Brewery Workers Comp Savings

1
What is the name of your brewery/taproom?* This field is required.
2
What are your current monthly payrolls? * This field is required.These would be your reduced payrolls because of closure/slow down
Monthly Payroll
# of Employees
2121 - Brewery and Malt houses - All Employees
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Row 0, Column 1
9079 - Restaurants or Taverns - All employees
Row 1, Column 0
Row 1, Column 1
8810 - Clerical Office Employees
Row 2, Column 0
Row 2, Column 1
Other
Row 3, Column 0
Row 3, Column 1
2121 - Brewery and Malt houses - All Employees
9079 - Restaurants or Taverns - All employees
8810 - Clerical Office Employees
Other
Monthly Payroll
Row 0, Column 0
# of Employees
Row 0, Column 1
Monthly Payroll
Row 1, Column 0
# of Employees
Row 1, Column 1
Monthly Payroll
Row 2, Column 0
# of Employees
Row 2, Column 1
Monthly Payroll
Row 3, Column 0
# of Employees
Row 3, Column 1
1 of 4
3
What percent of your sales are from on-site food sales?* This field is required.Select from the following options
0-25%
0-25%
26-50%
More than 50%
4
What is your brewery's Federal Tax ID Number (FEIN)?* This field is required.
5
What is your name?* This field is required.
First Name
Last Name
6
What is your email?* This field is required.We will send a confirmation that we are working on your project.
example@example.com
7
What is the best phone number to reach you at?We won't spam you. This is a time sensitive project so we want to assist you quickly.
Area Code
Phone Number
Should be Empty: