Specialty Insurance

Winery Insurance Quote

Complete this comprehensive application to receive a customized insurance quote for your winery, vineyard, or wine-related operation. All fields marked with * are required.

1 General Information

Name of Winery (all legal entities) *

Mailing Address *

City *

State *

Zip Code *

Risk Location (if different from mailing address)

Contact Name *

Title

Business Phone *

Email *

Website

FEIN

Desired Effective Date

Current Insurance Company

Expiring Premium

2 Winery Details

Wine Region

Nearest Town

Corporate Structure *

Corporation Partnership LLC Sole Prop

Full-Time Employees

Part-Time Employees

Seasonal Employees

Winemaker Name

Winemaker Years of Experience

Total Acres Owned

Total Acres Leased

Acres Planted to Grapes

Is the winery open year round?

Management/Ownership changed in last 12 months?

Grape/Wine Varieties Grown

3 Revenue Information

Wine Sales (Estimated Next 12 Months)

Total Gross Wine Sales

Total Cases to be Sold

Sales - Wholesale

Sales - Direct to Consumer

Sales - Direct to Restaurants

On-Site Wine Tastings

Bulk Wine Sales

Grape Sales

Other Revenue Sources

Food Operations

Banquet/Wedding Rentals

Tour Revenue

Guest Lodging Revenue

Custom Crush Revenue

Foreign Sales

4 Operations

Do you have a tasting room?

Do you offer tours?

Provide guest lodging?

Events rented to others (avg/year)

Average event attendance

Bottle wine for others?

Custom crush for others?

Store wine for others?

5 Property & Wine Inventory

Buildings & Equipment (Replacement Cost)

Main Building Value

Winemaking Equipment

Total Tanks Value

Agricultural Equipment

Wine Inventory

Bulk Wine - Max Gallons

Bulk Wine - Avg Value/Gallon

Cased Goods - Max Cases

Library Collection - Cases

Library Collection Value

Total Barrels

6 Liability & Claims History

Liquor License Name

License ever suspended?

Servers certified (SIP/TIPS)?

Quality control program?

Ever had product recall?

Claims or lawsuits in last 5 years (describe):

Business Interruption coverage needed?

Umbrella coverage needed?

Additional Comments or Information

I/We declare that the information in this application is true and correct and I/we have not withheld any relevant information. I/We understand that any statement made in this application will be treated as a statement made by all of the people to be insured.

Applicant Printed Name *

Title *

A member of our team will contact you within 1-2 business days.

Need Help With Your Application?

Our winery insurance specialists are ready to assist you with any questions.

(425) 242-5357 quoterequests@firstunderwriters.com