JotForm.setConditions([{"action":[{"id":"action_1582140980882","visibility":"Hide","isError":false,"field":"51"}],"id":"1582140996056","index":"0","link":"Any","priority":"0","terms":[{"id":"term_1582140980882","field":"37","operator":"equals","value":"Personal Insurance","isError":false}],"type":"field"},{"action":[{"id":"action_1565615259677","skipHide":"hidePage","skipTo":"page-3","isError":false}],"id":"1565615274715","index":"1","link":"Any","priority":"1","terms":[{"id":"term_1565615259677","field":"37","operator":"equals","value":"Personal Insurance","isError":false}],"type":"page"},{"action":[{"id":"action_0_1565615333821","skipTo":"page-2","isError":false,"skipHide":"hidePage"}],"id":"1565614855716","index":"5","link":"Any","priority":"5","terms":[{"id":"term_0_1565615333821","field":"37","operator":"equals","value":"Commercial Insurance","isError":false}],"type":"page"}]);
JotForm.init(function(){
if (window.JotForm && JotForm.accessible) $('input_51').setAttribute('tabindex',0);
if (window.JotForm && JotForm.accessible) $('input_44').setAttribute('tabindex',0);
JotForm.newDefaultTheme = false;
/*INIT-END*/
});
JotForm.prepareCalculationsOnTheFly([null,{"name":"justFive1","qid":"1","text":"Just five minutes can get you the quote you need.","type":"control_head"},{"name":"submitForm","qid":"2","text":"Submit Form","type":"control_button"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"name":"input18","qid":"18","text":"","type":"control_checkbox"},null,null,null,null,null,null,null,null,null,null,null,null,{"name":"personalInsurance","qid":"31","text":"Personal Insurance","type":"control_head"},null,null,null,null,null,{"description":"","name":"butter","qid":"37","text":"What type of insurance are you looking for today?","type":"control_radio"},null,null,{"name":"pageBreak40","qid":"40","text":"Page Break","type":"control_pagebreak"},null,{"name":"commercialInsurance","qid":"42","text":"Commercial Insurance","type":"control_head"},{"description":"","name":"input43","qid":"43","text":"","type":"control_checkbox"},{"description":"","name":"additionalCommentsquestions","qid":"44","subLabel":"","text":"Additional Comments\u002FQuestions","type":"control_textarea"},{"description":"","name":"emailAddress","qid":"45","subLabel":"example@example.com","text":"Email Address","type":"control_email"},{"name":"pageBreak","qid":"46","text":"Page Break","type":"control_pagebreak"},{"name":"pageBreak47","qid":"47","text":"Page Break","type":"control_pagebreak"},{"description":"","name":"name","qid":"48","text":"Name","type":"control_fullname"},{"description":"","name":"phoneNumber","qid":"49","text":"Phone Number","type":"control_phone"},{"name":"yourInformation","qid":"50","text":"Your Information","type":"control_head"},{"description":"","name":"businessName","qid":"51","subLabel":"","text":"Business Name","type":"control_textbox"}]);
setTimeout(function() {
JotForm.paymentExtrasOnTheFly([null,{"name":"justFive1","qid":"1","text":"Just five minutes can get you the quote you need.","type":"control_head"},{"name":"submitForm","qid":"2","text":"Submit Form","type":"control_button"},null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"name":"input18","qid":"18","text":"","type":"control_checkbox"},null,null,null,null,null,null,null,null,null,null,null,null,{"name":"personalInsurance","qid":"31","text":"Personal Insurance","type":"control_head"},null,null,null,null,null,{"description":"","name":"butter","qid":"37","text":"What type of insurance are you looking for today?","type":"control_radio"},null,null,{"name":"pageBreak40","qid":"40","text":"Page Break","type":"control_pagebreak"},null,{"name":"commercialInsurance","qid":"42","text":"Commercial Insurance","type":"control_head"},{"description":"","name":"input43","qid":"43","text":"","type":"control_checkbox"},{"description":"","name":"additionalCommentsquestions","qid":"44","subLabel":"","text":"Additional Comments\u002FQuestions","type":"control_textarea"},{"description":"","name":"emailAddress","qid":"45","subLabel":"example@example.com","text":"Email Address","type":"control_email"},{"name":"pageBreak","qid":"46","text":"Page Break","type":"control_pagebreak"},{"name":"pageBreak47","qid":"47","text":"Page Break","type":"control_pagebreak"},{"description":"","name":"name","qid":"48","text":"Name","type":"control_fullname"},{"description":"","name":"phoneNumber","qid":"49","text":"Phone Number","type":"control_phone"},{"name":"yourInformation","qid":"50","text":"Your Information","type":"control_head"},{"description":"","name":"businessName","qid":"51","subLabel":"","text":"Business Name","type":"control_textbox"}]);}, 20);
@import '//fonts.googleapis.com/css?family=Open+Sans:light,lightitalic,normal,italic,bold,bolditalic';
.form-label-left{
width:150px;
}
.form-line{
padding-top:12px;
padding-bottom:12px;
}
.form-label-right{
width:150px;
}
.form-all{
width:700px;
color:#ffffff !important;
font-family:'Open Sans';
font-size:14px;
}
.form-radio-item label, .form-checkbox-item label, .form-grading-label, .form-header{
color: false;
}
/* Injected CSS Code */
@import "https://fonts.googleapis.com/css?family=Open+Sans:light,lightitalic,normal,italic,bold,bolditalic";
.form-all:after {
content: "";
display: table;
clear: both;
}
.form-all {
font-family: "Open Sans", sans-serif;
}
.form-all {
width: 700px;
}
.form-label-left,
.form-label-right {
width: 150px;
}
.form-label {
white-space: normal;
}
.form-label.form-label-auto {
display: block;
float: none;
word-break: break-word;
text-align: left;
}
.form-label-left {
display: inline-block;
white-space: normal;
float: left;
text-align: left;
}
.form-label-right {
display: inline-block;
white-space: normal;
float: left;
text-align: right;
}
.form-label-top {
white-space: normal;
display: block;
float: none;
text-align: left;
}
.form-radio-item label:before {
top: 0;
}
.form-all {
font-size: 14px;
}
.form-label {
font-weight: bold;
}
.form-checkbox-item label,
.form-radio-item label {
font-weight: normal;
}
.supernova {
background-color: #0b7bd0;
background-color: #ffffff;
}
.supernova body {
background-color: transparent;
}
/*
@width30: (unit(@formWidth, px) + 60px);
@width60: (unit(@formWidth, px)+ 120px);
@width90: (unit(@formWidth, px)+ 180px);
*/
/* | */
@media screen and (min-width: 480px) {
.supernova .form-all {
border: 1px solid #e6e6e6;
-webkit-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
-moz-box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
box-shadow: 0 3px 9px rgba(0, 0, 0, 0.1);
}
}
/* | */
/* | */
@media screen and (max-width: 480px) {
.jotform-form .form-all {
margin: 0;
width: 100%;
}
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 767px) {
.jotform-form .form-all {
margin: 0;
width: 100%;
}
}
/* | */
/* | */
@media screen and (min-width: 480px) and (max-width: 699px) {
.jotform-form .form-all {
margin: 0;
width: 100%;
}
}
/* | */
/* | */
@media screen and (min-width: 768px) {
.jotform-form {
padding: 60px 0;
}
}
/* | */
/* | */
@media screen and (max-width: 699px) {
.jotform-form .form-all {
margin: 0;
width: 100%;
}
}
/* | */
.supernova .form-all,
.form-all {
background-color: #0b7bd0;
border: 1px solid transparent;
}
.form-header-group {
border-color: #085ea0;
}
.form-matrix-table tr {
border-color: #085ea0;
}
.form-matrix-table tr:nth-child(2n) {
background-color: #0a6db8;
}
.form-all {
color: #ffffff;
}
.form-header-group .form-header {
color: #ffffff;
}
.form-header-group .form-subHeader {
color: #ffffff;
}
.form-sub-label {
color: #ffffff;
}
.form-label-top,
.form-label-left,
.form-label-right,
.form-html {
color: #ffffff;
}
.form-checkbox-item label,
.form-radio-item label {
color: #ffffff;
}
.form-line.form-line-active {
-webkit-transition-property: all;
-moz-transition-property: all;
-ms-transition-property: all;
-o-transition-property: all;
transition-property: all;
-webkit-transition-duration: 0.3s;
-moz-transition-duration: 0.3s;
-ms-transition-duration: 0.3s;
-o-transition-duration: 0.3s;
transition-duration: 0.3s;
-webkit-transition-timing-function: ease;
-moz-transition-timing-function: ease;
-ms-transition-timing-function: ease;
-o-transition-timing-function: ease;
transition-timing-function: ease;
background-color: #ffffe0;
}
/* omer */
.form-radio-item,
.form-checkbox-item {
padding-bottom: 0px !important;
}
.form-radio-item:last-child,
.form-checkbox-item:last-child {
padding-bottom: 0;
}
/* omer */
.form-single-column .form-checkbox-item,
.form-single-column .form-radio-item {
width: 100%;
}
.form-checkbox-item .editor-container div,
.form-radio-item .editor-container div {
position: relative;
}
.form-checkbox-item .editor-container div:before,
.form-radio-item .editor-container div:before {
display: inline-block;
vertical-align: middle;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
left: 0;
width: 18px;
height: 18px;
}
.supernova {
height: 100%;
background-repeat: no-repeat;
background-attachment: scroll;
background-position: center top;
background-repeat: repeat;
}
.supernova {
background-image: none;
}
#stage {
background-image: none;
}
/* | */
.form-all {
background-repeat: no-repeat;
background-attachment: scroll;
background-position: center top;
background-repeat: repeat;
}
.form-header-group {
background-repeat: no-repeat;
background-attachment: scroll;
background-position: center top;
}
.form-line {
margin-top: 12px;
margin-bottom: 12px;
}
.form-line {
padding: 12px 36px;
}
.form-all .qq-upload-button,
.form-all .form-submit-button,
.form-all .form-submit-reset,
.form-all .form-submit-print {
font-size: 1em;
padding: 9px 15px;
font-family: "Open Sans", sans-serif;
font-size: 14px;
font-weight: normal;
}
.form-all .form-pagebreak-back,
.form-all .form-pagebreak-next {
font-size: 1em;
padding: 9px 15px;
font-family: "Open Sans", sans-serif;
font-size: 14px;
font-weight: normal;
}
/*
& when ( @buttonFontType = google ) {
@import (css) "@{buttonFontLink}";
}
*/
h2.form-header {
line-height: 1.618em;
font-size: 1.714em;
}
h2 ~ .form-subHeader {
line-height: 1.5em;
font-size: 1.071em;
}
.form-header-group {
text-align: left;
}
/*.form-dropdown,
.form-radio-item,
.form-checkbox-item,
.form-radio-other-input,
.form-checkbox-other-input,*/
.form-captcha input,
.form-spinner input,
.form-error-message {
padding: 4px 3px 2px 3px;
}
.form-header-group {
font-family: "Open Sans", sans-serif;
}
.form-section {
padding: 0px 0px 0px 0px;
}
.form-header-group {
margin: 12px 36px 12px 36px;
}
.form-header-group {
padding: 24px 0px 24px 0px;
}
.form-textbox,
.form-textarea {
padding: 4px 3px 2px 3px;
}
.form-textbox,
.form-textarea,
.form-radio-other-input,
.form-checkbox-other-input,
.form-captcha input,
.form-spinner input {
background-color: #ffffff;
}
[data-type="control_dropdown"] .form-input,
[data-type="control_dropdown"] .form-input-wide {
width: 150px;
}
.form-label {
font-family: "Open Sans", sans-serif;
}
li[data-type="control_image"] div {
text-align: left;
}
li[data-type="control_image"] img {
border: none;
border-width: 0px !important;
border-style: solid !important;
border-color: false !important;
}
.form-line-column {
width: auto;
}
.form-line-error {
overflow: hidden;
-webkit-transition-property: none;
-moz-transition-property: none;
-ms-transition-property: none;
-o-transition-property: none;
transition-property: none;
-webkit-transition-duration: 0.3s;
-moz-transition-duration: 0.3s;
-ms-transition-duration: 0.3s;
-o-transition-duration: 0.3s;
transition-duration: 0.3s;
-webkit-transition-timing-function: ease;
-moz-transition-timing-function: ease;
-ms-transition-timing-function: ease;
-o-transition-timing-function: ease;
transition-timing-function: ease;
background-color: #fff4f4;
}
.form-line-error .form-error-message {
background-color: #ff3200;
clear: both;
float: none;
}
.form-line-error .form-error-message .form-error-arrow {
border-bottom-color: #ff3200;
}
.form-line-error input:not(#coupon-input),
.form-line-error textarea,
.form-line-error .form-validation-error {
border: 1px solid #ff3200;
-webkit-box-shadow: 0 0 3px #ff3200;
-moz-box-shadow: 0 0 3px #ff3200;
box-shadow: 0 0 3px #ff3200;
}
.ie-8 .form-all {
margin-top: auto;
margin-top: initial;
}
.ie-8 .form-all:before {
display: none;
}
[data-type="control_clear"] {
display: none;
}
/* | */
@media screen and (max-width: 480px), screen and (max-device-width: 767px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape) {
.testOne {
letter-spacing: 0;
}
.form-all {
border: 0;
max-width: initial;
}
.form-sub-label-container {
width: 100%;
margin: 0;
margin-right: 0;
float: left;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
}
span.form-sub-label-container + span.form-sub-label-container {
margin-right: 0;
}
.form-sub-label {
white-space: normal;
}
.form-address-table td,
.form-address-table th {
padding: 0 1px 10px;
}
.form-submit-button,
.form-submit-print,
.form-submit-reset {
width: 100%;
margin-left: 0!important;
}
div[id*=at_] {
font-size: 14px;
font-weight: 700;
height: 8px;
margin-top: 6px;
}
.showAutoCalendar {
width: 20px;
}
img.form-image {
max-width: 100%;
height: auto;
}
.form-matrix-row-headers {
width: 100%;
word-break: break-all;
min-width: 80px;
}
.form-collapse-table,
.form-header-group {
margin: 0;
}
.form-collapse-table {
height: 100%;
display: inline-block;
width: 100%;
}
.form-collapse-hidden {
display: none !important;
}
.form-input {
width: 100%;
}
.form-label {
width: 100% !important;
}
.form-label-left,
.form-label-right {
display: block;
float: none;
text-align: left;
width: auto!important;
}
.form-line,
.form-line.form-line-column {
padding: 2% 5%;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
}
input[type=text],
input[type=email],
input[type=tel],
textarea {
width: 100%;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
max-width: initial !important;
}
.form-radio-other-input,
.form-checkbox-other-input {
max-width: 55% !important;
}
.form-dropdown,
.form-textarea,
.form-textbox {
width: 100%!important;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
}
.form-input,
.form-input-wide,
.form-textarea,
.form-textbox,
.form-dropdown {
max-width: initial!important;
}
.form-checkbox-item:not(#foo),
.form-radio-item:not(#foo) {
width: 100%;
}
.form-address-city,
.form-address-line,
.form-address-postal,
.form-address-state,
.form-address-table,
.form-address-table .form-sub-label-container,
.form-address-table select,
.form-input {
width: 100%;
}
div.form-header-group {
padding: 24px 0px !important;
margin: 0 12px 2% !important;
margin-left: 5%!important;
margin-right: 5%!important;
-moz-box-sizing: border-box;
-webkit-box-sizing: border-box;
box-sizing: border-box;
}
div.form-header-group.hasImage img {
max-width: 100%;
}
[data-type="control_button"] {
margin-bottom: 0 !important;
}
[data-type=control_fullname] .form-sub-label-container {
width: 48%;
}
[data-type=control_fullname] .form-sub-label-container:first-child {
margin-right: 4%;
}
[data-type=control_phone] .form-sub-label-container {
width: 65%;
margin-right: 0;
margin-left: 0;
float: left;
}
[data-type=control_phone] .form-sub-label-container:first-child {
width: 31%;
margin-right: 4%;
}
[data-type=control_datetime] .allowTime-container {
width: 100%;
}
[data-type=control_datetime] .form-sub-label-container:first-child {
width: 10%!important;
margin-left: 0;
margin-right: 0;
}
[data-type=control_datetime] .form-sub-label-container + .form-sub-label-container {
width: 24%!important;
margin-left: 6%;
margin-right: 0;
}
[data-type=control_datetime] span + span + span > span:first-child {
display: block;
width: 100% !important;
}
[data-type=control_birthdate] .form-sub-label-container,
[data-type=control_time] .form-sub-label-container {
width: 27.3%!important;
margin-right: 6% !important;
}
[data-type=control_time] .form-sub-label-container:last-child {
width: 33.3%!important;
margin-right: 0 !important;
}
.form-pagebreak-back-container,
.form-pagebreak-next-container {
min-height: 1px;
width: 50% !important;
}
.form-pagebreak-back,
.form-pagebreak-next,
.form-product-item.hover-product-item {
width: 100%;
}
.form-pagebreak-back-container {
padding: 0;
text-align: right;
}
.form-pagebreak-next-container {
padding: 0;
text-align: left;
}
.form-pagebreak {
margin: 0 auto;
}
.form-buttons-wrapper {
margin: 0!important;
margin-left: 0!important;
}
.form-buttons-wrapper button {
width: 100%;
}
.form-buttons-wrapper .form-submit-print {
margin: 0 !important;
}
table {
width: 100%!important;
max-width: initial!important;
}
table td + td {
padding-left: 3%;
}
.form-checkbox-item,
.form-radio-item {
white-space: normal!important;
}
.form-checkbox-item input,
.form-radio-item input {
width: auto;
}
.form-collapse-table {
margin: 0 5%;
display: block;
zoom: 1;
width: auto;
}
.form-collapse-table:before,
.form-collapse-table:after {
display: table;
content: '';
line-height: 0;
}
.form-collapse-table:after {
clear: both;
}
.fb-like-box {
width: 98% !important;
}
.form-error-message {
clear: both;
bottom: -10px;
}
.date-separate,
.phone-separate {
display: none;
}
.custom-field-frame,
.direct-embed-widgets,
.signature-pad-wrapper {
width: 100% !important;
}
}
/* | */
/*__INSPECT_SEPERATOR__*/
@media screen and (max-width: 480px), screen and (max-device-width: 767px) and (orientation: portrait), screen and (max-device-width: 415px) and (orientation: landscape){
div.form-header-group {
padding : 5px !important;
}
#id_37, #label_37 {
margin : 0;
}
.form-radio-item, .form-radio-item label {
margin : 0;
}
.form-radio-item .radio-image {
padding : 1px;
}
.radio-image h3 {
margin : 0;
}
}
.jotform-form input[type="color"],
.jotform-form input[type="date"],
.jotform-form input[type="datetime"],
.jotform-form input[type="datetime-local"],
.jotform-form input[type="email"],
.jotform-form input[type="month"],
.jotform-form input[type="number"],
.jotform-form input[type="password"],
.jotform-form input[type="search"],
.jotform-form input[type="tel"],
.jotform-form input[type="text"],
.jotform-form input[type="time"],
.jotform-form input[type="url"],
.jotform-form input[type="week"],
.jotform-form select:focus,
.jotform-form textarea {
font-size : 16px;
}
.form-submit-button, .form-submit-button:hover, .form-submit-button:focus {
background-color : #ed1b24 !important;
background-image : none !important;
color : white;
font-weight : bold;
width : 100%;
margin : 20px 0;
border : none !important;
box-shadow : none !important;
}
.form-buttons-wrapper {
margin : 0 !important;
}
.form-line {
margin : 0;
padding-top : 0;
padding-bottom : 0;
}
.form-label.form-label-top {
margin-top : 20px;
}
.form-radio-item label {
text-align : center;
}
.form-all {
width : auto;
max-width : 800px;
min-width : 300px;
padding : 0 !important;
width : 100% !important;
margin : auto;
border : 0;
}
.form-section {
padding : 0;
}
.jotform-form {
}
#label_37 {
margin-top : 20px;
}
.form-header {
margin-bottom : 0;
}
.form-textarea {
height : 4em;
}
div.form-header-group {
padding : 24px 30px;
background-color : #0c86e2;
margin : 0 !important;
border : none;
}
.form-checkbox-item {
margin : 0 !important;
display : flex;
align-items : center;
}
.form-checkbox-item label {
margin : 0 5px 0 0;
font-size : 18px;
}
.form-multiple-column {
display : flex;
flex-wrap : wrap;
}
#id_43 {
margin-bottom : 20px;
}
.form-radio-item .radio-image {
display : inline-block;
text-align : center;
padding : 0.5em;
border-radius : 6px;
}
.radio-image h3 {
color : white;
font-size : 1.3em;
}
/* Injected CSS Code */
JotForm.showJotFormPowered = "0";
document.getElementById("si" + "mple" + "_spc").value = "92203937037254-92203937037254";
