Village Of Richmond

Business Registration

Apr 12, 2024
submission #187
  • renewal
Business Information

Business Information

Business Name Richmond Quik Shop (GEI-118)
Street Address (Including Unit or Suite, if applicable) ---
City, State, Zip Richmond, IL 60071
Mailing Address (If different than business street address above) 750 Bunker Ct Ste 100, Vernon Hills IL 60061-1864
Business Phone +18156786139
Email Address ---
Would you like to sign up for the Village E-Blast for current events and information? ---
Website Address ---

Business Owner Information

Business Owner(s) Name ---
Business Owner(s) Home Address ---
Business Owner(s) Phone Number (Home or Cellphone) ---

Is This A New Business?

Is This A New Business? No, my business was registered under the same name prior to May 1st of this year.

Other Important Information

Illinois Sales and Use Tax and/or Retailers Occupation Tax ---
Operating Days Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
Operating Hours Monday thru Saturday: 5:00 am to midnight Sunday: 6:00 am to midnight
Number of Shifts 3
Number of Employees 5
Nature of Business gas station/convenience store

Fueling Stations

Does your business have fueling stations on site? Yes

Hoses

Number of gas hoses 12

Police Required Information

Burglar Alarm Yes
Fire Alarm No
Hazardous Materials Yes

Burglar Alarm

Please Provide Additional Information ---
Monitoring Agency ---
Monitoring Agency Telephone Number ---
Alarm Type ---

Hazardous Materials

Provide Detail Information ---

Emergency Contacts: Please provide 3 names/phone numbers of key holders who are available 24 hours in case of an emergency.

1) Name Elmer Gomez
1) Phone Number +12245459230
2) Name Shannon Delgado
2) Phone Number +18478509030
2) Alternate Phone Number
3) Name Harold DuBose
3) Phone Number +12247751690
Assign Certificate Number

Certification Number

Certificate No ---
Fiscal Year 2025