Hako Risk Winery Application Hako Risk & Insurance

1

NAMED INSURED* This field is required.

2

INSURANCE CONTACT* This field is required.

First Name

Last Name

3

EMAIL* This field is required.

example@example.com

4

ENTITY OWNERSHIP

5

FEIN# / EIN#

6

MAILING ADDRESS* This field is required.

7

WEBSITE

8

OPERATIONS BASICS

9

ESTIMATED GROSS SALES NEXT 12 MONTHS* This field is required.

10

SPARKLING %

11

STILL %

12

WHOLESALE %

13

RETAIL/DIRECT TO CONSUMER %

14

GROSS SALES PRIOR YEAR* This field is required.

15

GROSS SALES PRIOR YEAR 2* This field is required.

16

TOTAL # CASES TO BE SOLD NEXT 12 MONTHS

17

AVERAGE SELLING PRICE PER CASE

18

APPROX COST OF BOTTLING, CORKS, LABELS, CARDBOARD, LABOR, ETC. PER CASE

19

ESTIMATED BULK WINE SALES NEXT 12 MONTHS

20

AVERAGE SELLING PRICE PER GALLON

21

TOTAL GRAPE SALES NEXT 12 MONTHS

22

TOTAL DISTILLED SPIRITS SALES NEXT 12 MONTHS

23

TASTING ROOMS/DIRECT TO CONSUMER SALES

24

TOTAL REVENUE

25

TOTAL WINE SALES

26

TOTAL ‘OTHER THAN WINE’ SALES

27

TOTAL ‘TASTINGS’ SALES

28

DO YOU HAVE ANY RESTAURANT OR FOOD SALES

Yes

No

29

TOTAL FOOD SALES

30

TOTAL RESTAURANT WINE/ALC/BEER SALES

31

DO YOU PROVIDE GUEST LODGING

Yes

No

32

# OF ROOMS

33

ANNUAL REVENUE

34

DO YOU OFFER TOURS

Yes

No

35

# ANNUAL TOUR VISITORS

36

ANNUAL REVENUE

37

DO YOU TRANSPORT GUESTS ON OR OFF-PREMISES IN ANY WAY

Yes

No

38

SPECIAL EVENTS HOSTED BY YOU (HARVEST PARTIES, FESTIVALS, ETC.)

39

AVERAGE # PER YEAR

40

AVERAGE ATTENDANCE

41

MAXIMUM ATTENDANCE

42

ANNUAL REVENUE

43

SPECIAL EVENTS RENTED TO OTHERS (WEDDINGS, CORPORATE EVENTS, ETC.)

44

AVERAGE # PER YEAR

45

AVERAGE ATTENDANCE

46

MAXIMUM ATTENDANCE

47

NUMBER

48

DO YOU UTILIZE A STANDARD CONTRACT

Yes

No

49

DO YOU REQUIRE PROOF OF INSURANCE FOR EACH EVENT

Yes

No

50

DO YOUR EMPLOYEES POUR WINE AT THESE EVENTS

Yes

No

51

DO ANY EVENTS INCLUDE FIREWORKS, FIREARMS, ORGANIZED SPORTS OR CONCERTS

Yes

No

52

FOREIGN SALES

53

TOTAL SALES TO FOREIGN COUNTRIES

54

IF YES, PLEASE LIST THE COUNTRIES

55

ESTIMATED # TRIPS MADE OUTSIDE US BY EMPLOYEES

56

PURPOSE OF THESE TRIPS (SALES, MARKETING, ETC.)

57

MAX # OF EMPLOYEES TRAVELLING AT ANY ONE TIME

58

ANY EMPLOYEES BASED IN FOREIGN COUNTRIES

Yes

No

59

IF "YES", PLEASE PROVIDE DETAIL

60

LOCAL EMPLOYEES

61

WHO IS YOUR WINEMAKER

62

YEARS OF EXPERIENCE

63

TOTAL # OF FULL-TIME EMPLOYEES

64

TOTAL # OF PART-TIME EMPLOYEES

65

TOTAL # OF SEASONAL EMPLOYEES

66

DO YOU TRANSPORT ANY OF YOUR EMPLOYEES

Yes

No

67

IF "YES", PROVIDE DETAILS

68

DO YOU PROVIDE ANY EMPLOYEE HOUSING

Yes

No

69

IF YES, PROVIDE DETAILS

70

SAFETY / SERVING

71

DO YOU HAVE A WRITTEN QUALITY CONTROL PROGRAM

Yes

No

72

DO YOU HAVE A PROGRAM TO COMPLY WITH FED/STATE LABELING REQUIREMENTS

Yes

No

73

ARE EMPLOYEES TRAINED IN SAFETY PROCEDURES (CHEMICAL HANDLING, TANK CLEANING, EQUIP USE)

Yes

No

74

HAVE YOU EVER HAD A PRODUCT RECALLED

Yes

No

75

ARE TASTING ROOM SERVERS CERTIFIED IN ANY ALCOHOL TRAINING PROGRAMS

Yes

No

76

DO YOU HAVE A WRITTEN POLICY FOR RESPONSIBLE ALCOHOL SERVICE

Yes

No

77

ARE ALL SERVERS TRAINED ON THIS POLICY

Yes

No

78

HAVE YOU EVER BEEN FINED OR CITED FOR IMPROPER SERVICE OF ALCOHOL* This field is required.

Yes

No

79

ANY ALCOHOL RELATED CLAIMS DURING THE LAST 5 YEARS* This field is required.

Yes

No

80

OPERATIONS DETAIL

81

DO YOU BOTTLE YOUR OWN WINE?

Yes

No

82

# OF BOTTLING LINES

83

CAPACITY

84

DO YOU BOTTLE WINE FOR OTHERS

Yes

No

85

DO YOU UTILIZE A STANDARD CONTRACT

Yes

No

86

# OF CASES

87

ANNUAL BOTTLING REVENUE

88

DO YOU CUSTOM CRUSH FOR OTHERS?

Yes

No

89

DO YOU USE A STANDARD CONTRACT

Yes

No

90

# OF CUSTOMERS

91

TOTAL GALLONS

92

DO YOU STORE WINE FOR OTHERS?

Yes

No

93

DO YOU USE A STANDARD CONTRACT

Yes

No

94

TOTAL GALLONS

95

MAX VALUE OF ALL WINE STORED

96

WHEN STORING WINE FOR OTHERS, WHO IS RESPONSIBLE FOR INSURING THIS WINE AT YOUR PREMISES?

97

DO YOU PROVIDE CONSULTING SERVICES FOR OTHERS

Yes

No

98

DO YOU USE A STANDARD CONTRACT?

Yes

No

99

TOTAL CONSULTING REVENUE $

100

VINEYARD AND MANAGEMENT

101

DO YOU USE A VINEYARD MANAGEMENT COMPANY?

Yes

No

102

DO YOU MANAGE VINEYARDS FOR OTHERS?

Yes

No

103

DO YOU HIRE FARM LABOR CONTRACTORS?

Yes

No

104

DO YOU APPLY YOUR OWN HERBICIDES, PESTICIDES OR FERTILIZERS

Yes

No

105

DO YOU APPLY HERBICIDES, PESTICIDES OR FERTILIZERS FOR OTHERS

Yes

No

106

WHAT DO YOU TYPICALLY APPLY?

107

ARE THESE APPLIED BY A LICENSED APPLICATOR?

Yes

No

108

DO YOU HAVE AN EPA PROGRAM IN PLACE FOR ALL STORAGE & APPLICATIONS

Yes

No

109

ANY APPLICATIONS CONDUCTED USING AIRCRAFT?

Yes

No

110

ANY CHEMICAL DRIFT LOSSES OR ACTIONS AGAINST YOU IN THE LAST 5 YEARS

Yes

No

111

CAPTCHA* This field is required.