{"id":313,"date":"2020-07-24T00:27:43","date_gmt":"2020-07-24T00:27:43","guid":{"rendered":"https:\/\/dev.genesisels.com\/?page_id=313"},"modified":"2023-01-16T13:33:43","modified_gmt":"2023-01-16T13:33:43","slug":"intake-form","status":"publish","type":"page","link":"https:\/\/www.genesisels.com\/?page_id=313","title":{"rendered":"Intake Form"},"content":{"rendered":"\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-311\"><form id=\"wpforms-form-311\" class=\"wpforms-validate wpforms-form\" data-formid=\"311\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F313&#038;wpforms_form_id=311\" data-token=\"6d3353be2f5b99e0c1647823c109b4cb\" data-token-time=\"1780249570\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-page-indicator progress\" data-indicator=\"progress\" data-indicator-color=\"#72b239\" data-scroll=\"1\"><span class=\"wpforms-page-indicator-page-title\" ><\/span><span class=\"wpforms-page-indicator-page-title-sep\" style=\"display:none;\"> - <\/span><span class=\"wpforms-page-indicator-steps\">Step <span class=\"wpforms-page-indicator-steps-current\">1<\/span> of 4<\/span><div class=\"wpforms-page-indicator-page-progress-wrap\"><div class=\"wpforms-page-indicator-page-progress\" style=\"width:25%;background-color:#72b239\"><\/div><\/div><\/div><div class=\"wpforms-field-container\"><div class=\"wpforms-page wpforms-page-1 \" data-page=\"1\"><div id=\"wpforms-311-field_32-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"32\"><\/div><div id=\"wpforms-311-field_1-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"1\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_1\">Project Manager<\/label><input type=\"text\" id=\"wpforms-311-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" ><div class=\"wpforms-field-description\">Please enter Project Manager information<\/div><\/div><div id=\"wpforms-311-field_3-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_3\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-311-field_3\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][3]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-311-field_38-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"38\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_38\">Phone Number<\/label><input type=\"text\" id=\"wpforms-311-field_38\" class=\"wpforms-field-medium\" name=\"wpforms[fields][38]\" ><\/div><div id=\"wpforms-311-field_4-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"4\"><h3 id=\"wpforms-311-field_4\">Contact Information<\/h3><\/div><div id=\"wpforms-311-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_6\">Company Name<\/label><input type=\"text\" id=\"wpforms-311-field_6\" class=\"wpforms-field-medium\" name=\"wpforms[fields][6]\" ><\/div><div id=\"wpforms-311-field_5-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_5\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-311-field_5\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][5][first]\" required><label for=\"wpforms-311-field_5\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-311-field_5-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][5][last]\" required><label for=\"wpforms-311-field_5-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><div class=\"wpforms-field-description\">Person accepting invoices for the Company Listed<\/div><\/div><div id=\"wpforms-311-field_8-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"8\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_8\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-311-field_8\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][8]\" spellcheck=\"false\" required><\/div><div id=\"wpforms-311-field_39-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"39\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_39\">Phone Number<\/label><input type=\"text\" id=\"wpforms-311-field_39\" class=\"wpforms-field-medium\" name=\"wpforms[fields][39]\" ><\/div><div id=\"wpforms-311-field_7-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"7\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_7\">Address<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-311-field_7\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][7][address1]\" ><label for=\"wpforms-311-field_7\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-311-field_7-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][7][address2]\" ><label for=\"wpforms-311-field_7-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-311-field_7-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][7][city]\" ><label for=\"wpforms-311-field_7-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-311-field_7-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][7][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>--- Select state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-311-field_7-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-311-field_7-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][7][postal]\" ><label for=\"wpforms-311-field_7-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-311-field_31-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"31\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"1\" data-formid=\"311\" disabled>Next<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-2  \" data-page=\"2\" style=\"display:none;\"><div id=\"wpforms-311-field_10-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"10\"><h3 id=\"wpforms-311-field_10\">Job Location Information<\/h3><\/div><div id=\"wpforms-311-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_11\">Property Owner Name<\/label><input type=\"text\" id=\"wpforms-311-field_11\" class=\"wpforms-field-medium\" name=\"wpforms[fields][11]\" ><\/div><div id=\"wpforms-311-field_12-container\" class=\"wpforms-field wpforms-field-address\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_12\">Address<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-311-field_12\" class=\"wpforms-field-address-address1\" name=\"wpforms[fields][12][address1]\" ><label for=\"wpforms-311-field_12\" class=\"wpforms-field-sublabel after\">Address Line 1<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div ><input type=\"text\" id=\"wpforms-311-field_12-address2\" class=\"wpforms-field-address-address2\" name=\"wpforms[fields][12][address2]\" ><label for=\"wpforms-311-field_12-address2\" class=\"wpforms-field-sublabel after\">Address Line 2<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-311-field_12-city\" class=\"wpforms-field-address-city\" name=\"wpforms[fields][12][city]\" ><label for=\"wpforms-311-field_12-city\" class=\"wpforms-field-sublabel after\">City<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><select id=\"wpforms-311-field_12-state\" class=\"wpforms-field-address-state\" name=\"wpforms[fields][12][state]\" ><option class=\"placeholder\" value=\"\" selected disabled>--- Select state ---<\/option><option value=\"AL\" >Alabama<\/option><option value=\"AK\" >Alaska<\/option><option value=\"AZ\" >Arizona<\/option><option value=\"AR\" >Arkansas<\/option><option value=\"CA\" >California<\/option><option value=\"CO\" >Colorado<\/option><option value=\"CT\" >Connecticut<\/option><option value=\"DE\" >Delaware<\/option><option value=\"DC\" >District of Columbia<\/option><option value=\"FL\" >Florida<\/option><option value=\"GA\" >Georgia<\/option><option value=\"HI\" >Hawaii<\/option><option value=\"ID\" >Idaho<\/option><option value=\"IL\" >Illinois<\/option><option value=\"IN\" >Indiana<\/option><option value=\"IA\" >Iowa<\/option><option value=\"KS\" >Kansas<\/option><option value=\"KY\" >Kentucky<\/option><option value=\"LA\" >Louisiana<\/option><option value=\"ME\" >Maine<\/option><option value=\"MD\" >Maryland<\/option><option value=\"MA\" >Massachusetts<\/option><option value=\"MI\" >Michigan<\/option><option value=\"MN\" >Minnesota<\/option><option value=\"MS\" >Mississippi<\/option><option value=\"MO\" >Missouri<\/option><option value=\"MT\" >Montana<\/option><option value=\"NE\" >Nebraska<\/option><option value=\"NV\" >Nevada<\/option><option value=\"NH\" >New Hampshire<\/option><option value=\"NJ\" >New Jersey<\/option><option value=\"NM\" >New Mexico<\/option><option value=\"NY\" >New York<\/option><option value=\"NC\" >North Carolina<\/option><option value=\"ND\" >North Dakota<\/option><option value=\"OH\" >Ohio<\/option><option value=\"OK\" >Oklahoma<\/option><option value=\"OR\" >Oregon<\/option><option value=\"PA\" >Pennsylvania<\/option><option value=\"RI\" >Rhode Island<\/option><option value=\"SC\" >South Carolina<\/option><option value=\"SD\" >South Dakota<\/option><option value=\"TN\" >Tennessee<\/option><option value=\"TX\" >Texas<\/option><option value=\"UT\" >Utah<\/option><option value=\"VT\" >Vermont<\/option><option value=\"VA\" >Virginia<\/option><option value=\"WA\" >Washington<\/option><option value=\"WV\" >West Virginia<\/option><option value=\"WI\" >Wisconsin<\/option><option value=\"WY\" >Wyoming<\/option><\/select><label for=\"wpforms-311-field_12-state\" class=\"wpforms-field-sublabel after\">State<\/label><\/div><\/div><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-one-half wpforms-first\"><input type=\"text\" id=\"wpforms-311-field_12-postal\" class=\"wpforms-field-address-postal wpforms-masked-input\" data-inputmask-mask=\"(99999)|(99999-9999)\" data-inputmask-keepstatic=\"true\" data-rule-inputmask-incomplete=\"1\" name=\"wpforms[fields][12][postal]\" ><label for=\"wpforms-311-field_12-postal\" class=\"wpforms-field-sublabel after\">Zip Code<\/label><\/div><\/div><\/div><div id=\"wpforms-311-field_34-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"34\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"2\" data-formid=\"311\" disabled>Next<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-3  \" data-page=\"3\" style=\"display:none;\"><div id=\"wpforms-311-field_13-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"13\"><h3 id=\"wpforms-311-field_13\">Service Requested<\/h3><div class=\"wpforms-field-description\">Please include as much information possible regarding the services requested<\/div><\/div><div id=\"wpforms-311-field_14-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_14\">Service Requested<\/label><textarea id=\"wpforms-311-field_14\" class=\"wpforms-field-medium\" name=\"wpforms[fields][14]\" ><\/textarea><div class=\"wpforms-field-description\">Bulk Survey, Asbestos, Final Clearance, etc<\/div><\/div><div id=\"wpforms-311-field_15-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_15\">Date \/ Time<\/label><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-date-type-datepicker\"><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-311-field_15\" class=\"wpforms-field-date-time-date wpforms-datepicker\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][15][date]\" ><a title=\"Clear Date\" data-clear class=\"wpforms-datepicker-clear\" style=\"display:none;\"><\/a><\/div><label for=\"wpforms-311-field_15\" class=\"wpforms-field-sublabel after\">Date<\/label><\/div><div class=\"wpforms-field-row-block\"><input type=\"text\" id=\"wpforms-311-field_15-time\" class=\"wpforms-field-date-time-time wpforms-timepicker\" data-time-format=\"g:i A\" data-step=\"30\" data-rule-time12h=\"true\" name=\"wpforms[fields][15][time]\" ><label for=\"wpforms-311-field_15-time\" class=\"wpforms-field-sublabel after\">Time<\/label><\/div><\/div><\/div><div id=\"wpforms-311-field_16-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"16\"><h3 id=\"wpforms-311-field_16\">Location Description<\/h3><div class=\"wpforms-field-description\">Long driveway concrete, 2 story brick house, white trim, with 2 car garage, etc<\/div><\/div><div id=\"wpforms-311-field_17-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"17\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-311-field_17\">Location Description<\/label><textarea id=\"wpforms-311-field_17\" class=\"wpforms-field-medium\" name=\"wpforms[fields][17]\" ><\/textarea><\/div><div id=\"wpforms-311-field_35-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"35\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><button class=\"wpforms-page-button wpforms-page-next\" data-action=\"next\" data-page=\"3\" data-formid=\"311\" disabled>Next<\/button><\/div><\/div><\/div><div class=\"wpforms-page wpforms-page-4 last \" data-page=\"4\" style=\"display:none;\"><div id=\"wpforms-311-field_18-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"18\"><h3 id=\"wpforms-311-field_18\">Scope of Work to be Performed<\/h3><\/div><div id=\"wpforms-311-field_19-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"19\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-311-field_19\">Scope of Work<\/label><textarea id=\"wpforms-311-field_19\" class=\"wpforms-field-medium\" name=\"wpforms[fields][19]\" ><\/textarea><div class=\"wpforms-field-description\">Abatement VCT Floor tile and mastic, laundry room, ACM sheetrock walls and ceiling, etc<\/div><\/div><div id=\"wpforms-311-field_20-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"20\"><label class=\"wpforms-field-label\">Is there a Scope of Work?<\/label><ul id=\"wpforms-311-field_20\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_20_1\" name=\"wpforms[fields][20][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_20_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_20_2\" name=\"wpforms[fields][20][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_20_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-311-field_21-container\" class=\"wpforms-field wpforms-field-file-upload wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"21\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_21\">File Upload <span class=\"wpforms-required-label\">*<\/span><\/label><div\n\t\tclass=\"wpforms-uploader\"\n\t\tdata-field-id=\"21\"\n\t\tdata-form-id=\"311\"\n\t\tdata-input-name=\"wpforms_311_21\"\n\t\tdata-extensions=\"pdf,docx,doc\"\n\t\tdata-max-size=\"104857600\"\n\t\tdata-max-file-number=\"2\"\n\t\tdata-post-max-size=\"104857600\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg viewBox=\"0 0 1024 1024\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M885.2 446.3l-.2-.8-112.2-285.1c-5-16.1-19.9-27.2-36.8-27.2H281.2c-17 0-32.1 11.3-36.9 27.6L139.4 443l-.3.7-.2.8c-1.3 4.9-1.7 9.9-1 14.8-.1 1.6-.2 3.2-.2 4.8V830a60.9 60.9 0 0 0 60.8 60.8h627.2c33.5 0 60.8-27.3 60.9-60.8V464.1c0-1.3 0-2.6-.1-3.7.4-4.9 0-9.6-1.3-14.1zm-295.8-43l-.3 15.7c-.8 44.9-31.8 75.1-77.1 75.1-22.1 0-41.1-7.1-54.8-20.6S436 441.2 435.6 419l-.3-15.7H229.5L309 210h399.2l81.7 193.3H589.4zm-375 76.8h157.3c24.3 57.1 76 90.8 140.4 90.8 33.7 0 65-9.4 90.3-27.2 22.2-15.6 39.5-37.4 50.7-63.6h156.5V814H214.4V480.1z\"><\/path>\n\t\t<\/svg>\n\t\t<span class=\"modern-title\">Click or drag files to this area to upload.<\/span>\n\n\t\t\t\t\t<span class=\"modern-hint\">You can upload up to 2 files.<\/span>\n\t\t\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-311-field_21\"\n\t\tname=\"wpforms_311_21\" required\t\tvalue=\"\">\n<div class=\"wpforms-field-description\">Please upload the project scope of work in PDF, DOC, or DOCX format<\/div><\/div><div id=\"wpforms-311-field_22-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"22\"><label class=\"wpforms-field-label\">Electrical Power On-site?<\/label><ul id=\"wpforms-311-field_22\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_22_1\" name=\"wpforms[fields][22][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_22_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_22_2\" name=\"wpforms[fields][22][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_22_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-311-field_23-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"23\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_23\">Closest Electrical Power Source?<\/label><input type=\"text\" id=\"wpforms-311-field_23\" class=\"wpforms-field-medium\" name=\"wpforms[fields][23]\" ><\/div><div id=\"wpforms-311-field_24-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"24\"><label class=\"wpforms-field-label\">Site Locked?<\/label><ul id=\"wpforms-311-field_24\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_24_1\" name=\"wpforms[fields][24][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_24_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_24_2\" name=\"wpforms[fields][24][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_24_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-311-field_26-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"26\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_26\">POC for Access<\/label><input type=\"text\" id=\"wpforms-311-field_26\" class=\"wpforms-field-medium\" name=\"wpforms[fields][26]\" ><div class=\"wpforms-field-description\">Name and Phone Number<\/div><\/div><div id=\"wpforms-311-field_27-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"27\"><label class=\"wpforms-field-label\">Animals On-site?<\/label><ul id=\"wpforms-311-field_27\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_27_1\" name=\"wpforms[fields][27][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_27_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_27_2\" name=\"wpforms[fields][27][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_27_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-311-field_28-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"28\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_28\">Type and\/or Description<\/label><input type=\"text\" id=\"wpforms-311-field_28\" class=\"wpforms-field-medium\" name=\"wpforms[fields][28]\" ><div class=\"wpforms-field-description\">Please include details for all animals on-site.<\/div><\/div><div id=\"wpforms-311-field_29-container\" class=\"wpforms-field wpforms-field-divider\" data-field-id=\"29\"><h3 id=\"wpforms-311-field_29\">Any Other Details?<\/h3><\/div><div id=\"wpforms-311-field_30-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"30\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-311-field_30\">Other Details<\/label><textarea id=\"wpforms-311-field_30\" class=\"wpforms-field-medium\" name=\"wpforms[fields][30]\" ><\/textarea><\/div><div id=\"wpforms-311-field_37-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-conditional-trigger\" data-field-id=\"37\"><label class=\"wpforms-field-label\">Do you have Project Pictures?<\/label><ul id=\"wpforms-311-field_37\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_37_1\" name=\"wpforms[fields][37][]\" value=\"Yes\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_37_1\">Yes<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-311-field_37_2\" name=\"wpforms[fields][37][]\" value=\"No\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-311-field_37_2\">No<\/label><\/li><\/ul><\/div><div id=\"wpforms-311-field_36-container\" class=\"wpforms-field wpforms-field-file-upload wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"36\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-311-field_36\">Picture Upload<\/label><div\n\t\tclass=\"wpforms-uploader\"\n\t\tdata-field-id=\"36\"\n\t\tdata-form-id=\"311\"\n\t\tdata-input-name=\"wpforms_311_36\"\n\t\tdata-extensions=\"png,jpg,bmp\"\n\t\tdata-max-size=\"104857600\"\n\t\tdata-max-file-number=\"5\"\n\t\tdata-post-max-size=\"104857600\"\n\t\tdata-max-parallel-uploads=\"4\"\n\t\tdata-parallel-uploads=\"true\"\n\t\tdata-file-chunk-size=\"2097152\">\n\t<div class=\"dz-message\">\n\t\t<svg viewBox=\"0 0 1024 1024\" focusable=\"false\" data-icon=\"inbox\" width=\"50px\" height=\"50px\" fill=\"currentColor\" aria-hidden=\"true\">\n\t\t\t<path d=\"M885.2 446.3l-.2-.8-112.2-285.1c-5-16.1-19.9-27.2-36.8-27.2H281.2c-17 0-32.1 11.3-36.9 27.6L139.4 443l-.3.7-.2.8c-1.3 4.9-1.7 9.9-1 14.8-.1 1.6-.2 3.2-.2 4.8V830a60.9 60.9 0 0 0 60.8 60.8h627.2c33.5 0 60.8-27.3 60.9-60.8V464.1c0-1.3 0-2.6-.1-3.7.4-4.9 0-9.6-1.3-14.1zm-295.8-43l-.3 15.7c-.8 44.9-31.8 75.1-77.1 75.1-22.1 0-41.1-7.1-54.8-20.6S436 441.2 435.6 419l-.3-15.7H229.5L309 210h399.2l81.7 193.3H589.4zm-375 76.8h157.3c24.3 57.1 76 90.8 140.4 90.8 33.7 0 65-9.4 90.3-27.2 22.2-15.6 39.5-37.4 50.7-63.6h156.5V814H214.4V480.1z\"><\/path>\n\t\t<\/svg>\n\t\t<span class=\"modern-title\">Click or drag files to this area to upload.<\/span>\n\n\t\t\t\t\t<span class=\"modern-hint\">You can upload up to 5 files.<\/span>\n\t\t\t<\/div>\n<\/div>\n<input\n\t\ttype=\"text\"\n\t\tautocomplete=\"off\"\n\t\treadonly\n\t\tclass=\"dropzone-input\"\n\t\tstyle=\"position:absolute!important;clip:rect(0,0,0,0)!important;height:1px!important;width:1px!important;border:0!important;overflow:hidden!important;padding:0!important;margin:0!important;\"\n\t\tid=\"wpforms-311-field_36\"\n\t\tname=\"wpforms_311_36\" \t\tvalue=\"\">\n<\/div><div id=\"wpforms-311-field_33-container\" class=\"wpforms-field wpforms-field-pagebreak\" data-field-id=\"33\"><div class=\"wpforms-clear wpforms-pagebreak-left\"><\/div><\/div><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-field wpforms-field-hp\"><label for=\"wpforms-311-field-hp\" class=\"wpforms-field-label\">Phone<\/label><input type=\"text\" name=\"wpforms[hp]\" id=\"wpforms-311-field-hp\" class=\"wpforms-field-medium\"><\/div><div class=\"wpforms-submit-container\" style=\"display:none;\"><input type=\"hidden\" name=\"wpforms[id]\" value=\"311\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/www.genesisels.com\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F313\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-311\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-313","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/pages\/313"}],"collection":[{"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.genesisels.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=313"}],"version-history":[{"count":4,"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/pages\/313\/revisions"}],"predecessor-version":[{"id":380,"href":"https:\/\/www.genesisels.com\/index.php?rest_route=\/wp\/v2\/pages\/313\/revisions\/380"}],"wp:attachment":[{"href":"https:\/\/www.genesisels.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=313"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}