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cellspacing=0 border=0 class="esmT" width="100%"><tr class="esmR"><td class="esmD"> <div class="gbox3" id="gb-c" > <div id="gb-m"> <div id="gb-mx"> <div class="gb-t"> <span class="gb3">Request A Quote </span> </div> <div id="gb-mi"> <div id="gb-mii" style="padding:4px;"> <div id="gb-miii"> <div> </div> <div align=left id="comp293" class="esbSec" > <style type="text/css"> table.esbFormTable, table.esbFormHolder {width:100%} .esbFormField {width:100%;box-sizing:border-box;margin-right:10px;} div.forms-def .esbFormTable td {padding-right:10px;} div.forms-def label.esbFormLab {display:block;} ::-webkit-input-placeholder {opacity:.6;} ::-moz-placeholder {opacity:.6;} :-ms-input-placeholder {opacity:.6;} :-moz-placeholder {opacity:.6;} .esbRF {display:none} td.esbFormLab {width:1%} </style> <script type="text/javascript"> var hasuploads=false,uploadispresent=false; function uploadpresent() { hasuploads=true; } function addfile(f,label,fid) { var form=document.forms["fform"+fid] var v=form.filelist.value; f=f.replace(/\+/g," ") v=v+label+"|"+f+";"; form.filelist.value=v; fb_lastup=""; uploadispresent=true; } function startupload() { fb_lastup="1"; } </script> <div class="forms-def"> <form method="POST" id="fform293" name="fform293" action="/blog/view/981/saved___//post/" onSubmit='return formverify("293");' > <input type=hidden name="postPageName" value="/blog/view/981/saved___/?sub=1"> <input type=hidden name="thisPageName" value="/blog/view/981/saved___/"> <input type=hidden name="thisDomain" value="correirainsurance.com"> <input type=hidden name="id" value="293"> <input type=hidden name="sdb" value="1"> <input type=hidden name=options value=""> <input type="hidden" name="filelist" value=""> <input type=hidden name=compName value=compFormBuilder2> <input type=hidden name=MAILSUBJECT value="Quick Quote Request"> <div class="esbFormMessage1" style="margin-bottom:25px"></div> <input type=hidden name=pageon value=y> <input type=hidden name=uploadreq value=n> <table class="esbFormHolder esmTT" style="margin:0px" border="0"><tr><td valign=top> <table class="esbFormTable"> <tr><td colspan=2 class="esbLabel esbFormLab" style="text-align:left" valign=top><div class="form-group"><label class="esbLabel esbFormLab esbFormRequired" style="text-align:left;display:none" style="font-size:12pt" for="f293a1"><b>Full Name:</b></label><input class="esbFormField esbFormRequired" type="text" id="f293a1" name="form_Full_Name:" placeholder="Full Name: (required)" size=10><font class="esbRF" color=red>*</font></div></td></tr><tr><td colspan=2 class="esbLabel esbFormLab" style="text-align:left" valign=top><div class="form-group"><label class="esbLabel esbFormLab esbFormRequired" style="text-align:left;display:none" style="font-size:12pt" for="f293a2"><b>Email:</b></label><input class="esbFormField esbFormRequired" type="email" id="f293a2" name="form_Email:" placeholder="Email: (required)" size=25><font class="esbRF" color=red>*</font></div></td></tr><tr><td colspan=2 class="esbLabel esbFormLab" style="text-align:left" valign=top><div class="form-group"><label class="esbLabel esbFormLab " style="text-align:left;display:none" style="font-size:12pt" for="f293a3"><b>Telephone:</b></label><input class="esbFormField" type="text" id="f293a3" name="form_Telephone:" placeholder="Telephone:" size=10></div></td></tr><tr><td colspan=2><font size=2><b>Interested In...</b></font></td></tr><tr><td colspan="2" class="esbFormData"><table cellpadding=0 cellspacing=0 border=0><tr> <td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-0" class="" type=checkbox name="form_Interested_In..._Auto" value="checked"><label class="" for="f293a5-0">Auto</label></div></td></tr><tr><td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-1" class="" type=checkbox name="form_Interested_In..._Home" value="checked"><label class="" for="f293a5-1">Home</label></div></td></tr><tr><td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-2" class="" type=checkbox name="form_Interested_In..._Life" value="checked"><label class="" for="f293a5-2">Life</label></div></td></tr><tr><td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-3" class="" type=checkbox name="form_Interested_In..._Group" value="checked"><label class="" for="f293a5-3">Group</label></div></td></tr><tr><td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-4" class="" type=checkbox name="form_Interested_In..._Business" value="checked"><label class="" for="f293a5-4">Business</label></div></td></tr><tr><td><div class="esbFormOptions" style="font-size:12pt" ><input id="f293a5-5" class="" type=checkbox name="form_Interested_In..._Other" value="checked"><label class="" for="f293a5-5">Other</label></div></td></tr></table></td></tr><tr><td colspan=2> <input type="hidden" name="form_esbFormSpace" value="esbFormSpace"></td></tr> <script src="https://www.google.com/recaptcha/api.js" async defer></script><input type="hidden" name="recaptcha-response"><tr><td valign=top class="esbLabel esbFormLab esbFormFF"><label class="esbLabel esbFormLab esbFormFF " style="font-size:12pt" for="field_addr"><b>Do not enter anything in this field:</b></label><input class="esbFormField" type="text" name="field_addr" size=6></td></tr></table> </td></tr></table> <script src="//ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script> <script>var j$=$</script> <div class="esbRequiredField esbRF"><font color=red>*</font> indicates a required field</div> <a class="esbB3" onclick="return verifier('293');"><span>Send To Agent</span></a> <div id="recaptcha-div" class="g-recaptcha" data-sitekey="6LcBOkMUAAAAAKX53vIbuVOoRvigaPBfIQujN_6f" data-callback="captchasubmit" data-size="invisible"> </div> <script type="text/javascript"> var handlepostcaptcha=null; function captchasubmit() { if(handlepostcaptcha!=null) handlepostcaptcha(); } var xmlreq; function sendXmlHttpRequest(url){ var obj=getXmlHttpRequestObj(url); if(obj==null) return false; try { if (window.XMLHttpRequest) {obj.send(null); return true;} else if (window.ActiveXObject) { if (obj) { obj.send(); return true;} } } catch(e) { } return false; } function sendXmlHttpRequestObj(obj){ try { if (window.XMLHttpRequest) {obj.send(null); return true; } else if (window.ActiveXObject) { if (obj) { obj.send(); return true;} } } catch(e) { } return false; } function getXmlHttpRequestObj(url){ try { if (window.XMLHttpRequest) { xmlreq = new XMLHttpRequest(); xmlreq.onreadystatechange = processStateChange; xmlreq.open("GET", url, true); return xmlreq; } else if (window.ActiveXObject) { xmlreq = new ActiveXObject("Microsoft.XMLHTTP"); if (xmlreq) { xmlreq.onreadystatechange = processStateChange; xmlreq.open("GET", url, true); return xmlreq;} } } catch(e) { } return null; } function processStateChange(){ if (xmlreq.readyState == 4) httpXmlDone(xmlreq); } var processId; function captchasubmitFB() { var fname="fform"+processId; m=document.getElementById(fname); m["recaptcha-response"].value=grecaptcha.getResponse() m.submit(); } function verifier(id) { processId=id; var fname="fform"+id; m=document.getElementById(fname); if(!(typeof m.fmcompare==="undefined")) { var id=m.fmcompare.value; var code=m.fmdata.value; var r=Math.abs(Math.round(100*Math.random())); var sent=sendXmlHttpRequest("/inc/xmlxfer?rtype=formok&id="+id+"&code="+code+"&rand="+r); if(sent==false) httpXmlDone("1"); return false; } else { if(formverify(processId)) { handlepostcaptcha=captchasubmitFB grecaptcha.execute(); } } } var tryCount=0; function httpXmlDone(xmlreq) { if(xmlreq.responseText==1 || tryCount>30) { if(formverify(processId)) { var fname="fform"+processId; m=document.getElementById(fname); m.submit(); } } else { tryCount++; alert("Please be sure you've entered the correct security code shown"); } } </script> </form> </div> <script type="text/javascript"> var verifylist=new Array(); var funclist=new 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Please wait till your file upload has finished to submit this form."); return false; } var fname="fform"+id; var m=document.getElementById(fname); fname="f"+id; try { var func=funclist[fname]; if(func.call(id)==false) return false; } catch(e) { } if(m.uploadreq.value=="y" && uploadispresent==false) { alert("Please upload a file."); return false; } var toverify=verifylist[fname]; var e=m.elements; for(i=0;i<e.length;i++){ var t=e[i].type; if(t==null || t=="" || t=="hidden") continue; var n=e[i].name; n=n.substring(5); if(t=="text" || t=="textarea" || t=="email" || t=="date" || t=="checkbox"){ for(j=0;j<toverify.length;j++){ if(n==toverify[j]) { var verify=true; if(t=="checkbox") { if(e[i].checked==false) verify=false; } else { var l=e[i].value; re=new RegExp(" +"); if(l.length==0 || l.replace(re,"").length==0) verify=false } if(verify==false) { //alert("Please ensure all required fields are entered."); var msg="Please fill out this field." if(t=="checkbox") msg="Check this box to proceed." document.getElementById("esbFormReqMsg-box1").innerHTML=msg; document.getElementById("esbFormReqMsg").style.display="block"; var p2=j$(e[i]).offset() j$("#esbFormReqMsg").css({"left":p2.left+"px","top":(p2.top-66)+"px"}) $('html, body').animate({scrollTop: $("#esbFormReqMsg").offset().top-170}, 500); $("#esbFormReqMsg").delay(5000).fadeOut(500); return false; } break; } } } } return true; } verifylist.f293=new Array(); verifylist.f293[0]="Full_Name:"; verifylist.f293[1]="Email:"; function sfunc293(id) { return true; } funclist.f293=sfunc293; </script> <input type="text" value="ccc" style="display:none" id="phtest"> <script type="text/javascript"> var pp=document.getElementById("phtest") var hsupport='placeholder' in pp if(hsupport==false) { j$('[placeholder]').focus(function() { var input = j$(this); if (input.val() == input.attr('placeholder')) { input.val(''); input.removeClass('placeholder'); } }).blur(function() { var input = j$(this); if (input.val() == '' || input.val() == input.attr('placeholder')) { input.addClass('placeholder'); input.val(input.attr('placeholder')); } }).blur(); j$('[placeholder]').parents('form').submit(function() { j$(this).find('[placeholder]').each(function() { var input = j$(this); if (input.val() == input.attr('placeholder')) { input.val(''); } }) }); } </script> <style type="text/css"> .esbFormField {box-sizing:border-box} .placeholder {color: #990000;} </style> <style type="text/css"> div#esbFormReqMsg {position:absolute;cursor:pointer;display:none;} div#esbFormReqMsg .arr {position:absolute;;bottom:2px;left:26px;width:18px;height:18px;border-radius:2px;background-color:#b0b0b0;transform: rotate(45deg)} div#esbFormReqMsg .arr2 {z-index:101;position:absolute;bottom:3px;left:27px;width:17px;height:17px;border-radius:2px;background-color:#ffffff;transform: rotate(45deg)} div#esbFormReqMsg-box1 {background-image:url(https://correirainsurance.com/i/t/w/cp/requiredfield.png);background-repeat:no-repeat;background-size:29px;background-position:10px center;position:relative;z-index:100;margin-bottom:9px;padding:14px;padding-right:20px;background-color:#ffffff;color:#000000;border-radius:4px;border:1px solid #b0b0b0;display:inline-block;padding-left:45px;} </style> <div id="esbFormReqMsg" onclick="j$('#esbFormReqMsg').hide()"> <div class="arr"></div><div class="arr2"></div> <div id="esbFormReqMsg-box1" class="box1"> Please fill this field. </div> </div> <div class="esbFormPrivacyDiv"> </div> </div> <div align=left id="comp295" class="esbSec" > </div></div></div></div></div></div></td></tr></table> </div> <div align=left id="comp1863" class="esbSec" > <style type="text/css"> table.tab1863 div.tc {height:100%;} table.tab1863 td.tc {background-color:#;padding:0px;} </style> <table style="border-collapse:collapse" class="tab1863 esmT" cellpadding=0 cellspacing=0 border=0 width="100%"> <tr class="esmR"> <td valign="top" id="esbTab1863-1864" class="tc esmD" width="100%" style=""> <div class="tc esmD"><div align=left id="comp1865" class="esbSec" > <div class="esbMod"><div class="esbModtx"> <div class="t2 xtx"><p class="fpg"><img alt="" height="1" src="//o.b5z.net/i/u/10253032/i/spacer.gif" width="350" /></p> </div> </div> </div> </div> </div></td> </tr></table> </div> </div> <div id="esbSideSpaceRight"><img src="https://correirainsurance.com/zirw/h499b4/i/t/w/rnddot.gif" height="1" alt="" style="display:block" width="100"></div></div> </div></div></div></div></div> <div id="esbF"><div class="esbContentDiv" id="esbFs"><div id="ftext-wrap"> <span id="ftext"> <div class="esbFooterCols" id="esbFooterCols" style="_display:inline-block"> <div class="footlt"> <table width="100%" cellpadding="0" cellspacing="0" class="esmT"> <tr class="esmR"> <td valign="top" class="esmD" id="esbFc1" width="33%"> <div class="esbFootCol esbFootColFirst"> <div id="compdiv624"> <div class="esbFootTitle1 esbFootTitleH1">Customer Service Center</div> <div class="esbFootSec"><div class="footlinks1"><ul> <li><a href="/service"><span>Service</span></a> <li><a href="/payments---claims"><span>Payments & Claims</span></a> <li><a href="/auto-id-card-request"><span>Auto ID Card Request</span></a> <li><a href="/policy-change-request"><span>Policy Change Request</span></a> <li><a href="/certificate-of-insurance-request"><span>Certificate of Insurance Request</span></a> </ul> <div class="esbFootTitle1">Request A Quote</div> <ul> <li><a href="/request-a-quote"><span>Request A Quote</span></a> </ul> <div class="esbFootTitle1">Personal Insurance</div> <ul> <li><a href="/auto"><span>Auto</span></a> <li><a href="/homeowners"><span>Homeowners</span></a> <li><a href="/condominium"><span>Condominium</span></a> <li><a href="/personal-insurance-products"><span>Personal Insurance Products</span></a> </ul> <div class="esbFootTitle1">Business Insurance Products</div> <ul> <li><a href="/business-owners-policy"><span>Business Owners Policy</span></a> <li><a href="/commercial-auto"><span>Commercial Auto</span></a> <li><a href="/commercial-liability"><span>Commercial Liability</span></a> <li><a href="/business-insurance-products"><span>Business Insurance Products</span></a> </ul> </div></div> </div> </div> </td> <td valign="top" class="esmD" id="esbFc2" width="33%"><div class="esbFootCol"> <div id="compdiv625"> <div class="esbFootTitle1 esbFootTitleH1">Contact Us</div> <div class="esbFootSec"><div class="esbPageText"><div itemscope="" itemtype="https://schema.org/InsuranceAgency"><meta itemprop="name" content="Correira Insurance Agency"> <div>Correira Insurance Agency</div> <div itemprop="address" itemscope="" itemtype="https://schema.org/PostalAddress"><span itemprop="streetAddress">123 Broadway<br /> <span itemprop="addressLocality">Taunton</span>, <span itemprop="addressRegion">MA</span> <span itemprop="postalCode">02780</span></span></div> <a href="contact#emailus" onclick="ezgu('contact#emailus','_self');return false;">Email Us</a> <div itemprop="telephone"><strong>Phone:</strong> <a href="tel:+15088222999">(508) 822-2999 </a></div> <p><strong>Hours of Operation:</strong></p> <div content="Mo,Tu,We,Th,Fr, 08:00-17:00" itemprop="openingHours"><strong>Mon-Fri: </strong>8:00am-5:00pm<br /> <strong>Saturday</strong> - By appointment<br /> <strong>Sunday</strong> - Closed</div> </div></div></div> <div class="esbFootSec"> <style type="text/css"> div.esbFooterSocialIco img, div.esbFooterSocialIco a {display:block;padding-right:2px;} div.esbFooterSocialIco img {width:32x32px;} </style> <div class="esbFooterSocialIco"><div class="esbFooterSocialIcoDiv"><table cellpadding=0 cellspacing=0 border=0><tr> <td><a href="http://www.facebook.com/CorreiraInsurance/" target="facebook" ><img src="https://correirainsurance.com/zirw/h499b4/i/t/w/integration/social/icons/fc2/fb_32x32.png" alt="our facebook page" border=0></a></td> </tr></table></div></div> </div> </div> </div> </td> <td valign="top" class="esmD" id="esbFc5" width="33%"> <div class="esbFootCol esbFootColLast"> <div id="compdiv628"> <div class="esbFootTitle1 esbFootTitleH1">Map</div> <div class="esbFootSec"><div class="esbPageText"><p class="fpg"><iframe allowfullscreen="" height="400" loading="lazy" referrerpolicy="no-referrer-when-downgrade" src="https://www.google.com/maps/embed?pb=!1m18!1m12!1m3!1d2969.285948545016!2d-71.09427578455796!3d41.908211279219806!2m3!1f0!2f0!3f0!3m2!1i1024!2i768!4f13.1!3m3!1m2!1s0x89e48ca8c656784f%3A0x5f4942ff5e970312!2sCorreira%20Insurance%20Inc!5e0!3m2!1sen!2sus!4v1649910852727!5m2!1sen!2sus" style="border:0;" width="100%"></iframe></p> <div itemscope="" itemtype="https://schema.org/InsuranceAgency"><a class="esbB3" href="https://maps.google.com/maps?cid=17196746078471934452" itemprop="hasMap" target="_blank"><span>Get Directions</span></a></div></div></div> </div> </div> </td> </tr></table> </div></div> </span> <span id="ftext"> <div style="text-align:center;"> <div class="esbFL"></div> <script defer src="https://connect.podium.com/widget.js#ORG_TOKEN=d99b92b6-d84e-4931-b12d-21f27c9304ee" id="podium-widget" data-organization-api-token="d99b92b6-d84e-4931-b12d-21f27c9304ee"></script> <p style="text-align: center; "> </p> <p style="text-align: center; "><br /> <br /> <span style="font-size:small;"><a href="terms-of-service" onclick="ezgu('terms-of-service','_self');return false;">Terms & Conditions</a> | <a href="privacy-policy" onclick="ezgu('privacy-policy','_self');return false;">Privacy Policy</a> | <a href="accessibility-statement" onclick="ezgu('accessibility-statement','_self');return false;">Accessibility Statement</a></span><br /> <span style="color:#FFFFFF;"><span style="font-size: small;">©2009-<script type="text/javascript"> document.write(new Date().getFullYear()); </script> The Correira Insurance Agency, Inc.</span></span></p> <script> // When the user scrolls down 20px from the 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