{"id":235,"date":"2018-12-14T08:50:19","date_gmt":"2018-12-14T08:50:19","guid":{"rendered":"https:\/\/gillespieinsuranceservices.com\/?page_id=235"},"modified":"2025-04-22T14:44:08","modified_gmt":"2025-04-22T14:44:08","slug":"request-a-certificate-of-insurance","status":"publish","type":"page","link":"https:\/\/finfrockweb.com\/gis\/service-center\/request-a-certificate-of-insurance\/","title":{"rendered":"Request a Certificate of Insurance"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"235\" class=\"elementor elementor-235\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-23f2ffa e-flex e-con-boxed e-con e-parent\" data-id=\"23f2ffa\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-12593e4 at-heading-animation at-animation-heading-none elementor-widget elementor-widget-heading\" data-id=\"12593e4\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Please complete this form if you need to present a Certificate of Insurance to a person or business entity. We will get to work ASAP!<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e69193e e-con-full e-flex e-con e-parent\" data-id=\"e69193e\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ffce516 elementor-widget elementor-widget-elementskit-contact-form7\" data-id=\"ffce516\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"elementskit-contact-form7.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" ><div class=\"ekit-form\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f13138-p235-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"13138\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/gis\/service-center\/request-a-certificate-of-insurance\/#wpcf7-f13138-p235-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"13138\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.4\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f13138-p235-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"235\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<div class=\"row\">\n\t<div class=\"form-group col-md-6 col-12 mb-4\">\n\t\t<p><label><strong>Your Name *<\/strong> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"ci_name\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_name\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-md-6 col-12 mb-4\">\n\t\t<p><label><strong>Your Company or Organization *<\/strong> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_cmpny\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" id=\"ci_cmpny\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_cmpny\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-md-6 col-12 mb-4\">\n\t\t<p><label><strong>Your Email *<\/strong> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" id=\"ci_email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"ci_email\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-md-6 col-12 mb-4\">\n\t\t<p><label><strong>Your Phone Number *<\/strong> <\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" id=\"ci_phone\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"ci_phone\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-md-6 col-12 mb-4\">\n\t\t<p><label><strong>Who Needs the Certificate? *<\/strong> <\/label><br \/>\n<label>Please separate names with a comma or semi colon.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_needcer\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" id=\"ci_needcer\" aria-required=\"true\" aria-invalid=\"false\" name=\"ci_needcer\"><\/textarea><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>What is Their Address? *<\/label><br \/>\n<label>The address of the person or entity that's asking for a certificate.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"thr_add\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"ci_stadd\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"thr_add\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>Street Address<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_stadd\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_stadd\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-6\">\n\t\t<p><label>Address Line 2<\/label><br \/>\n<label class=\"input\" for=\"file\"><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_add2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"ci_add2\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_add2\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-6\">\n\t\t<p><label>State<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_state\"><select class=\"wpcf7-form-control wpcf7-select\" id=\"ci_state\" aria-invalid=\"false\" name=\"ci_state\"><option value=\"Alabama\">Alabama<\/option><option value=\"Alaska\">Alaska<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Arizona\">Arizona<\/option><option value=\"Arkansas\">Arkansas<\/option><option value=\"California\">California<\/option><option value=\"Colorado\">Colorado<\/option><option value=\"Connecticut\">Connecticut<\/option><option value=\"Delaware\">Delaware<\/option><option value=\"District of Columbia\">District of Columbia<\/option><option value=\"Florida\">Florida<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Guam\">Guam<\/option><option value=\"Hawaii\">Hawaii<\/option><option value=\"Idaho\">Idaho<\/option><option value=\"Illinois\">Illinois<\/option><option value=\"Indiana\">Indiana<\/option><option value=\"Iowa\">Iowa<\/option><option value=\"Kansas\">Kansas<\/option><option value=\"Kentucky\">Kentucky<\/option><option value=\"Louisiana\">Louisiana<\/option><option value=\"Maine\">Maine<\/option><option value=\"Maryland Massachusetts\">Maryland Massachusetts<\/option><option value=\"Michigan\">Michigan<\/option><option value=\"Minnesota\">Minnesota<\/option><option value=\"Mississippi\">Mississippi<\/option><option value=\"Missouri\">Missouri<\/option><option value=\"Montana Nebraska\">Montana Nebraska<\/option><option value=\"Nevada\">Nevada<\/option><option value=\"New Hampshire\">New Hampshire<\/option><option value=\"New Jersey\">New Jersey<\/option><option value=\"New Mexico\">New Mexico<\/option><option value=\"ew York\">ew York<\/option><option value=\"North Carolina\">North Carolina<\/option><option value=\"North Dakota\">North Dakota<\/option><option value=\"Northern Marianas Islands\">Northern Marianas Islands<\/option><option value=\"Ohio\">Ohio<\/option><option value=\"Oklahoma\">Oklahoma<\/option><option value=\"Oregon\">Oregon<\/option><option value=\"Pennsylvania\">Pennsylvania<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Rhode Island\">Rhode Island<\/option><option value=\"South Carolina\">South Carolina<\/option><option value=\"South Dakota\">South Dakota<\/option><option value=\"Tennessee\">Tennessee<\/option><option value=\"Texas\">Texas<\/option><option value=\"Utah\">Utah<\/option><option value=\"Vermont\">Vermont<\/option><option value=\"Virginia\">Virginia<\/option><option value=\"Virgin Islands\">Virgin Islands<\/option><option value=\"Washington\">Washington<\/option><option value=\"West Virginia\">West Virginia<\/option><option value=\"Wisconsin\">Wisconsin<\/option><option value=\"Wyoming\">Wyoming<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-6\">\n\t\t<p><label>City<\/label><br \/>\n<label class=\"input\" for=\"file\"><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"ci_city\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_city\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-6\">\n\t\t<p><label>Zip Code<\/label><br \/>\n<label class=\"input\" for=\"file\"><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" id=\"ci_zip\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ci_zip\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12\">\n\t\t<p><label>What is Their Email?<\/label><br \/>\n<label class=\"input\" for=\"file\"><span class=\"wpcf7-form-control-wrap\" data-name=\"thr_email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" id=\"thr_email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"thr_email\" \/><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>Which of Your Policies Do They Need a Certificate For?*<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_check1\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"ci_check1[]\" value=\"General Liability\" \/><span class=\"wpcf7-list-item-label\">General Liability<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"ci_check1[]\" value=\"Workers Comp\" \/><span class=\"wpcf7-list-item-label\">Workers Comp<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"ci_check1[]\" value=\"Auto\" \/><span class=\"wpcf7-list-item-label\">Auto<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"ci_check1[]\" value=\"Umbrella \/ Excess\" \/><span class=\"wpcf7-list-item-label\">Umbrella \/ Excess<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Do They Need to be Named as an Additional Insured?<\/strong>*<\/label><br \/>\n<label>Referring to the person or entity requiring the certificate.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"menu-982\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"menu-982\"><option value=\"No\">No<\/option><option value=\"Yes\">Yes<\/option><\/select><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>For Which Policies?<\/strong>*<\/label><br \/>\n<label>Check all that apply.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_check2\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\" id=\"ci_check2\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"ci_check2[]\" value=\"General Liability\" \/><span class=\"wpcf7-list-item-label\">General Liability<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"ci_check2[]\" value=\"Auto\" \/><span class=\"wpcf7-list-item-label\">Auto<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Is There a Separate Certificate Holder?<\/strong><\/label><br \/>\n<label>Sometimes a separate entity, other than the additional insured, needs to receive a certificate of insurance as well.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_radio2\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"ci_radio2\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ci_radio2\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ci_radio2\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>What is their name and address?<\/strong><\/label><br \/>\n<label>Name:&nbsp;&nbsp;<span class=\"wpcf7-form-control-wrap\" data-name=\"text-711\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-711\" \/><\/span><\/label><br \/>\n<label>Address: &nbsp;<span class=\"wpcf7-form-control-wrap\" data-name=\"textarea-183\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"textarea-183\"><\/textarea><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row form-group comet\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Waiver of Subrogation Required?<\/strong><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_radio3\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"ci_radio3\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ci_radio3\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ci_radio3\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row form-group comet\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Primary and\/or Non-Contributory Wording Required?<\/strong><\/label>\n\t\t<\/p>\n\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_radio4\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"ci_radio4\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ci_radio4\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ci_radio4\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row form-group comet\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Are There Any Special Wording or Form Requirements?<\/strong><\/label><br \/>\n<label>For example, do they require a \"CG 2010 11 85,\" or \"Completed Operations Coverage\"?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_radio5\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"ci_radio5\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ci_radio5\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ci_radio5\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row form-group comet\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Please describe the special wording and\/or form type<\/strong><\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-914\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-914\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row form-group comet\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Is this Certificate Needed for a Construction, Janitorial, or Landscaping Project?<\/strong>*<\/label>\n\t\t<\/p>\n\t\t<p><label>Any job or project having to do with new construction, remodeling, or repair, service, or maintenance of a building, landscape, or structure.<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ci_need\"><span class=\"wpcf7-form-control wpcf7-radio\" id=\"ci_need\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"ci_need\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"ci_need\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row \">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Please describe the project<\/strong> *<\/label><br \/>\n<label>What type of work are you doing (plumbing, electrical, etc.) ?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-16\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-16\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>What type of service?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-950\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-950[]\" value=\"New Construction\" \/><span class=\"wpcf7-list-item-label\">New Construction<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-950[]\" value=\"Remodel\" \/><span class=\"wpcf7-list-item-label\">Remodel<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-950[]\" value=\"Repair\/Service\" \/><span class=\"wpcf7-list-item-label\">Repair\/Service<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>What type of building?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-970\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-970[]\" value=\"Commercial\" \/><span class=\"wpcf7-list-item-label\">Commercial<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-970[]\" value=\"Residential\" \/><span class=\"wpcf7-list-item-label\">Residential<\/span><\/span><\/span><\/span>\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label>Estimated gross revenue to be earned?<\/label><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-334\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-334\" \/><\/span>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Any Additional Comments?<\/strong><\/label>\n\t\t<\/p>\n\t\t<p><label class=\"textarea\"><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_msg\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"ci_msg\" aria-invalid=\"false\" name=\"ci_msg\"><\/textarea><\/span><\/label>\n\t\t<\/p>\n\t<\/div>\n<\/div>\n<div class=\"row\">\n\t<div class=\"form-group col-sm-12 mb-4\">\n\t\t<p><label><strong>Send Us Some Helpful Documentation<\/strong><\/label><br \/>\n<label>For example, a copy of the request for a certificate, your contract, or a sample certificate.<\/label>\n\t\t<\/p>\n\t\t<div class=\"uploadPh\">\n\t\t\t<div class=\"input-group col-xs-12\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"ci_file\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file browse btn uploadPhoto input-lg\" id=\"ci_file\" accept=\"audio\/*,video\/*,image\/*\" aria-invalid=\"false\" type=\"file\" name=\"ci_file\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"form-group\">\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner btn btn-submit\" id=\"ci_submit\" type=\"submit\" value=\"Submit\" \/>\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Please complete this form if you need to present 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