, food service, entertainment, and safety measures. It allows insurers to evaluate risks and offer appropriate coverage.

No. This is a supplement and must be completed alongside the Acord 125, the main commercial insurance application.

Yes, it affects insurance costs. The information you provide, such as safety measures, fire protection, and sales, directly influences risk assessment and premium pricing.

You can fill out the form yourself. Many restaurants choose to work with insurance agents or brokers to ensure all information is accurately filled out.