Free Quotations
   NEW YORK RESTAURANTS
Tom Larsen, CEO
NY Restaurant Specialist

Let me show you how I
save most restaurant owners
an average of 37% on their
Restaurant Insurance. I have
New York's best restaurant
insurance carriers, and as a
restaurant owner myself, I
have the knowledge and
experience to help you
SAVE BIG MONEY!

Easy Online Application

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   NY Restaurant Insurance.com,
   Tom Larsen Insurance Agency

   6351 Transit Rd.

   Lancaster, NY 14043

   PHONE: (800) 914-1178

   FAX:(716) 684-3642

   E-Mail: tom@nyrestaurant
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Restaurant "Quick Quote" Application

Complete this 2 minute form, and we will show you how much
we can save you on your Restaurant Insurance Plan!

Your Name/Restaurant Name:  
Contact Phone Number:  
Your E-Mail Address:  
Confirm E-mail Address Again:  
Location City, State and Zip Code (Must be in New York):  
Restaurant Type:  
Current Insurance Company:  
Renewal Date:  
Current Cost:  
Any Claims in the Last 3 Years?  
Liquor Liability Included in Current Coverage?  
Building Coverage:  
Age of Building:  
Business Property Amount:  
Ansul Type:  
Deductible:  
Catering?  
Patio?  
Live Music?  
DJ?  
Total Square Footage:  
Public Access Sq. Ft.:  
Approximate Gross Sales:  
Food Sale %:  
Alcohol Sale %:  
Number of Employees: