Bowling Supplemental Application

XChange Bowling Supplemental App

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Cover Page Information

Executive summary

Reason for marketing

Effective Date

MM slash DD slash YYYY

Need By Date

MM slash DD slash YYYY

Target Premium

Coverage needs

Describe any LOB beyond GL, UMB, Property that will be needed

Diligent Effort Information

Carrier 1 Contacted

Carrier Contact Date

MM slash DD slash YYYY

Carrier 1 Reason For Decline

Carrier 2 Contacted

Carrier 2 Reason For Decline

Carrier 3 Contacted

Carrier 3 Reason For Decline

Contact Information

Legal name of business(Required)

DBA (if applicable)

Primary Contact Name

First Last

Phone

FEIN / Tax I.D. number

Building Information

Location address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mailing address (if different)

Building construction type(Required)

(e.g., masonry, frame, steel, etc.)

Square footage(Required)

Year built(Required)

If built more than 15 years ago, provide update years below.

Year of update - electrical

Year of update - heating

Year of update - plumbing

Year of update - roof

Is the building sprinklered?(Required)

If the building is partially sprinklered, put "Yes"

Yes

Is there a fire/smoke alarm system?(Required)

Yes

Is the fire/smoke alarm system centrally monitored?(Required)

Yes

Does the building have emergency backup lighting?(Required)

Yes

Does the building have a bow-truss roof?(Required)

Yes

What is the age of the ball return equipment

If it's original with the building, leave this blank

How often is the ball return system full maintenance cycle?

How many exits from your building?

Do exits discharge to a safe exterior area?(Required)

Yes

Bowling Operations

Total years in business?

Number of bowling lanes?

Hours - summer

if applicable

Hours - winter

if applicable

Hours - late nights / special events

Annual Receipts/Sales

Bowling receipts ($)(Required)

Food receipts ($)(Required)

Alcohol receipts ($)(Required)

Arcade / gaming receipts ($)(Required)

Total receipts ($)

Lane construction type (pick one)(Required)

Wood

Synthetic

Lane finish material (pick one)(Required)

Oil

Water-Based

Confirm whether you use flammable waxes/solvents on your lanes(Required)

Confirmed. We do not use flammable waxes/ solvents.

We use flammable waxes/solvents on our lanes.

Pin maintenance on premises(Required)

Pins are not refinished on premises

Pins are repainted/refinished on premises

Describe the repainting/refinishing work done on pins on premises

Are flammable liquids stored on premises?(Required)

Yes

If yes, list products and quantities

Business Mix (% of operations)

League Play (% of total bowling)

Open Play (% of total bowling)

Tournament Play (% of total bowling)

Maximum registered bowlers during tournaments

Maximum total occupancy (including spectators)

Is there a pro shop on premises?(Required)

Yes

Pro Shop Questions

Is your pro shop operated by employees or a third party?

Employees

Third party

Pro shop annual sales/receipts ($)

Is the space leased?

Yes

Square footage leased

Is a Certificate of Insurance obtained from the lessee?(Required)

Yes

Is your business named as Additional Insured?(Required)

Yes

Is there a Hold Harmless agreement in place?(Required)

Yes

Childcare Questions

Describe childcare services offered

Are childcare services operated by employees or a contractor?

Employees

Contractor

Is a Certificate of Insurance obtained from the contractor?(Required)

Yes

Is your business added as Additional Insured on the COI?(Required)

Yes

Does your business have a Hold Harmless agreement with the contractor?(Required)

Yes

Square footage of childcare area(Required)

Restaurant / Bar / Vending Questions

Business operations (check all that apply)(Required)

Restaurant

Bar/Lounge

Vending

Banquet/Event Space

Liquor license type

Are all servers/bartenders trained and certified in compliance with your state's alcoholic beverage commission?(Required)

Yes

Kitchen Protections

Does your kitchen have a hood and duct system?(Required)

Yes

Is there a third-party cleaning contract for the hood & duct system?(Required)

Yes

What is the frequency of hood & duct cleanings?

Is there an automated fire suppression system?(Required)

Yes

Is a deep fryer present in your kitchen?(Required)

Yes

Is food/beverages allowed in bowling area?(Required)

Yes

Bar/Lounge Exposure

Does your bar/lounge have a separate entrance?(Required)

Yes

Do you have live entertainment?(Required)

Yes

Describe live entertainment

Is there a dedicated space for a dance floor?(Required)

Yes

Dance floor square footage (estimated)

Are security or off-duty police officers provided?(Required)

Yes

Describe your security program

File upload

Max. file size: 98 MB.

XChange Bowling Supplemental App

Cover Page Information

Diligent Effort Information

Contact Information

Building Information

Bowling Operations

Annual Receipts/Sales

Business Mix (% of operations)

Pro Shop Questions

Other Recreational Questions

Childcare Questions

Restaurant / Bar / Vending Questions

Kitchen Protections

Bar/Lounge Exposure