Mike Humphrey Larry Wayman A.W. (Bill) Bailey, Jr. Wes Bailey George Kidwell
   
   
     
   
 
Please complete and submit the form below, or click here to download a printable version, which you can complete and fax to (254) 753-1132.
Young Chefs Franchise Insurance Questionnaire

Name of Entity that will own the franchise: 
Mailing Address:
Physical Address (if different):
Contact Person:
Telephone No:
Fax Number:  Email Address: 
 
Date when you need coverage to begin: 
*We suggest that the effective date of your insurance be no later than the date upon which you take possession of the premises.

Federal Tax ID No: 

Applicant is:
 Individual  Corporation  Limited Liability Corp  Other (please specify) 

Do you own the Building you’ll be occupying?  Yes   No
If yes, what is the replacement cost value of the Building? 

Limit of Business Personal Property coverage desired: 
*This limit is to include any improvements or betterments to your leased space, as well as any equipment, furniture, supplies or products.
 
Is there a Bank or any other Financial Institution that you’re using to finance your business that needs to be added as a Lienholder to your policy?   Yes   No
If Yes, give name and address:
Name:     
Address:  
 
Building Construction Type?
  Frame/ Wood
  Brick with Wood Frame Construction
  Brick with Steel Frame
  Tilt up Wall Steel Frame
  Other:  
 
Total square feet of space you're occupying    Year your building was built  
Fire Alarm: YES  NO      Fire Extinguishers: YES  NO
Burglar Alarm: YES  NO  
If yes, is it just a local alarm or is it connected to a Central Station?  
 
Additional Insureds (for Liability Purposes) include:
1) Young Chefs International, L.P., 1404 South New Road, Waco, TX 76711
2) (Name & Address of Building Lessor)
 
What is the approximate average number of kids that will be in your classes each day? $
Total Estimated Annual Payroll (including all Owners & Executive Officers) $  # of Employees
 
Names and titles of all Owners & Executive Officers   
 
 
In order to receive a written quotation, please complete & submit this form.
Should you have any questions, please call (254) 753-5317
Note: Your completing this form does not initiate coverage.