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🥤 Specialty Quote Form

Smoothie Shop & Juice Bar Insurance Quote

Complete this questionnaire for your smoothie shop or juice bar. A licensed broker will respond with coverage options within one business day.

✓ No obligation
✓ Multiple carriers compared
✓ Response within 1 business day
✓ 18+ years commercial experience
0% complete
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Policy Timing

Coverage start, takeover, or expiration date

Effective / Start Date * Reason for This Date * Select one... New shop / opening date Current policy expiration date Shop acquisition / takeover date Mid-term switch Other Current Policy Expiration Date (if renewing or switching) Do You Own or Lease This Smoothie Shop Property? *
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Business Identity

Legal name, DBA, EIN, and experience

Entity / Legal Name * DBA / Shop Name (if different) EIN # * Legal Entity Type * Select... Sole Proprietorship Partnership LLC S-Corporation C-Corporation Other Years of Experience in Smoothie / Food & Beverage Business * Month & Year Business Started at This Location * 📍 Property & Mailing Addresses Shop / Property Address Street Address * City * State * Select... WashingtonOregonIdaho NevadaArkansasSouth Dakota PennsylvaniaTexasIndiana Other ZIP Code * County * Inside or Outside City Limits? *
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Property & Mailing Addresses

Shop / Property Address
Mailing Address (if different from above)
Mailing Street Address City State ZIP 👤 Owner / Contact Information Owner's Full Name * Owner's Cell Phone * Owner's Email Address * Hours of Operation * 🏗️ Building DetailsConstruction, size, outdoor space, and renovation history Year Building Was Built * Building Construction Type * Select... Wood frame Brick Metal Concrete / Masonry Mixed Shop Interior Sq Ft (customer area + prep/kitchen) * Number of Stories * Select... 1 story2 stories 3+ stories Is There a Basement? *
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Owner / Contact Information

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Building Details

Construction, size, outdoor space, and renovation history

Total Property Area Sq Ft (shop + seating + parking if owned) * Outdoor Seating or Patio?
Describe Outdoor Seating / Patio Renovation History — Most Recent Year for Each System Plumbing Updated Wiring Updated Heating Updated Roof Updated Other Buildings Do You Own Any Other Buildings Adjacent to the Shop?
Renovation History — Most Recent Year for Each System
Other Buildings
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Employees & Operations

Full-Time Employees * Part-Time Employees * Total Annual Payroll * Select range... Under $50,000$50,000 – $100,000 $100,000 – $250,000$250,000 – $500,000 $500,000 – $1,000,000Over $1,000,000 Cash Kept Overnight (cash drawer limit) * 🔒 Safety & Security Systems Alarm System Type *
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Safety & Security Systems

Cameras — Inside Cameras — Outside Do You Have and Use a Safe on Premises?
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Property Values & Coverage

Building, equipment, inventory, and spoilage

Equipment note: List blenders, juicers, refrigeration units, freezers, POS systems, and furniture separately from inventory. These are distinct coverage categories.
Estimated Value of Building (building structure only, exclude equipment) Estimated Value of Equipment & Fixtures (blenders, juicers, refrigeration, POS, furniture) * Estimated Value of Inventory (fresh/frozen ingredients, bottles, cups, supplements, retail items) * Food Spoilage / Refrigeration Breakdown Coverage Needed?
How Much Coverage? 📊 Annual Sales BreakdownEstimates by category — carriers rate by revenue type Why the breakdown? Supplement and retail sales carry different product liability exposures than blended drinks. Providing estimates by category helps underwriters assign the right coverage and rate. Revenue Category Estimated Annual Amount Smoothies & Blended Drinks Juices / Cold-Pressed Acai Bowls & Food Items Bottled / Packaged Drinks Supplements & Retail Items Other (merchandise, classes, etc.) Total Annual Gross Sales 🥝 Menu, Ingredients & OperationsWhat you use, how you prepare it, and who you serve Main Ingredients Used (fresh fruits, vegetables, dairy/alternatives, frozen items) * Do You Offer Add-Ins or Supplements? (protein powder, vitamins, CBD/hemp, adaptogens) *
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Annual Sales Breakdown

Estimates by category — carriers rate by revenue type

Why the breakdown? Supplement and retail sales carry different product liability exposures than blended drinks. Providing estimates by category helps underwriters assign the right coverage and rate.
Revenue Category Estimated Annual Amount
Smoothies & Blended Drinks
Juices / Cold-Pressed
Acai Bowls & Food Items
Bottled / Packaged Drinks
Supplements & Retail Items
Other (merchandise, classes, etc.)
Total Annual Gross Sales
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Menu, Ingredients & Operations

What you use, how you prepare it, and who you serve

What Add-Ins / Supplements? Supplement Sales as % of Total Do Any Supplements Contain CBD / Hemp Products?
Allergen-Heavy Items Sold? (nuts, dairy, soy, gluten) *
Which Allergens? Cross-Contamination Prevention Procedures?
Number & Type of Major Equipment * Do You Prepare Any Cooked Food Items? (toasting, grilling for bowls, warming) *
Describe Cooking Equipment & Operations Do You Use Deep Frying or Open Flame Cooking? *
Indoor Seating Capacity Outdoor / Patio Seating Capacity 🚀 Delivery, Special Features & Events (Optional)Anything that extends your exposure beyond the four walls Third-Party Delivery Services? (DoorDash, Uber Eats, etc.)
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Delivery, Special Features & Events (Optional)

Anything that extends your exposure beyond the four walls

Which Platforms? Delivery as % of Total Sales Any Fast-Casual or Grab-and-Go Features? Any Tastings, Events, or Classes on Premises?
Describe Events / Classes Any Unique Features? 📋 Current Insurance & Claims History Current Insurance Company Current Policy Number Any Claims in the Last 5 Years? *
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Current Insurance & Claims History

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Upload Documents (Optional)

Attach current dec pages and/or loss runs to speed up quoting

Current Dec Page(s)
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Declarations Page

PDF, JPG, PNG, or DOC — max 10 MB

    Loss Runs
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    Loss Run Report

    3–5 years preferred — PDF, XLS, or DOC

      Max 10 MB per file  ·  You can also email documents directly to CommercialInsuranceAgency@gmail.com

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