JSA Homepage
Current Quote Status
Started:
02/20/2017
Incomplete Provide Basic Information
Incomplete Generate Applications
Incomplete Submit For Binding Approval
Quote Look-Up
Need Help?
Rachel Patterson, CIC If at any time you need assistance please contact Rachel Patterson, CIC at 800-342-5572 or rachel@jsausa.com
Tools
Ask Question
New Quote
If you can not see the log in box click this link.
2017 CE Dates and Cities Available

Homeowners Program Start Quote
facebook

facebook

twitter
Get Adobe Reader
You will need Adobe Reader© to view PDF documents in this website.

Liquor Liability Quote

Agency Information:
Agent Name:
Note: This is the name of the agent requesting the quote, NOT the agency name.
Agency Name:
Agency Phone:  -  - 
Agency Fax (optional):  -  - 

Applicant Information:
Applicant Name:
Choose a state:
Number of years in business:
Number of years experience in this field:
Does the applicant have a valid liquor license:  
 

Basic Quote Information:
What is the desired effective date?
Type of risk:
Desired Limits:
What is the latest time the establishment will EVER close: 24-hour
Have all alcohol-serving employees taken an alcohol training course:  
 
Number of violations, losses or claims:
Has the applicant filed for bankruptcy in the last 12 months:  
 
Are employees allowed to consume alcoholic beverages while working:  
 
Are GL limits greater than or equal to liquor liability limits:  
 
Number of additional insureds needed:
Gross Alcohol Receipts: $
Gross Food Receipts:
Note: Only needed for restaurants
$

AAMGA Member NAPSLO Member
This program is only available to properly licensed retail insurance offices
© 1981 - 2017 Jackson Sumner & Associates - All Rights Reserved - Patent Pending