Bar Supplemental Application

Section I – Applicant Information

Section II – Estimated Receipts

Fill in the financial information for the past three (3) years as requested below:

Section III – Business Description

Section IV – Operations

Please provide the following:

Section V – Entertainment

Section VI – Cooking Hazards

Section VII – Life Safety & Security

If applicant employs bouncers, security or doormen:

If Applicant contracts security firms:

Section VIII – Liquor Liability

General Information

If YES, please complete the following:

Average cost of beer/wine/mixed drinks

Does or will the applicant ever offer or allow:

If YES, please complete the following:

Alcohol Safety Awareness

Section IX – Loss / Claim History

If YES, provide the following information on each fine or citation: