Questionnaire

2. Referral Source
How did you hear of us? (News, Internet, CA Hospitality Coalition, Food & Wine, Attorney, Friend, Other)*

3. Policy Information
PRIVILEGED & CONFIDENTIAL – ATTORNEY CLIENT COMMUNICATION
Who is the Carrier (insurance company)?*
What is the name of your business and where is it located (city and state)?*
Can you send us the policy?*
- Yes
- No
If you know, what are your policy limits for business interruption?*

4. Business Interruption Claim (Damages)
What is the current status of your business (i.e. completely shut down, open for take-out only, etc.)? Please include relevant dates where applicable (i.e. date business became open for takeout only).*
Can you estimate what your lost profits are so far?*
Have you made a claim for BI with your insurance company regarding COVID-19?*
- Yes
- No
please provide a brief description of what has gone on in the claim to date (when was the claim opened, what have you submitted to the carrier regarding losses, what has the carrier’s response been):*