Mixing Bowl Kitchen Application
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Business Name *
Trade Name *
Business Structure *
State of Formation *
Do you have an EIN? *
Business Address *
Phone *
Website / Social *
Primary Contact Name  *
Title/Role *
Phone *
Email *
Are you the primary day-to-day operator?  *
Will any minors be present? *
Total Number of Employees (including owner) *
Number of Employees Requiring Kitchen Access *
Number of Employees Per Shift (max at one time) *
Do you anticipate hiring additional staff during your contract term? *
If yes, estimated additional employees *
Describe your product(s) *
Product Type *
Sales Channel *
Distribution Locations *
Estimated Monthly Revenue *
Estimated Monthly Hours *
Preferred Days/Times *
Minimum Hours Needed  *
Seasonal Fluctuation? *
Seasonal Notes *
Desired Term  *
Preferred Start Date *
MM
/
DD
/
YYYY
Open to Minimum Commitment? *
Equipment you will bring onsite *
Any special utilities needs? *
Utilities Details *
Storage Needed *
Storage Size Estimate *
Food safety certified? *
Certification Type *
Do you hold required licenses? *
License Details *
Any prior health violations? *
Violation Details *
Do you carry general liability insurance? *
Coverage Amount *
Will you name the facility as additional insured? *
Any felony convictions? *
Details *
Any pending legal issues? *
Details *
How do you handle conflict in shared spaces? *
Any prior disputes with landlords or shared kitchens? *
How do you maintain cleanliness? *
What does success look like for your operations? *
Do you acknowledge that no meat or poultry is allowed on facility floor?  *
Do you acknowledge that violations may impact the facility’s kosher certification? *
Required
Do you have your full ingredient list? *
Do any ingredients contain alcohol? *
Are any ingredients prepared outside this facility? *
Details *
Are all ingredients kosher certified? *
Do you confirm no meat or meat-derived ingredients will be brought into the facility?  *
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