{"id":7050,"date":"2024-01-30T06:25:15","date_gmt":"2024-01-30T12:25:15","guid":{"rendered":"http:\/\/best-formula-insurance-services.three.zysites.com\/?page_id=7050"},"modified":"2024-01-30T06:28:56","modified_gmt":"2024-01-30T12:28:56","slug":"general-liability-request","status":"publish","type":"page","link":"https:\/\/www.bestformulainsurance.com\/es\/general-liability-request\/","title":{"rendered":"General Liability Request"},"content":{"rendered":"<p>&nbsp;<\/p>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'>After submitting your request, we have a verification process in place. We will review the information provided and contact the insured to confirm the details. Our customers private information's security is a top priority. Once they confirm to release the certificate, you will be receiving it to the email requested. If you have any questions you can call us at (888)242-9922. The Certificate of Liability will be sent by email.<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/es\/wp-json\/wp\/v2\/pages\/7050' data-formid='11' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6LeVrXshAAAAAJ2AIMbEnFbMCwEuwzz5yuvnPiic' data-tabindex='0'><input id=\"input_e85d73a21a0b46b4c09a843dddcafe5f\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_e85d73a21a0b46b4c09a843dddcafe5f\" value=\"\"\/><\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_above description_below validation_below' data-column-layout='fill'><div id=\"field_11_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7c5d3a21\" data-field-span=\"12\"><h3 class=\"gsection_title\">Insureds Information<\/h3><\/div><div id=\"field_11_16\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"a4533de0\" data-field-span=\"6\"><label id='gfield_label_11_16' class='gfield_label gform-field-label' for='input_11_16'><span class='gform-field-label__text'>Name, Company Name or DBA<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_11_16' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_30\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"a4533de0\" data-field-span=\"6\"><label id='gfield_label_11_30' class='gfield_label gform-field-label' for='input_11_30'><span class='gform-field-label__text'>Policy Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_11_30' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_10\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"e6216e3c\" data-field-span=\"12\"><h3 class=\"gsection_title\">Company Request the Certificate<\/h3><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"635edd30\" data-field-span=\"12\"><label id='gfield_label_11_20' class='gfield_label gform-field-label' for='input_11_20'><span class='gform-field-label__text'>Requester<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_11_20' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"654ebb58\" data-field-span=\"12\"><label id='gfield_label_11_21' class='gfield_label gform-field-label' for='input_11_21'><span class='gform-field-label__text'>Name on Certificate<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_11_21' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_4\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"aaa2ed03\" data-field-span=\"12\"><legend id='gfield_label_11_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Company Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gform-grid-row' id='input_11_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_11_4_1_container' >\n                                        <label for='input_11_4_1' id='input_11_4_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                        <input type='text' name='input_4.1' id='input_11_4_1' value=''    aria-required='true'   autocomplete=\"address-line1\" aria-labelledby=\"input_11_4_1_label gfield_label_11_4\"\/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_11_4_2_container' >\n                                        <label for='input_11_4_2' id='input_11_4_2_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n 2<\/label>\n                                        <input type='text' name='input_4.2' id='input_11_4_2' value=''    autocomplete=\"address-line2\" aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_11_4_3_container' >\n                                    <label for='input_11_4_3' id='input_11_4_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                    <input type='text' name='input_4.3' id='input_11_4_3' value=''    aria-required='true'   autocomplete=\"address-level2\" \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_11_4_4' value='Virginia'\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_11_4_5_container' >\n                                    <label for='input_11_4_5' id='input_11_4_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                    <input type='text' name='input_4.5' id='input_11_4_5' value=''    aria-required='true'   autocomplete=\"postal-code\" \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_11_4_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_11_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2ba7fd4b\" data-field-span=\"6\"><legend id='gfield_label_11_24' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Include Coverages<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_24'><div class='gchoice gchoice_11_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='Additional Insured'  id='choice_11_24_1'    aria-labelledby=\"label_11_24_1 gfield_label_11_24\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_1' id='label_11_24_1' class='gform-field-label gform-field-label--type-inline'>Additional Insured<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_24_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.2' type='checkbox'  value='Certificate Holder'  id='choice_11_24_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_2' id='label_11_24_2' class='gform-field-label gform-field-label--type-inline'>Certificate Holder<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_24_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.3' type='checkbox'  value='Primary &amp; Non-Contributory'  id='choice_11_24_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_3' id='label_11_24_3' class='gform-field-label gform-field-label--type-inline'>Primary &amp; Non-Contributory<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_24_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.4' type='checkbox'  value='Waiver of Subrogation'  id='choice_11_24_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_24_4' id='label_11_24_4' class='gform-field-label gform-field-label--type-inline'>Waiver of Subrogation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_23\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2ba7fd4b\" data-field-span=\"6\"><legend id='gfield_label_11_23' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Include Insurance Types<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_11_23'><div class='gchoice gchoice_11_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='Automobile Liability'  id='choice_11_23_1'    aria-labelledby=\"label_11_23_1 gfield_label_11_23\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_23_1' id='label_11_23_1' class='gform-field-label gform-field-label--type-inline'>Automobile Liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_23_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.2' type='checkbox'  value='Umbrella Liability'  id='choice_11_23_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_23_2' id='label_11_23_2' class='gform-field-label gform-field-label--type-inline'>Umbrella Liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_23_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.3' type='checkbox'  value='Excess Liability'  id='choice_11_23_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_23_3' id='label_11_23_3' class='gform-field-label gform-field-label--type-inline'>Excess Liability<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_11_23_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.4' type='checkbox'  value='Workers&#039; Compensation'  id='choice_11_23_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_23_4' id='label_11_23_4' class='gform-field-label gform-field-label--type-inline'>Workers' Compensation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"d29d6400\" data-field-span=\"6\"><label id='gfield_label_11_25' class='gfield_label gform-field-label' for='input_11_25'><span class='gform-field-label__text'>Additional Information<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_11_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_26\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"d29d6400\" data-field-span=\"6\"><label id='gfield_label_11_26' class='gfield_label gform-field-label' for='input_11_26'><span class='gform-field-label__text'>Additional Information<\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='10240000' \/><input name='input_26' id='input_11_26' type='file' class='large' aria-describedby=\"gfield_upload_rules_11_26\" onchange='javascript:gformValidateFileSize( this, 10240000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_11_26'>Tama\u00f1o m\u00e1ximo de archivo: 10 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_11_26'><\/div> <\/div><\/div><div id=\"field_11_27\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"9e145df0\" data-field-span=\"12\"><h3 class=\"gsection_title\">Submission<\/h3><\/div><fieldset id=\"field_11_28\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"41a17122\" data-field-span=\"12\"><legend id='gfield_label_11_28' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_11_28'>\n                            \n                            <span id='input_11_28_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_11_28_3' id='input_11_28_3_label' class='gform-field-label gform-field-label--type-sub '>Nombre<\/label>\n                                                    <input type='text' name='input_28.3' id='input_11_28_3' value=''   aria-required='true'     aria-labelledby=\"input_11_28_3_label gfield_label_11_28\"\/>\n                                                <\/span>\n                            \n                            <span id='input_11_28_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_11_28_6' id='input_11_28_6_label' class='gform-field-label gform-field-label--type-sub '>Apellidos<\/label>\n                                                            <input type='text' name='input_28.6' id='input_11_28_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_11_29\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"6004f34a\" data-field-span=\"12\"><label id='gfield_label_11_29' class='gfield_label gform-field-label' for='input_11_29'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Obligatorio)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_29' id='input_11_29' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_11' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' 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