Business Information
Business Information
| Business Name |
Richmond Quik Shop (GEI-118)
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| Street Address (Including Unit or Suite, if applicable) |
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| City, State, Zip |
Richmond, IL 60071
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| Mailing Address (If different than business street address above) |
750 Bunker Ct Ste 100, Vernon Hills IL 60061-1864
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| Business Phone |
+18156786139
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| Email Address |
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| Would you like to sign up for the Village E-Blast for current events and information? |
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| Website Address |
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Business Owner Information
| Business Owner(s) Name |
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| Business Owner(s) Home Address |
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| Business Owner(s) Phone Number (Home or Cellphone) |
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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.
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Other Important Information
| Illinois Sales and Use Tax and/or Retailers Occupation Tax |
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| Operating Days |
Sunday, Monday, Tuesday, Wednesday, Thursday, Friday, Saturday
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| Operating Hours |
Monday thru Saturday: 5:00 am to midnight
Sunday: 6:00 am to midnight
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| Number of Shifts |
3
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| Number of Employees |
6
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| Nature of Business |
gas station/convenience store
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Fueling Stations
| Does your business have fueling stations on site? |
Yes
|
Hoses
Police Required Information
| Burglar Alarm |
Yes
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| Fire Alarm |
No
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| Hazardous Materials |
Yes
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Burglar Alarm
| Please Provide Additional Information |
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| Monitoring Agency |
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| Monitoring Agency Telephone Number |
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| Alarm Type |
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Hazardous Materials
| Provide Detail Information |
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Emergency Contacts: Please provide 3 names/phone numbers of key holders who are available 24 hours in case of an emergency.
| 1) Name |
Amber Polcyn
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| 1) Phone Number |
+18176899707
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| 2) Name |
Stephanie Walters
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| 2) Phone Number |
+12244129547
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| 2) Alternate Phone Number |
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| 3) Name |
Shannon Delgado
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| 3) Phone Number |
+18478509030
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Assign Certificate Number
Certification Number
| Certificate No |
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| Fiscal Year |
2026
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