Property Additions / Changes - Insurance Works - Dayton, Miami Valley, Ohio Full Service Insurance Agency

Bed and Breakfast Insurance Questionnaire

Please fill out the form with your property information.

One of our staff members will contact you after we receive your submission to confirm the updates.

B&B Insurance Request Form
*Fields denoted with an asterisk are required.
Property Information
* Insured's Name:
* Agent:
* Insured's Email Address:
* Does the owner reside on the premises where the Bed and Breakfast (B&B) is located?	Yes No
If no, does a manager reside on the premises 24 hours per day and owner reside in the same town and oversee operations?	Yes No
* Does a family member or realtor oversee operations?	Yes No
* Does the B&B close for any seasonal period?	Yes No
If "Yes," provide details including approximate dates and whether the B&B is left unoccupied.
* Number of Stories:
* Do guest rooms have at least two means of escape (stairway, ramp, door, or window)?	Yes No
* Is travel distance from each guest room doorway to an acceptable means of escape 100 feet or less?	Yes No
* Are smoke detectors installed on every floor and in each sleeping room?	Yes No
* Does the B&B have a no smoking policy for the entire premises?	Yes No
* How many rooms are used for guest sleeping?
* Has the original bedroom capacity of the building been increased by a building addition or remodeling?	Yes No
Does the B&B have any of the following facilities:	Pools Whirlpool, Hot Tubs, Saunas, Steam Rooms Exercise Equipment Tennis or Raquetball Courts Other
If "Yes" to any of the above, provide further details (if a pool provide comments on depth of pool, fencing around the pool, warnings, walking surfaces, lifeguards, or other supervision).
* Are any individuals other than guests allowed to use the above facilities?	Yes No
If "Yes," please explain:
* Are any staff members trained in first aid?	Yes No
If "Yes," please provide details:
List any animals the B&B has on the premises?
* Are there any horses or stable facilities available for the use of guests or the public?	Yes No
If "Yes," is customer riding permitted?	Yes No
* Does the B&B have under its ownership and control any rivers, lakes, ponds, or any other body of water other than swimming pools?	Yes No
If "Yes," does the B&B promote or provide:	Boating Swimming Fishing Ice Skating
* Does the B&B rent, loan, or lease any row boats, canoes, sailboats, or kayaks?	Yes No
If "Yes," please provide number and sizes involved:
* Are there motorboats of any kind?	Yes No
* Is the Named Insured involved in any other rental or lease operations?	Yes No
If "Yes," please provide details:
Will the B&B allow use of its property for or sell, rent or lease equipment for any of the following:	Downhill skiing/snowboarding/sledding Cross Country Skiing Snowmobiling
If "Yes," please provide details:
* Does the B&B groom trails daily?	Yes No
* Are hayrides, sleigh rides or carriage rides provided (or subcontracted out) for guests or the public?	Yes No
What meals are provided to B&B guests?	Breakfast Lunch Dinner
* What is the restaurant seating capacity?
* What are the restaurant's hours of operation?
* Is there a restaurant or bar at the B&B open to the general public?	Yes No
* What are the estimated annual sales from the sale of food and beverages to the general public, and what percentage is this of total receipts?
* Does the restaurant provide only one seating at dinner?	Yes No
* Is there limited selection of dinner entrées with only full dinners served?	Yes No
* What is the bar seating capacity?
* Is the restaurant/bar open for "happy hours"?	Yes No
* What are the restaurant and bar's hours of operation?
* Are there any alcoholic beverages sold or regularly provided to guests or to the general public?	Yes No
If "Yes", please provide details:
* Are all cooking facilities protected by an automatic extinguishing system?	Yes No
If "Yes", please provide specifics:
* Is any a deep fat frying zone?	Yes No
* Does the risk have fireplaces?	Yes No
* Is any individual antique valued at more than $10,000 or are all items valued greater than $25,000?	Yes No
Describe any other activities, business enterprises, etc. not covered by the questions above:

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