{"id":99048,"date":"2025-11-05T08:25:41","date_gmt":"2025-11-05T13:25:41","guid":{"rendered":"https:\/\/farmerbrown.com\/personal-auto-home-form\/"},"modified":"2026-07-27T10:22:35","modified_gmt":"2026-07-27T15:22:35","slug":"seguro-para-auto-y-hogar","status":"publish","type":"page","link":"https:\/\/farmerbrown.com\/es\/seguro-para-auto-y-hogar\/","title":{"rendered":"Seguro para auto y hogar"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"99048\" class=\"elementor elementor-99048 elementor-89618\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3bd2ac98 e-flex e-con-boxed e-con e-parent\" data-id=\"3bd2ac98\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a72ebcb elementor-widget elementor-widget-heading\" data-id=\"a72ebcb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Obtenga su cotizaci\u00f3n para seguro de auto y hogar<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-045f74b elementor-widget elementor-widget-shortcode\" data-id=\"045f74b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><script data-cfasync=\"false\">\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 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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_97' style='display:none'><style>\/* .repeater-field-item .read_only_class {\r\n    margin-top: 7px;\r\n} *\/\r\n#gform_wrapper_97 #gform_wrapper_97 .gfield_label{\r\n    margin-bottom: 20px !important;\r\n}\r\n#gform_wrapper_97 .gfield_error .repeater-field-item .read_only_class{\r\n\tmargin-top: 0px;\r\n}\r\n#gform_wrapper_97 .gfield--type-repeater_end{\r\n    margin-top: -50px;\r\n    padding-left: 0 !important;\r\n    padding-right: 0 !important;\r\n}\r\n#gform_wrapper_97 .extra-choices .gfield_radio{\r\n\tdisplay: flex;\r\n    gap: 20px;\r\n}\r\n#gform_wrapper_97 .pricing-container{\r\n  display: flex;\r\n  justify-content: center;\r\n  gap: 20px;\r\n  flex-wrap: wrap;\r\n  margin: 0px auto 20px auto;\r\n  font-family: Arial, sans-serif;\r\n}\r\n#gform_wrapper_97 .pricing-box{\r\n  flex: 1 1;\r\n  display: flex;\r\n  flex-direction: column;\r\n  border: 2px solid #ddd;\r\n  border-radius: 12px;\r\n  box-shadow: 0 4px 12px rgba(0,0,0,0.08);\r\n  overflow: hidden;\r\n  transition: transform 0.2s, border-color 0.2s;\r\n  position: relative;\r\n  cursor: pointer;\r\n}\r\n#gform_wrapper_97 .pricing-box:hover{\r\n  transform: translateY(-5px);\r\n}\r\n#gform_wrapper_97 .pricing-box.basic .pricing-header{\r\n  background-color: #e0f0ff;\r\n  color: #004a99;\r\n}\r\n#gform_wrapper_97 .pricing-box.standard .pricing-header{\r\n  background-color: #e8f9e9;\r\n  color: #1a7a1a;\r\n}\r\n#gform_wrapper_97 .pricing-box.premium .pricing-header{\r\n  background-color: #fff3cd; \r\n  color: #8a6d00;\r\n}\r\n#gform_wrapper_97 .pricing-header{\r\n  text-align: center;\r\n  padding: 20px 10px;\r\n  font-size: 1.4em;\r\n  font-weight: bold;\r\n  position: relative;\r\n}\r\n#gform_wrapper_97 .pricing-tag{\r\n  position: absolute;\r\n  top: 8px;\r\n  right: 10px;\r\n  background-color: #ffebc6;\r\n  color: #a66a00;\r\n  font-size: 10px;\r\n  font-weight: bold;\r\n  text-transform: uppercase;\r\n  padding: 3px 6px;\r\n 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rgba(0,74,153,0.3);\r\n  background-color: #fff;\r\n}\r\n#gform_wrapper_97 .pricing-box.standard.active{\r\n  border-color: #1a7a1a;\r\n  box-shadow: 0 0 10px rgba(26,122,26,0.3);\r\n  background-color: #fff;\r\n}\r\n#gform_wrapper_97 .pricing-box.premium.active{\r\n  border-color: #8a6d00;\r\n  box-shadow: 0 0 10px rgba(138,109,0,0.3);\r\n  background-color: #fff;\r\n}\r\n#gform_wrapper_97 .pricing-box ul{\r\n  list-style: none;\r\n  padding-left: 0;\r\n}\r\n#gform_wrapper_97 .pricing-box ul li{\r\n  position: relative;\r\n  padding-left: 28px;\r\n  margin-bottom: 8px;\r\n  display: inline-flex;\r\n  align-items: center;\r\n}\r\n#gform_wrapper_97 .pricing-box ul li::before{\r\n  content: \"\u2713\";\r\n  display: inline-block;\r\n  width: 16px;\r\n  height: 16px;\r\n  line-height: 16px;\r\n  text-align: center;\r\n  border: 2px solid #000;\r\n  border-radius: 1px;\r\n  color: #000;\r\n  font-weight: 600;\r\n  margin-right: 8px;\r\n  font-size: 12px;\r\n}\r\n\r\n\/* Responsive 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flex: 1;\r\n  }\r\n#gform_wrapper_97 .option-footer{\r\n    margin-top: 20px;\r\n    text-align: center;\r\n  }\r\n#gform_wrapper_97 .select-btn-insurance{\r\n    background: #cc6f3e;\r\n    color: #fff;\r\n    border: none;\r\n    padding: 10px 18px;\r\n    border-radius: 8px;\r\n    cursor: pointer;\r\n    font-weight: 600;\r\n    transition: 0.2s ease;\r\n    width: 100%;\r\n  }\r\n\r\n\/*   .select-btn-insurance:hover {\r\n    background: #095b91;\r\n  } *\/\r\n#gform_wrapper_97 @media (max-width: 768px){\r\n#gform_wrapper_97 .option-card{\r\n      flex: 1 1 100%;\r\n    }\r\n  }\r\n\r\n\/* Step css  *\/\r\n@media (min-width: 1024px) {\r\n#gform_wrapper_97 #gform_97 .gform-body{\r\n\t\tpadding-left: 2rem;\r\n\t\tpadding-right: 2rem;\r\n\t}\r\n#gform_wrapper_97 #gf_page_steps_97{ \r\n\t\tpadding-left: 2rem;\r\n        padding-right: 2rem;\r\n\t}\r\n}\r\n\r\n@media (min-width: 640px) { \r\n#gform_wrapper_97 #gform_97 .gform-body{\r\n\t\tpadding-left: 1.5rem;\r\n        padding-right: 1.5rem;\r\n\t}\r\n#gform_wrapper_97 #gf_page_steps_97{ \r\n\t\tpadding-left: 1.5rem;\r\n        padding-right: 1.5rem;\r\n\t}\r\n}\r\n\r\n@media (max-width: 768px) { \r\n#gform_wrapper_97 #gf_page_steps_97 .gf_step::after{\r\n\t\tdisplay: none;\r\n\t}\r\n#gform_wrapper_97 #gform_97 .gform_next_button, #gform_submit_button_97{\r\n\t\twidth: 100%;\r\n\t}\r\n#gform_wrapper_97 #gform_next_button_97_136{\r\n\t\twidth: 100% !important;\r\n\t}\r\n#gform_wrapper_97 #gf_page_steps_97{\r\n\t\tjustify-content: center !important\r\n\t}\r\n\t\r\n\/* \t#gform_97 .gform-body {\r\n\t\tpadding-left: 1rem;\r\n        padding-right: 1rem;\r\n\t} *\/\r\n#gform_wrapper_97 #gform_97 .gform-body .gform_page{\r\n\t\tmargin-top: 1rem;\r\n\t}\r\n#gform_wrapper_97 .gform_page .gform-page-footer{\r\n\t\tflex-direction: column !important;\r\n\t\tgap: 1rem;\r\n\t}\r\n}\r\n#gform_wrapper_97 #gf_page_steps_97{\r\n\talign-items: center;\r\n    display: flex;\r\n    justify-content: center;\r\n    padding-top: 1rem;\r\n    padding-bottom: 1rem;\r\n    margin-left: auto;\r\n    margin-right: auto;\r\n    border-bottom: none !important;\r\n    width: 100%;\r\n    max-width: 1080px;\r\n    gap: 2rem;\r\n}\r\n#gform_wrapper_97 #gf_page_steps_97 .gf_step:not(.gf_step_hidden){\r\n\tflex-direction: column;\r\n\talign-items: center;\r\n\tdisplay: flex;\r\n\tmargin: 0px;\r\n    min-width: 70px;\r\n}\r\n#gform_wrapper_97 #gform_97 .gf_step_active .gf_step_number{\r\n\t--tw-bg-opacity: 1;\r\n    background-color: rgb(230 126 34) !important;\r\n\t--tw-text-opacity: 1;\r\n    color: rgb(255 255 255 \/ var(--tw-text-opacity, 1)) !important;\r\n}\r\n#gform_wrapper_97 .gf_step_active .gf_step_label{\r\n\tfont-size: 14px;\r\n    font-weight: 600;\r\n    line-height: 16px;\r\n\t--tw-text-opacity: 1;\r\n    color: rgb(17 24 39 \/ var(--tw-text-opacity, 1)) !important;\r\n}\r\n#gform_wrapper_97 #gform_97 .gf_step_label{\r\n\tpadding-left:0px;\r\n\tfont-weight: 500;\r\n\ttext-align: center;\r\n}\r\n#gform_wrapper_97 #gform_97 .gf_step_number{\r\n\tmargin-bottom: 0.25rem;\r\n\tfont-weight: 600;\r\n\tjustify-content: center;\r\n\talign-items: center;\r\n\tdisplay: flex;\r\n\tborder: none;\r\n\t--tw-bg-opacity: 1;\r\n    background-color: rgb(209 213 219 \/ var(--tw-bg-opacity, 1));\r\n    --tw-text-opacity: 1;\r\n    color: rgb(75 85 99 \/ var(--tw-text-opacity, 1));\r\n\t width: 2rem;\r\n    height: 2rem;\r\n}\r\n#gform_wrapper_97 #gf_page_steps_97 .gf_step{\r\n  position: relative;\r\n}\r\n\r\n\/* #gf_page_steps_97 .gf_step:not(:last-child)::after {\r\n  content: \"\";\r\n  position: absolute;\r\n  top: 50%;\r\n  left: 90%;\r\n  width: 3rem;\r\n  height: 2px;\r\n  background-color: #d1d5db;\r\n  transform: translateY(-50%);\r\n}\r\n *\/\r\n#gform_wrapper_97 .gf_step_completed .gf_step_number::before{\r\n\tdisplay: none;\r\n}\r\n#gform_wrapper_97 .gf_step_completed .gf_step_number::after{\r\n\tdisplay: none;\r\n}\r\n#gform_wrapper_97 #gform_97 .gf_step_completed .gf_step_number{\r\n\t--tw-bg-opacity: 1;\r\n    background-color: rgb(209 213 219 \/ var(--tw-bg-opacity, 1));\r\n\t--tw-text-opacity: 1;\r\n    color: rgb(159 159 159);\r\n}\r\n#gform_wrapper_97 .repeater-field-footer .gf-repeater-field-button-add:hover{\r\n\tcolor: #fff !important;\r\n    background: rgb(230 126 34) !important;\r\n\tbox-shadow: none !important;\r\n}\r\n\r\n\/* #gform_97 .gf_step_completed:not(:last-child)::after {\r\n  content: \"\";\r\n  position: absolute;\r\n  top: 50%;\r\n  left: 125%;\r\n  width: 3rem;\r\n  height: 2px;\r\n  background-color: rgb(52 152 219);\r\n  transform: translateY(-50%);\r\n}\r\n *\/\r\n#gform_wrapper_97 .gform_next_button, #gform_submit_button_97, #gform_next_button_97_136{\r\n\twidth: auto;\r\n    font-size: 14px;\r\n    line-height: 24px;\r\n    font-weight: 600;\r\n    padding: 12px 32px !important;\r\n    border-radius: 0.5rem;\r\n    background-color: rgb(230 126 34);\r\n    margin: 0;\r\n    font-size: 16px;\r\n    font-weight: 600;\r\n    border: 0;\r\n\tmargin-left: auto;\r\n    color: #fff;\r\n\tcursor: pointer;\r\n} \r\n#gform_wrapper_97 .gform-page-footer.gform_page_footer{\r\n    padding: 0px;\r\n    margin-top: 32px;\r\n    display: flex;\r\n    justify-content: space-between;\r\n}\r\n#gform_wrapper_97 .gform_previous_button{\r\n    width: auto;\r\n    font-size: 14px;\r\n    line-height: 24px;\r\n    font-weight: 600;\r\n    padding: 12px 32px !important;\r\n    border-radius: 0.5rem;\r\n    background-color: transparent;\r\n    margin: 0;\r\n    border: 1px solid #c5c9d2;\r\n    color: #374151;\r\n    font-size: 16px;\r\n    font-weight: 600;\r\n    box-shadow: none;\r\n}\r\n#gform_wrapper_97 .gform-theme-button{\r\n\tmargin-bottom: 0px !important;\r\n}\r\n#gform_wrapper_97 .gform_save_link{\r\n    border-radius: 10px;\r\n    transition: all 0.3s ease-in-out;\r\n    border-style: none;\r\n    font-size: 21px;\r\n    cursor: pointer;\r\n    border: 1px solid #c5c9d2;\r\n\t width: fit-content;\r\n\tbox-shadow: none;\r\n\tfont-weight: 600;\r\n}\r\n#gform_wrapper_97 #gform_page_97_1 .gform_save_link{\r\n\tdisplay: none;\r\n}\r\n#gform_wrapper_97 .form_saved_message_emailform #gform_97{\r\n\topacity: 1 !important;\r\n}\r\n#gform_wrapper_97 .partial_entry_warning{\r\n\tdisplay: none;\r\n}\r\n#gform_wrapper_97 .gfield_label{\r\n\tline-height: unset;\r\n}\r\n#gform_wrapper_97 .gform_required_legend{\r\n\tdisplay:none;\r\n}<\/style><div id='gf_97' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; se\u00f1ala los campos obligatorios<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_97' id='gform_97'  action='\/es\/wp-json\/wp\/v2\/pages\/99048#gf_97' data-formid='97' novalidate><div id='gf_page_steps_97' class='gf_page_steps'><div id='gf_step_97_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'>Seleccionar seguro<\/span><\/div><div id='gf_step_97_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'>Informaci\u00f3n Personal<\/span><\/div><div id='gf_step_97_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'>Seguro de auto<\/span><\/div><div id='gf_step_97_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'>Seguro de hogar<\/span><\/div><div id='gf_step_97_5' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'>Seguro de auto<\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_97_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_97' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_132\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class=\"gfield_label gform-field-label\">Seleccione su seguro<\/legend>\n<div class=\"options-insurance\">\n    <div class=\"option-card auto-insurance\" data-type=\"auto\">\n      <div>\n        <div class=\"option-title\">Seguro de Auto Personal<\/div>\n        <div class=\"option-desc\">\n          Cotizaci\u00f3n r\u00e1pida para cobertura de auto. Conduzca protegido.\n        <\/div>\n      <\/div>\n      <div class=\"option-footer\">\n        <button type=\"button\" class=\"select-btn-insurance\">Seleccionar<\/button>\n      <\/div>\n    <\/div>\n    \n    <div class=\"option-card commercial-auto-insurance\" data-type=\"commercial-auto\">\n      <div>\n        <div class=\"option-title\">Seguro de Auto Comercial<\/div>\n        <div class=\"option-desc\">\n          Cobertura confiable para sus veh\u00edculos y conductores comerciales. Prot\u00e9jase hoy.\n        <\/div>\n      <\/div>\n      <div class=\"option-footer\">\n        <button type=\"button\" class=\"select-btn-insurance\">Seleccionar<\/button>\n      <\/div>\n    <\/div>\n\n    <div class=\"option-card home-insurance\" data-type=\"home\">\n      <div>\n        <div class=\"option-title\">Seguro de Hogar<\/div>\n        <div class=\"option-desc\">\n          Proteja su casa, pertenencias y responsabilidad civil. Aseg\u00farese ahora.\n        <\/div>\n      <\/div>\n      <div class=\"option-footer\">\n        <button type=\"button\" class=\"select-btn-insurance\">Seleccionar<\/button>\n      <\/div>\n    <\/div>\n\n    <div class=\"option-card both-insurance\" data-type=\"both\">\n      <div>\n        <div class=\"option-title\">Seguro de Hogar y Auto<\/div>\n        <div class=\"option-desc\">\n          \u00a1Comb\u00edbelos y ahorre! Obtenga cobertura conjunta para su hogar y su auto.\n        <\/div>\n      <\/div>\n      <div class=\"option-footer\">\n        <button type=\"button\" class=\"select-btn-insurance\">Seleccionar<\/button>\n      <\/div>\n    <\/div>\n  <\/div>\n<\/div><fieldset id=\"field_97_131\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col gfield--width-full select-insurance gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-columns\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Este campo est\u00e1 oculto cuando se visualiza el formulario\"><\/i><span>Este campo est\u00e1 oculto cuando se visualiza el formulario<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Seleccione su seguro<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_131'>\n\t\t\t<div class='gchoice gchoice_97_131_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='Auto'  id='choice_97_131_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_131_0' id='label_97_131_0' class='gform-field-label gform-field-label--type-inline'>Seguro de Auto Personal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_131_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='Commercial Auto'  id='choice_97_131_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_131_1' id='label_97_131_1' class='gform-field-label gform-field-label--type-inline'>Seguro de Auto Comercial<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_131_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='Home'  id='choice_97_131_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_131_2' id='label_97_131_2' class='gform-field-label gform-field-label--type-inline'>Seguro de Hogar<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_131_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_131' type='radio' value='Both'  id='choice_97_131_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_131_3' id='label_97_131_3' class='gform-field-label gform-field-label--type-inline'>Hogar y Auto<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_97_141' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next'  \/>Siguiente<\/button> <button type='button'  id='gform_save_97_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save Draft<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_97_2' class='gform_page' data-js='page-field-id-141' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_97_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_82\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half firstname-insurance gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_82'><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_97_82' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_83\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half lastname-insurance gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_83'><span class='gform-field-label__text'>Apellidos<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_97_83' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_160\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_160'><span class='gform-field-label__text'>Nombre del Negocio<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_160' id='input_97_160' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_73\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_73'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_73' id='input_97_73' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_97_74\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_74'><span class='gform-field-label__text'>Tel\u00e9fono<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_74' id='input_97_74' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_97_135' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous'  \/>Anterior<\/button> <button type='button' id='gform_next_button_97_135' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next'  \/>Siguiente<\/button> <button type='button'  id='gform_save_97_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save Draft<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_97_3' class='gform_page' data-js='page-field-id-135' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_97_3' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_142\" class=\"gfield gfield--type-section gfield--input-type-section gsection auto-insurance-section field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Seguro de Auto Personal<\/h3><\/div><div id=\"field_97_56\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><style>\n\/* ===== CONTENEDOR GENERAL ===== *\/\n.pricing-container {\n  display: flex;\n  justify-content: center;\n  flex-wrap: wrap;\n  gap: 24px;\n  margin: 20px 0;\n  font-family: \"Inter\", \"Segoe UI\", sans-serif;\n  position: relative;\n  overflow: visible !important;\n  z-index: 10;\n}\n\n\/* ===== TARJETAS ===== *\/\n.pricing-box {\n  background: #fff;\n  border: 1.5px solid #e0e6f0;\n  border-radius: 12px;\n  width: 280px;\n  box-shadow: 0 4px 10px rgba(0,0,0,0.05);\n  overflow: visible !important;\n  position: relative;\n  z-index: 20;\n  transition: transform 0.25s ease, box-shadow 0.25s ease;\n}\n\n.pricing-box:hover {\n  transform: translateY(-3px);\n  box-shadow: 0 6px 16px rgba(0,0,0,0.12);\n}\n\n\/* ===== CABECERA ===== *\/\n.pricing-header {\n  background: #f6f8fc;\n  color: #013766;\n  font-weight: 700;\n  font-size: 1.2rem;\n  text-align: center;\n  padding: 14px;\n  border-bottom: 1px solid #dce3f5;\n  border-radius: 12px 12px 0 0;\n}\n\n\/* ===== CONTENIDO ===== *\/\n.pricing-content {\n  padding: 18px;\n  overflow: visible !important;\n}\n\n.pricing-content ul {\n  list-style: none;\n  margin: 0;\n  padding: 0;\n}\n\n.pricing-content li {\n  background: #f9fbfd;\n  margin-bottom: 10px;\n  padding: 10px 12px;\n  border-radius: 8px;\n  font-size: 0.95rem;\n  color: #333;\n  display: flex;\n  justify-content: space-between;\n  align-items: center;\n  position: relative;\n  overflow: visible !important;\n}\n\n\/* ===== ICONO INFO ===== *\/\n.info-icon {\n  background-color: #013766;\n  color: #fff;\n  border-radius: 50%;\n  width: 20px;\n  height: 20px;\n  font-size: 12px;\n  font-weight: bold;\n  display: inline-flex;\n  justify-content: center;\n  align-items: center;\n  cursor: pointer;\n  margin-left: 8px;\n  position: relative;\n  z-index: 1000;\n  flex-shrink: 0;\n  box-shadow: 0 1px 3px rgba(0,0,0,0.25);\n  transition: all 0.2s ease;\n}\n\n.info-icon:hover {\n  background-color: #0a4d9b;\n  transform: scale(1.08);\n}\n\n\/* ===== TOOLTIP GLOBAL ===== *\/\n.info-icon .info-box {\n  position: fixed;\n  background: #fff;\n  color: #333;\n  border: 1px solid #e1e6f2;\n  border-radius: 8px;\n  box-shadow: 0 4px 12px rgba(0,0,0,0.15);\n  font-size: 0.65rem;\n  line-height: 1.4;\n  padding: 9px 11px;\n  width: 240px;\n  text-align: left;\n  white-space: normal;\n  opacity: 0;\n  visibility: hidden;\n  transform: translate(10px, -50%);\n  transition: opacity 0.25s ease, transform 0.25s ease;\n  z-index: 99999;\n}\n\n.info-icon:hover .info-box {\n  opacity: 1;\n  visibility: visible;\n  transform: translate(13px, -50%);\n}\n\n\/* Flecha *\/\n.info-icon .info-box::after {\n  content: \"\";\n  position: absolute;\n  top: 50%;\n  left: -6px;\n  transform: translateY(-50%);\n  border-width: 6px;\n  border-style: solid;\n  border-color: transparent #fff transparent transparent;\n}\n\n\/* ===== TOOLTIP DERECHA (Basic y Standard) ===== *\/\n.pricing-box:nth-child(1) .info-icon .info-box,\n.pricing-box:nth-child(2) .info-icon .info-box {\n  left: auto;\n  right: calc(100% + 10px);\n}\n\n\/* ===== TOOLTIP IZQUIERDA (Premium) ===== *\/\n.pricing-box:last-child .info-icon .info-box {\n  position: absolute !important;\n  top: 50%;\n  right: calc(100% + 10px) !important;\n  left: auto !important;\n  transform: translateY(-50%) !important;\n  z-index: 9999;\n}\n\n.pricing-box:last-child .info-icon .info-box::after {\n  content: \"\";\n  position: absolute;\n  top: 50%;\n  right: -6px;\n  transform: translateY(-50%);\n  border-width: 6px;\n  border-style: solid;\n  border-color: transparent transparent transparent #fff;\n}\n\n.pricing-box:last-child .info-icon:hover .info-box {\n  opacity: 1;\n  visibility: visible;\n  transform: translateY(-50%) !important;\n}\n\n\/* ===== BOT\u00d3N ===== *\/\n.select-btn {\n  width: 100%;\n  background-color: #013766;\n  color: #fff;\n  font-weight: 600;\n  font-size: 1rem;\n  border: none;\n  border-radius: 0 0 10px 10px;\n  padding: 14px;\n  cursor: pointer;\n  transition: background 0.2s ease;\n}\n\n.select-btn:hover {\n  background-color: #0a4d9b;\n}\n\n\/* ===== RESPONSIVE ===== *\/\n@media (max-width: 992px) {\n  .pricing-container {\n    flex-direction: column;\n    align-items: center;\n  }\n\n  .pricing-box {\n    width: 90%;\n  }\n\n  \/* Tooltip general centrado en mobile *\/\n  .info-icon .info-box {\n    left: 50% !important;\n    top: auto !important;\n    bottom: 125% !important;\n    transform: translateX(-50%) !important;\n    position: absolute !important;\n  }\n\n  .info-icon .info-box::after {\n    top: 100%;\n    left: 50%;\n    margin-left: -6px;\n    border-color: #fff transparent transparent transparent;\n  }\n\n  \/* Tooltip del Premium corregido en mobile *\/\n  .pricing-box.premium .info-icon .info-box {\n    right: auto !important;\n    left: 50% !important;\n    top: auto !important;\n    bottom: 125% !important;\n    transform: translateX(-50%) !important;\n    position: absolute !important;\n  }\n\n  .pricing-box.premium .info-icon .info-box::after {\n    top: 100%;\n    right: auto;\n    left: 50%;\n    margin-left: -6px;\n    border-width: 6px;\n    border-style: solid;\n    border-color: #fff transparent transparent transparent;\n  }\n}\n<\/style>\n\n<legend class=\"gfield_label gform-field-label\">Seleccione su paquete<\/legend>\n\n<div class=\"pricing-container\">\n\n  <!-- B\u00c1SICO -->\n  <div class=\"pricing-box basic\">\n    <div class=\"pricing-header\">B\u00e1sico<\/div>\n    <div class=\"pricing-content\">\n      <ul>\n        <li>\n          DA\/DP: 25 | 50\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Cubre lesiones y da\u00f1os a la propiedad causados por su negligencia. Ejemplo: $250 \/ $500 \/ $100 = $250k por persona, $500k por accidente, $100k l\u00edmite por da\u00f1os a la propiedad.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          UM\/UIM: 25 | 50\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Lo protege si otro conductor no tiene seguro o tiene seguro insuficiente. Generalmente los mismos l\u00edmites que DA\/DP, ej. $250 \/ $500.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          MedPay: 5000\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Paga los gastos m\u00e9dicos para usted y sus pasajeros, independientemente de qui\u00e9n tenga la culpa. Normalmente $5,000, var\u00eda en estados sin culpa como MI o NJ.\n            <\/span>\n          <\/span>\n        <\/li>\n      <\/ul>\n    <\/div>\n    <div class=\"pricing-footer\">\n      <button type=\"button\" class=\"select-btn\">Seleccionar y continuar \u00bb<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- EST\u00c1NDAR -->\n  <div class=\"pricing-box standard\">\n    <div class=\"pricing-header\">Est\u00e1ndar<\/div>\n    <div class=\"pricing-content\">\n      <ul>\n        <li>\n          DA\/DP: 100 | 300 | 100\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Cubre lesiones y da\u00f1os a la propiedad causados por su negligencia. Ejemplo: $100 \/ $300 \/ $100 = $100k por persona, $300k por accidente, $100k l\u00edmite por da\u00f1os a la propiedad.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          UM\/UIM: 100 | 300\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Lo protege si otro conductor no tiene seguro o tiene seguro insuficiente. Generalmente los mismos l\u00edmites que DA\/DP, ej. $100 \/ $300.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          MedPay: 5000\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Proporciona hasta $5,000 para gastos m\u00e9dicos, independientemente de qui\u00e9n tenga la culpa. Var\u00eda en estados sin culpa como MI o NJ.\n            <\/span>\n          <\/span>\n        <\/li>\n      <\/ul>\n    <\/div>\n    <div class=\"pricing-footer\">\n      <button type=\"button\" class=\"select-btn\">Seleccionar y continuar \u00bb<\/button>\n    <\/div>\n  <\/div>\n\n  <!-- PREMIUM -->\n  <div class=\"pricing-box premium\">\n    <div class=\"pricing-header\">\n      Premium\n      <span class=\"pricing-tag\">Para propietario de vivienda<\/span>\n    <\/div>\n    <div class=\"pricing-content\">\n      <ul>\n        <li>\n          DA\/DP: 250 | 500 | 100\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Cubre lesiones y da\u00f1os a la propiedad causados por su negligencia. Ejemplo: $250 \/ $500 \/ $100 = $250k por persona, $500k por accidente, $100k l\u00edmite por da\u00f1os a la propiedad.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          UM\/UIM: 250 | 500\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Paga sus lesiones si es impactado por un conductor sin seguro o con seguro insuficiente. Generalmente iguala a DA\/DP, ej. $250 \/ $500.\n            <\/span>\n          <\/span>\n        <\/li>\n        <li>\n          MedPay: 5000\n          <span class=\"info-icon\">i\n            <span class=\"info-box\">\n              Proporciona hasta $5,000 para gastos m\u00e9dicos, independientemente de qui\u00e9n tenga la culpa. Var\u00eda en estados sin culpa como MI o NJ.\n            <\/span>\n          <\/span>\n        <\/li>\n      <\/ul>\n    <\/div>\n    <div class=\"pricing-footer\">\n      <button type=\"button\" class=\"select-btn\">Seleccionar y continuar \u00bb<\/button>\n    <\/div>\n  <\/div>\n<\/div><\/div><fieldset id=\"field_97_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_3col gfield--width-full select-package field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-columns\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"Este campo est\u00e1 oculto cuando se visualiza el formulario\"><\/i><span>Este campo est\u00e1 oculto cuando se visualiza el formulario<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Seleccionar Paquete<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_55'>\n\t\t\t<div class='gchoice gchoice_97_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Basic'  id='choice_97_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_0' id='label_97_55_0' class='gform-field-label gform-field-label--type-inline'>Paquete B\u00e1sico<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Standard'  id='choice_97_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_1' id='label_97_55_1' class='gform-field-label gform-field-label--type-inline'>Paquete Standard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Premium'  id='choice_97_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_55_2' id='label_97_55_2' class='gform-field-label gform-field-label--type-inline'>Paquete Premium<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_6\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full vehicle-repeater-section field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_6'><span class='gform-field-label__text'>Informaci\u00f3n del Veh\u00edculo<\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt;Veh&iacute;culo &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full vin-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_35'><span class='gform-field-label__text'>VIN #<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_97_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_234\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>\u2013O\u2013<\/p><\/div><div id=\"field_97_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third year-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_19'><span class='gform-field-label__text'>A\u00f1o<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_97_19' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_9\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third make-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_9'><span class='gform-field-label__text'>Marca<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_97_9' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_18\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third model-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_18'><span class='gform-field-label__text'>Modelo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_97_18' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Colisi\u00f3n y Todo Riesgo:<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_47'>\n\t\t\t<div class='gchoice gchoice_97_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='$500 deducible'  id='choice_97_47_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_47_0' id='label_97_47_0' class='gform-field-label gform-field-label--type-inline'>$500 deducible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='$1,000 deducible'  id='choice_97_47_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_47_1' id='label_97_47_1' class='gform-field-label gform-field-label--type-inline'>$1,000 deducible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_47_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='$2,500 deducible'  id='choice_97_47_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_47_2' id='label_97_47_2' class='gform-field-label gform-field-label--type-inline'>$2,500 deducible<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_47_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='Solo responsabilidad civil'  id='choice_97_47_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_47_3' id='label_97_47_3' class='gform-field-label gform-field-label--type-inline'>Solo responsabilidad civil<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_57\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Extras:<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_97_57'><div class='gchoice gchoice_97_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Servicio de gr\u00faa'  id='choice_97_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_57_1' id='label_97_57_1' class='gform-field-label gform-field-label--type-inline'>Servicio de gr\u00faa<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_7\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_7'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_7\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Additional Vehicle +<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_7' name='input_7' id='input_97_7' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><div id=\"field_97_66\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_66'><span class='gform-field-label__text'>Informaci\u00f3n del Conductor<\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt;Conductor &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_80\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half driver-firstname gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_80'><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_97_80' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_81\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half driver-lastname gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_81'><span class='gform-field-label__text'>Apellidos<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_97_81' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_59\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fecha de nacimiento<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_97_59' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_97_59_1_container'>\n                                        <input type='number' maxlength='2' name='input_59[]' id='input_97_59_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_97_59_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Mes<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_97_59_2_container'>\n                                        <input type='number' maxlength='2' name='input_59[]' id='input_97_59_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_97_59_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>D\u00eda<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_97_59_3_container'>\n                                        <input type='number' maxlength='4' name='input_59[]' id='input_97_59_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                        <label for='input_97_59_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>A\u00f1o<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><fieldset id=\"field_97_75\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-half field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Estado<\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_state ginput_container_address gform-grid-row' id='input_97_75' >\n                        <span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_97_75_4_container' >\n                                        <select name='input_75.4' id='input_97_75_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/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' >Maryland<\/option><option value='Massachusetts' >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' >Montana<\/option><option value='Nebraska' >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='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/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='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_97_75_4' id='input_97_75_4_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Provincia<\/label>\n                                      <\/span><input type='hidden' class='gform_hidden' name='input_75.6' id='input_97_75_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_97_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_64'><span class='gform-field-label__text'>N\u00famero de licencia de conducir<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_97_64' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_61\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_61'><span class='gform-field-label__text'>Estado Civil<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_61' id='input_97_61' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Soltero' >Soltero<\/option><option value='Casado' >Casado<\/option><option value='Separado' >Separado<\/option><option value='Divorciado' >Divorciado<\/option><option value='Viudo' >Viudo<\/option><\/select><\/div><\/div><div id=\"field_97_150\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_150'><span class='gform-field-label__text'>Profesi\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_150' id='input_97_150' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_63\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_63'><span class='gform-field-label__text'>SS#\/TIN<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_97_63' type='text' value='' class='large'  aria-describedby=\"gfield_description_97_63\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_97_63'><span style=\"color: red;\">Opcional.<\/span>\nNuestro sistema encripta el n\u00famero y lo procesa sin almacenarlo de manera permanente.<\/div><\/div><div id=\"field_97_65\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_65'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_65\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Conductor Adicional +<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_65' name='input_65' id='input_97_65' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><div id=\"field_97_67\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_67'><span class='gform-field-label__text'>\u00bfEs propietario de su vivienda?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_67' id='input_97_67' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='S\u00ed' >S\u00ed<\/option><option value='No' >No<\/option><\/select><\/div><\/div><fieldset id=\"field_97_68\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_97_68' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_97_68_1_container' >\n                                        <label for='input_97_68_1' id='input_97_68_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n donde estaciona el veh\u00edculo<\/label>\n                                        <input type='text' name='input_68.1' id='input_97_68_1' value=''    aria-required='false'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_97_68_2_container' >\n                                        <label for='input_97_68_2' id='input_97_68_2_label' class='gform-field-label gform-field-label--type-sub '>Apt\/Suite\/Otro<\/label>\n                                        <input type='text' name='input_68.2' id='input_97_68_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_97_68_3_container' >\n                                    <label for='input_97_68_3' id='input_97_68_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                    <input type='text' name='input_68.3' id='input_97_68_3' value=''    aria-required='false'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_97_68_4_container' >\n                                        <label for='input_97_68_4' id='input_97_68_4_label' class='gform-field-label gform-field-label--type-sub '>Estado<\/label>\n                                        <select name='input_68.4' id='input_97_68_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/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' >Maryland<\/option><option value='Massachusetts' >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' >Montana<\/option><option value='Nebraska' >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='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/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='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_97_68_5_container' >\n                                    <label for='input_97_68_5' id='input_97_68_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                    <input type='text' name='input_68.5' id='input_97_68_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_68.6' id='input_97_68_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_coords_68\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_97_144\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_144'><span class='gform-field-label__text'>Aseguradora actual<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_144' id='input_97_144' class='large gfield_select'     aria-invalid=\"false\" ><option value='Ninguno' >Ninguno<\/option><option value='Progressive' >Progressive<\/option><option value='Geico' >Geico<\/option><option value='State Farm' >State Farm<\/option><option value='Allstate' >Allstate<\/option><option value='Travelers' >Travelers<\/option><option value='USAA' >USAA<\/option><option value='Liberty Mutual' >Liberty Mutual<\/option><option value='Farmers' >Farmers<\/option><option value='The Country Companies' >The Country Companies<\/option><option value='Bristol West' >Bristol West<\/option><option value='Dairyland' >Dairyland<\/option><option value='Sentry' >Sentry<\/option><option value='Root' >Root<\/option><option value='American Family' >American Family<\/option><option value='Otro' >Otro<\/option><\/select><\/div><\/div><div id=\"field_97_145\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_145'><span class='gform-field-label__text'>Nombre de la aseguradora<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_145' id='input_97_145' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_79\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_79'><span class='gform-field-label__text'>Fecha de inicio deseada<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_97_79'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_79'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_97_79' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_97_79' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_97_79' aria-label='Fecha de inicio deseada: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_97_69\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Preguntas para la evaluaci\u00f3n de su p\u00f3liza<\/h3><\/div><div id=\"field_97_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_13'><span class='gform-field-label__text'>\u00bfPor cu\u00e1ntos a\u00f1os ha tenido seguro continuo?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_97_13' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='5+' >5+<\/option><\/select><\/div><\/div><div id=\"field_97_44\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_44'><span class='gform-field-label__text'>\u00bfHa presentado reclamaciones o recibido sanciones de tr\u00e1nsito en los \u00faltimos 5 a\u00f1os?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_44' id='input_97_44' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='No' >No<\/option><option value='S\u00ed' >S\u00ed<\/option><\/select><\/div><\/div><div id=\"field_97_236\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_236'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt; &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_238\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informaci\u00f3n del Incidente<\/h3><\/div><fieldset id=\"field_97_235\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fecha<\/span><\/legend><div class='gfield_description' id='gfield_description_97_235'>Puede ser un aproximado<\/div><div id='input_97_235' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_97_235_1_container'>\n                                        <input type='number' maxlength='2' name='input_235[]' id='input_97_235_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_97_235_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Mes<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_97_235_2_container'>\n                                        <input type='number' maxlength='2' name='input_235[]' id='input_97_235_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_97_235_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>D\u00eda<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_97_235_3_container'>\n                                        <input type='number' maxlength='4' name='input_235[]' id='input_97_235_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                        <label for='input_97_235_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>A\u00f1o<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><div id=\"field_97_46\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_46'><span class='gform-field-label__text'>Por favor explique:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_46' id='input_97_46' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_97_237\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_237'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_237\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Add more<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_237' name='input_237' id='input_97_237' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_97_136' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous'  \/>Anterior<\/button> <button type='button' id='gform_next_button_97_136' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next'  \/>Siguiente<\/button> <button type='button'  id='gform_save_97_4_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save Draft<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_97_4' class='gform_page' data-js='page-field-id-136' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_97_4' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_84\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Seguro de Hogar<\/h3><\/div><div id=\"field_97_146\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half residence_type gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_146'><span class='gform-field-label__text'>Tipo de Residencia<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_146' id='input_97_146' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='I own a Single-Family Home' selected='selected'>Soy due\u00f1o de una vivienda unifamiliar<\/option><option value='I own a 2 to 4 Unit Dwelling' >Soy due\u00f1o de una vivienda de 2 a 4 unidades<\/option><option value='I own a Condominium' >Soy due\u00f1o de un condominio<\/option><option value='I rent an Apartment\/Home' >Alquilo un apartamento\/casa<\/option><\/select><\/div><\/div><div id=\"field_97_148\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_148'><span class='gform-field-label__text'>N\u00famero de unidades<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_148' id='input_97_148' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><\/select><\/div><\/div><fieldset id=\"field_97_149\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full copy-68.1-to-85.1 copy-68.2-to-85.2 copy-68.3-to-85.3 copy-68.4-to-85.4 copy-68.5-to-85.5 copy-68.6-to-85.6 gfcopy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_97_149'><div class='gchoice gchoice_97_149_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_149.1' type='checkbox'  value='Marque esta casilla para usar la misma direcci\u00f3n donde estaciona el veh\u00edculo.'  id='choice_97_149_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_149_1' id='label_97_149_1' class='gform-field-label gform-field-label--type-inline'>Marque esta casilla para usar la misma direcci\u00f3n donde estaciona el veh\u00edculo.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_85\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Direcci\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_97_85' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_97_85_1_container' >\n                                        <label for='input_97_85_1' id='input_97_85_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n de domicilio<\/label>\n                                        <input type='text' name='input_85.1' id='input_97_85_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_97_85_2_container' >\n                                        <label for='input_97_85_2' id='input_97_85_2_label' class='gform-field-label gform-field-label--type-sub '>Apt\/Suite\/Otro<\/label>\n                                        <input type='text' name='input_85.2' id='input_97_85_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_97_85_3_container' >\n                                    <label for='input_97_85_3' id='input_97_85_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                    <input type='text' name='input_85.3' id='input_97_85_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_97_85_4_container' >\n                                        <label for='input_97_85_4' id='input_97_85_4_label' class='gform-field-label gform-field-label--type-sub '>Estado<\/label>\n                                        <select name='input_85.4' id='input_97_85_4'     aria-required='true'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/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' >Maryland<\/option><option value='Massachusetts' >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' >Montana<\/option><option value='Nebraska' >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='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/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='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_97_85_5_container' >\n                                    <label for='input_97_85_5' id='input_97_85_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                    <input type='text' name='input_85.5' id='input_97_85_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_85.6' id='input_97_85_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_coords_85\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_97_86\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_86'><span class='gform-field-label__text'>Aseguradora de hogar actual<\/span><\/label><div class='gfield_description' id='gfield_description_97_86'>Escriba \"ninguna\" si no tiene seguro actual<\/div><div class='ginput_container ginput_container_text'><input name='input_86' id='input_97_86' type='text' value='' class='large'  aria-describedby=\"gfield_description_97_86\"    aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_87\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_87'><span class='gform-field-label__text'>Fecha de inicio deseada<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_97_87'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_87'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_97_87' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_97_87' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_97_87' aria-label='Fecha de inicio deseada: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_97_88\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_88'><span class='gform-field-label__text'>A\u00f1o de construcci\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_97_88' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_130\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_130'><span class='gform-field-label__text'>Metros cuadrados<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_130' id='input_97_130' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_91\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_91'><span class='gform-field-label__text'>N\u00famero de pisos (sin incluir el s\u00f3tano)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_91' id='input_97_91' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='M\u00e1s de 3' >M\u00e1s de 3<\/option><\/select><\/div><\/div><fieldset id=\"field_97_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfLa vivienda tiene s\u00f3tano?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_90'>\n\t\t\t<div class='gchoice gchoice_97_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='S\u00ed'  id='choice_97_90_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_90_0' id='label_97_90_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_90_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='No'  id='choice_97_90_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_90_1' id='label_97_90_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_89\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Tipo de construcci\u00f3n<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_89'>\n\t\t\t<div class='gchoice gchoice_97_89_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='Ladrillo'  id='choice_97_89_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_89_0' id='label_97_89_0' class='gform-field-label gform-field-label--type-inline'>Ladrillo<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_89_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_89' type='radio' value='Estructura de madera \/ Entramado'  id='choice_97_89_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_89_1' id='label_97_89_1' class='gform-field-label gform-field-label--type-inline'>Estructura de madera \/ Entramado<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_239\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>\u00bfLa vivienda ha sido renovada desde el a\u00f1o de construcci\u00f3n?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_239'>\n\t\t\t<div class='gchoice gchoice_97_239_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='S\u00ed'  id='choice_97_239_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_239_0' id='label_97_239_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_239_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_239' type='radio' value='No'  id='choice_97_239_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_239_1' id='label_97_239_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_97_98\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reemplazo de techo<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_98'>\n\t\t\t<div class='gchoice gchoice_97_98_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='S\u00ed'  id='choice_97_98_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_98_0' id='label_97_98_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_98_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_98' type='radio' value='No'  id='choice_97_98_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_98_1' id='label_97_98_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_99\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_99'><span class='gform-field-label__text'>A\u00f1o de reemplazo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_99' id='input_97_99' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_100\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reemplazo de plomer\u00eda<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_100'>\n\t\t\t<div class='gchoice gchoice_97_100_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='S\u00ed'  id='choice_97_100_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_100_0' id='label_97_100_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_100_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_100' type='radio' value='No'  id='choice_97_100_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_100_1' id='label_97_100_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_101\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_101'><span class='gform-field-label__text'>A\u00f1o de reemplazo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_101' id='input_97_101' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_102\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reemplazo de HVAC (calefacci\u00f3n y aire acondicionado)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_102'>\n\t\t\t<div class='gchoice gchoice_97_102_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_102' type='radio' value='S\u00ed'  id='choice_97_102_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_102_0' id='label_97_102_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_102_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_102' type='radio' value='No'  id='choice_97_102_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_102_1' id='label_97_102_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_103\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_103'><span class='gform-field-label__text'>A\u00f1o de reemplazo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_103' id='input_97_103' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_104\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Reemplazo de sistema el\u00e9ctrico<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_104'>\n\t\t\t<div class='gchoice gchoice_97_104_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='S\u00ed'  id='choice_97_104_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_104_0' id='label_97_104_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_104_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='No'  id='choice_97_104_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_104_1' id='label_97_104_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_105\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_105'><span class='gform-field-label__text'>A\u00f1o de reemplazo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_105' id='input_97_105' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_107\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Cobertura del edificio<\/h3><\/div><div id=\"field_97_129\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half dwelling_amount gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_129'><span class='gform-field-label__text'>Monto de la vivienda<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_129' id='input_97_129' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_159\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_159'><span class='gform-field-label__text'>Adiciones a la vivienda<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_159' id='input_97_159' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_111\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_111'><span class='gform-field-label__text'>Deducible<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_111' id='input_97_111' class='large gfield_select'     aria-invalid=\"false\" ><option value='$1000' >$1000<\/option><option value='$2500' >$2500<\/option><option value='$5000' >$5000<\/option><\/select><\/div><\/div><div id=\"field_97_151\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/div><div id=\"field_97_138\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third seperate_structure gfield--width-third gfield_calculation field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible read_only_class\"  data-field-class=\"read_only_class\" ><label class='gfield_label gform-field-label' for='input_97_138'><span class='gform-field-label__text'>Estructura separada<\/span><\/label><div class='ginput_container ginput_container_number'><input readonly name='input_138' id='input_97_138' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_139\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third personal_property gfield--width-third gfield_calculation field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible read_only_class\"  data-field-class=\"read_only_class\" ><label class='gfield_label gform-field-label' for='input_97_139'><span class='gform-field-label__text'>Propiedad personal<\/span><\/label><div class='ginput_container ginput_container_number'><input readonly name='input_139' id='input_97_139' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_158\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_158'><span class='gform-field-label__text'>Propiedad personal<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_158' id='input_97_158' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_140\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full loss_of_use gfield--width-third gfield_calculation field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible read_only_class\"  data-field-class=\"read_only_class\" ><label class='gfield_label gform-field-label' for='input_97_140'><span class='gform-field-label__text'>Gastos de manutenci\u00f3n<\/span><\/label><div class='ginput_container ginput_container_number'><input readonly name='input_140' id='input_97_140' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_152\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><\/div><div id=\"field_97_116\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_116'><span class='gform-field-label__text'>Responsabilidad civil general<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_116' id='input_97_116' class='large gfield_select'     aria-invalid=\"false\" ><option value='$100,000' >$100,000<\/option><option value='$300,000' >$300,000<\/option><option value='$500,000' >$500,000<\/option><\/select><\/div><\/div><div id=\"field_97_137\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_137'><span class='gform-field-label__text'>Reembolso de alcantarillado<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_137' id='input_97_137' class='large gfield_select'     aria-invalid=\"false\" ><option value='Ninguno' >Ninguno<\/option><option value='$5000' >$5000<\/option><option value='$10,000' >$10,000<\/option><option value='$25,000' >$25,000<\/option><option value='$50,000' >$50,000<\/option><\/select><\/div><\/div><div id=\"field_97_117\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-third field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_117'><span class='gform-field-label__text'>Gastos m\u00e9dicos<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_117' id='input_97_117' class='large gfield_select'     aria-invalid=\"false\" ><option value='$1000' >$1000<\/option><option value='$5000' >$5000<\/option><\/select><\/div><\/div><fieldset id=\"field_97_119\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Joyas con valor declarado<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_119'>\n\t\t\t<div class='gchoice gchoice_97_119_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='S\u00ed'  id='choice_97_119_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_119_0' id='label_97_119_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_119_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_119' type='radio' value='No'  id='choice_97_119_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_119_1' id='label_97_119_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_143\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_143'><span class='gform-field-label__text'>Valor de joyas declaradas<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_143' id='input_97_143' type='text' step='any'   value='' class='large'      aria-invalid=\"false\" aria-describedby=\"gfield_description_97_143\" \/><\/div><div class='gfield_description' id='gfield_description_97_143'>Solo se incluyen en este total las joyas valorizadas en m\u00e1s de $2,500.<\/div><\/div><fieldset id=\"field_97_123\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Alarma central<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_123'>\n\t\t\t<div class='gchoice gchoice_97_123_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='S\u00ed'  id='choice_97_123_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_123_0' id='label_97_123_0' class='gform-field-label gform-field-label--type-inline'>S\u00ed<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_123_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_123' type='radio' value='No'  id='choice_97_123_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_123_1' id='label_97_123_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_125\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_125'><span class='gform-field-label__text'>\u00bfHa tenido reclamos en los \u00faltimos 5 a\u00f1os?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_125' id='input_97_125' class='large gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='S\u00ed' >S\u00ed<\/option><\/select><\/div><\/div><div id=\"field_97_242\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_242'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt; &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_241\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informaci\u00f3n del Incidente<\/h3><\/div><fieldset id=\"field_97_240\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fecha<\/span><\/legend><div class='gfield_description' id='gfield_description_97_240'>Puede ser un aproximado<\/div><div id='input_97_240' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_97_240_1_container'>\n                                        <input type='number' maxlength='2' name='input_240[]' id='input_97_240_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_97_240_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Mes<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_97_240_2_container'>\n                                        <input type='number' maxlength='2' name='input_240[]' id='input_97_240_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_97_240_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>D\u00eda<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_97_240_3_container'>\n                                        <input type='number' maxlength='4' name='input_240[]' id='input_97_240_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                        <label for='input_97_240_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>A\u00f1o<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><div id=\"field_97_127\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_127'><span class='gform-field-label__text'>Por favor explique:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_97_127' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_97_243\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_243'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_243\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Add more<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_243' name='input_243' id='input_97_243' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_97_161' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous'  \/>Previous<\/button> <button type='button' id='gform_next_button_97_161' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next'  \/>Next<\/button> <button type='button'  id='gform_save_97_5_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save Draft<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_97_5' class='gform_page' data-js='page-field-id-161' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_97_5' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_97_169\" class=\"gfield gfield--type-section gfield--input-type-section gsection auto-insurance-section field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Seguro de Auto Comercial<\/h3><\/div><fieldset id=\"field_97_208\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Por favor seleccione una opci\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_208'>\n\t\t\t<div class='gchoice gchoice_97_208_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_208' type='radio' value='vin'  id='choice_97_208_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_208_0' id='label_97_208_0' class='gform-field-label gform-field-label--type-inline'>VIN#<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_208_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_208' type='radio' value='ymm'  id='choice_97_208_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_208_1' id='label_97_208_1' class='gform-field-label gform-field-label--type-inline'>A\u00f1o\/Marca\/Modelo<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_209\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Vehicles with VIN#<\/h3><\/div><div id=\"field_97_172\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full vehicle-repeater-section field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_172'><span class='gform-field-label__text'>Informaci\u00f3n del Veh\u00edculo<\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt;Veh&iacute;culo &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_173\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full vin-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_173'><span class='gform-field-label__text'>VIN #<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_173' id='input_97_173' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_180\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third year-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_180'><span class='gform-field-label__text'>A\u00f1o<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_180' id='input_97_180' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_181\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third make-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_181'><span class='gform-field-label__text'>Marca<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_181' id='input_97_181' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_182\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third model-input field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_182'><span class='gform-field-label__text'>Modelo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_182' id='input_97_182' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_174\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Radio de conducci\u00f3n:<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_174'>\n\t\t\t<div class='gchoice gchoice_97_174_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_174' type='radio' value='Menos de 50 millas'  id='choice_97_174_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_174_0' id='label_97_174_0' class='gform-field-label gform-field-label--type-inline'>Menos de 50 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_174_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_174' type='radio' value='50-250 millas'  id='choice_97_174_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_174_1' id='label_97_174_1' class='gform-field-label gform-field-label--type-inline'>50-250 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_174_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_174' type='radio' value='250-500 millas'  id='choice_97_174_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_174_2' id='label_97_174_2' class='gform-field-label gform-field-label--type-inline'>250-500 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_174_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_174' type='radio' value='500 millas o m\u00e1s'  id='choice_97_174_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_174_3' id='label_97_174_3' class='gform-field-label gform-field-label--type-inline'>500 millas o m\u00e1s<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_177\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_177'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_177\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Veh\u00edculo Adicional +<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_177' name='input_177' id='input_97_177' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><div id=\"field_97_211\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Veh\u00edculos con A\u00f1o\/Marca\/Modelo<\/h3><\/div><div id=\"field_97_212\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full vehicle-repeater-section field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_212'><span class='gform-field-label__text'>Informaci\u00f3n del Veh\u00edculo<\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt;Vehicle &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_213\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third year-MakeModel field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_213'><span class='gform-field-label__text'>A\u00f1o<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_213' id='input_97_213' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_214\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third year-MakeModel field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_214'><span class='gform-field-label__text'>Marca<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_214' id='input_97_214' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_215\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-third year-MakeModel field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_215'><span class='gform-field-label__text'>Modelo<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_215' id='input_97_215' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_217\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Radio de conducci\u00f3n:<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_97_217'>\n\t\t\t<div class='gchoice gchoice_97_217_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_217' type='radio' value='Menos de 50 millas'  id='choice_97_217_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_217_0' id='label_97_217_0' class='gform-field-label gform-field-label--type-inline'>Menos de 50 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_217_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_217' type='radio' value='50-250 millas'  id='choice_97_217_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_217_1' id='label_97_217_1' class='gform-field-label gform-field-label--type-inline'>50-250 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_217_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_217' type='radio' value='250-500 millas'  id='choice_97_217_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_217_2' id='label_97_217_2' class='gform-field-label gform-field-label--type-inline'>250-500 millas<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_97_217_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_217' type='radio' value='500 millas o m\u00e1s'  id='choice_97_217_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_97_217_3' id='label_97_217_3' class='gform-field-label gform-field-label--type-inline'>500 millas o m\u00e1s<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_210\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_210'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_210\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Veh\u00edculo Adicional +<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_210' name='input_210' id='input_97_210' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><div id=\"field_97_187\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Driver Information<\/h3><\/div><div id=\"field_97_188\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_188'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt;Driver &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_189\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half driver-firstname gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_189'><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_189' id='input_97_189' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_190\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half driver-lastname gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_190'><span class='gform-field-label__text'>Apellidos<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_190' id='input_97_190' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_97_191\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fecha de Nacimiento<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_97_191' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_97_191_1_container'>\n                                        <input type='number' maxlength='2' name='input_191[]' id='input_97_191_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_97_191_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Mes<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_97_191_2_container'>\n                                        <input type='number' maxlength='2' name='input_191[]' id='input_97_191_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_97_191_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>D\u00eda<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_97_191_3_container'>\n                                        <input type='number' maxlength='4' name='input_191[]' id='input_97_191_3' value=''   aria-required='true'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                        <label for='input_97_191_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>A\u00f1o<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><fieldset id=\"field_97_192\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Estado donde expidi\u00f3 la licencia<\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_state ginput_container_address gform-grid-row' id='input_97_192' >\n                        <span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_97_192_4_container' >\n                                        <select name='input_192.4' id='input_97_192_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/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' >Maryland<\/option><option value='Massachusetts' >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' >Montana<\/option><option value='Nebraska' >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='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/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='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_97_192_4' id='input_97_192_4_label' class='gform-field-label gform-field-label--type-sub '>Estado<\/label>\n                                      <\/span><input type='hidden' class='gform_hidden' name='input_192.6' id='input_97_192_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_97_193\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_193'><span class='gform-field-label__text'>N\u00famero de licencia de conducir<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_193' id='input_97_193' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_194\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_194'><span class='gform-field-label__text'>Industria<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_194' id='input_97_194' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Cami\u00f3n de comida' >Cami\u00f3n de comida<\/option><option value='Transporte comercial de carga' >Transporte comercial de carga<\/option><option value='Transporte de pasajeros' >Transporte de pasajeros<\/option><option value='Iglesia' >Iglesia<\/option><option value='Servicio de reparto \/ Mensajer\u00eda \/ Env\u00edos' >Servicio de reparto \/ Mensajer\u00eda \/ Env\u00edos<\/option><option value='Servicio' >Servicio<\/option><option value='Comercial' >Comercial<\/option><\/select><\/div><\/div><div id=\"field_97_195\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_195'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_195\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Additional Driver +<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_195' name='input_195' id='input_97_195' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><fieldset id=\"field_97_196\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_97_196' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_97_196_1_container' >\n                                        <label for='input_97_196_1' id='input_97_196_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n donde estaciona el veh\u00edculo<\/label>\n                                        <input type='text' name='input_196.1' id='input_97_196_1' value=''    aria-required='false'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_97_196_2_container' >\n                                        <label for='input_97_196_2' id='input_97_196_2_label' class='gform-field-label gform-field-label--type-sub '>Apt\/Suite\/Otro<\/label>\n                                        <input type='text' name='input_196.2' id='input_97_196_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_97_196_3_container' >\n                                    <label for='input_97_196_3' id='input_97_196_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                    <input type='text' name='input_196.3' id='input_97_196_3' value=''    aria-required='false'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_97_196_4_container' >\n                                        <label for='input_97_196_4' id='input_97_196_4_label' class='gform-field-label gform-field-label--type-sub '>Estado<\/label>\n                                        <select name='input_196.4' id='input_97_196_4'     aria-required='false'    ><option value='' selected='selected'><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Samoa Americana' >Samoa Americana<\/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' >Maryland<\/option><option value='Massachusetts' >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' >Montana<\/option><option value='Nebraska' >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='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Islas Marianas del Norte' >Islas Marianas del Norte<\/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='Islas V\u00edrgenes de los Estados Unidos' >Islas V\u00edrgenes de los Estados Unidos<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_97_196_5_container' >\n                                    <label for='input_97_196_5' id='input_97_196_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo Postal<\/label>\n                                    <input type='text' name='input_196.5' id='input_97_196_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_196.6' id='input_97_196_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><input type=\"hidden\" name=\"gpaa_coords_196\" class=\"gform_hidden\" value=\"\"><\/fieldset><div id=\"field_97_197\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_197'><span class='gform-field-label__text'>Aseguradora actual<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_197' id='input_97_197' class='large gfield_select'     aria-invalid=\"false\" ><option value='Ninguna' >Ninguna<\/option><option value='Progressive' >Progressive<\/option><option value='Geico' >Geico<\/option><option value='State Farm' >State Farm<\/option><option value='Allstate' >Allstate<\/option><option value='Travelers' >Travelers<\/option><option value='USAA' >USAA<\/option><option value='Liberty Mutual' >Liberty Mutual<\/option><option value='Farmers' >Farmers<\/option><option value='The Country Companies' >The Country Companies<\/option><option value='Bristol West' >Bristol West<\/option><option value='Dairyland' >Dairyland<\/option><option value='Sentry' >Sentry<\/option><option value='Root' >Root<\/option><option value='American Family' >American Family<\/option><option value='Otra' >Otra<\/option><\/select><\/div><\/div><div id=\"field_97_198\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_198'><span class='gform-field-label__text'>Nombre de la aseguradora<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_198' id='input_97_198' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_97_199\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_199'><span class='gform-field-label__text'>Fecha de inicio deseada<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/aaaa'\n\t\t\t\t\tid='input_97_199'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_199'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_97_199' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_97_199' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_97_199' aria-label='Fecha de inicio deseada: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/div><div id=\"field_97_200\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Preguntas para la evaluaci\u00f3n de su p\u00f3liza<\/h3><\/div><div id=\"field_97_201\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_201'><span class='gform-field-label__text'>\u00bfCu\u00e1ntos a\u00f1os de cobertura ininterrumpida posee?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_201' id='input_97_201' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='5+' >5+<\/option><\/select><\/div><\/div><div id=\"field_97_204\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_204'><span class='gform-field-label__text'>\u00bfHa tenido infracciones de tr\u00e1nsito en los \u00faltimos 5 a\u00f1os?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_204' id='input_97_204' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='No' >No<\/option><option value='S\u00ed' >S\u00ed<\/option><\/select><\/div><\/div><div id=\"field_97_227\" class=\"gfield gfield--type-repeater_start gfield--input-type-repeater_start gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text' for='input_97_227'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_text'> <div class=\"wpforms-field-repeater-start\">\r\n\t\t\t<input type=\"hidden\" class=\"repeater-field-header-data hidden\" value=\"&lt;div class=&quot;repeater-field-header&quot;&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-title&quot;&gt; &lt;span class=&quot;repeater-field-header-count&quot;&gt;1&lt;\/span&gt;&lt;\/div&gt;\r\n\t\t\t\t&lt;div class=&quot;repeater-field-header-acctions&quot;&gt;\r\n\t\t\t\t\t&lt;ul&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-down-open repeater-field-header-acctions-toogle&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t\t&lt;li&gt;&lt;i class=&quot;repeater-icon icon-cancel-1 repeater-field-header-acctions-remove&quot; aria-hidden=&quot;true&quot;&gt;&lt;\/i&gt;&lt;\/li&gt;\r\n\t\t\t\t\t&lt;\/ul&gt;\r\n\t\t\t\t&lt;\/div&gt;\r\n\t\t\t&lt;\/div&gt;\" \/>\r\n\t\t<\/div> <\/div><\/div><div id=\"field_97_231\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informaci\u00f3n del Incidente<\/h3><\/div><fieldset id=\"field_97_205\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fecha del incidente<\/span><\/legend><div class='gfield_description' id='gfield_description_97_205'>Puede ser un aproximado<\/div><div id='input_97_205' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_97_205_1_container'>\n                                        <input type='number' maxlength='2' name='input_205[]' id='input_97_205_1' value=''   aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_97_205_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Mes<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_97_205_2_container'>\n                                        <input type='number' maxlength='2' name='input_205[]' id='input_97_205_2' value=''   aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_97_205_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>D\u00eda<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_97_205_3_container'>\n                                        <input type='number' maxlength='4' name='input_205[]' id='input_97_205_3' value=''   aria-required='false'   placeholder='AAAA' min='1920' max='2027' step='1'\/>\n                                        <label for='input_97_205_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>A\u00f1o<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><div id=\"field_97_206\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_206'><span class='gform-field-label__text'>Por favor explique:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_206' id='input_97_206' class='textarea small'    placeholder='Multa por exceso de velocidad'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_97_228\" class=\"gfield gfield--type-repeater_end gfield--input-type-repeater_end gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_228'><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container'><div data-initial_rows_map_check=\"\" class=\"repeater-field-warp-item-data\" data-initial_rows=\"1\" data-limit=\"5\" data-initial_rows_map=\"input_97_\" data-map_id=\"field_97_228\">\n\t\t\t<div class=\"repeater-field-warp-item\">\n\t\t\t<\/div>\n\t\t\t<div class=\"repeater-field-footer\"><a href=\"#\"\" class=\"gf-repeater-field-button-add\" >Add more<\/a><\/div>\n\t\t\t<input data-initial_rows_map_check='' data-initial_rows_map='input_97_' data-map_id='field_97_228' name='input_228' id='input_97_228' type='hidden' value='' class='large gf-field-repeater-data hidden'    aria-invalid=\"false\" \/>\n\t\t\t<input type=\"hidden\" class=\"gf-field-repeater-data-html hidden\" \/>\n\t\t<\/div><\/div><\/div><div id=\"field_97_220\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Coberturas para veh\u00edculos comerciales<\/h3><\/div><div id=\"field_97_221\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_221'><span class='gform-field-label__text'>Responsabilidad civil (lesiones corporales \/ da\u00f1os a la propiedad)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_221' id='input_97_221' class='large gfield_select'     aria-invalid=\"false\" ><option value='$1,000,000' >$1,000,000<\/option><option value='$500,000' >$500,000<\/option><option value='$300,000' >$300,000<\/option><\/select><\/div><\/div><div id=\"field_97_226\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_calculation field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible read_only_class\"  data-field-class=\"read_only_class\" ><label class='gfield_label gform-field-label' for='input_97_226'><span class='gform-field-label__text'>Conductor sin seguro \/ con seguro insuficiente<\/span><\/label><div class='ginput_container ginput_container_number'><input readonly name='input_226' id='input_97_226' type='text' step='any'   value='' class='large gform-text-input-reset'  readonly=\"readonly\"    aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_223\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible read_only_class\"  data-field-class=\"read_only_class\" ><label class='gfield_label gform-field-label' for='input_97_223'><span class='gform-field-label__text'>Gastos m\u00e9dicos<\/span><\/label><div class='ginput_container ginput_container_number'><input readonly name='input_223' id='input_97_223' type='text' step='any'   value='' class='large'    placeholder='$5,000'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_97_224\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_224'><span class='gform-field-label__text'>Deducible por todo riesgo<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_224' id='input_97_224' class='large gfield_select'     aria-invalid=\"false\" ><option value='$1,000' >$1,000<\/option><option value='$2,500' >$2,500<\/option><option value='$5,000' >$5,000<\/option><\/select><\/div><\/div><div id=\"field_97_229\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_229'><span class='gform-field-label__text'>Deducible por colisi\u00f3n<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_229' id='input_97_229' class='large gfield_select'     aria-invalid=\"false\" ><option value='$1,000' >$1,000<\/option><option value='$500' >$500<\/option><option value='$2,500' >$2,500<\/option><option value='Liability only' >Liability only<\/option><\/select><\/div><\/div><fieldset id=\"field_97_219\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Coberturas opcionales:<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_97_219'><div class='gchoice gchoice_97_219_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_219.1' type='checkbox'  value='Servicio de Gr\u00faa'  id='choice_97_219_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_219_1' id='label_97_219_1' class='gform-field-label gform-field-label--type-inline'>Servicio de Gr\u00faa<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_97_219_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_219.3' type='checkbox'  value='Reembolso de alquiler de veh\u00edculo'  id='choice_97_219_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_97_219_2' id='label_97_219_2' class='gform-field-label gform-field-label--type-inline'>Reembolso de alquiler de veh\u00edculo<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_97_230\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_230'><span class='gform-field-label__text'>Reembolso de alquiler de veh\u00edculo<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_230' id='input_97_230' class='large gfield_select'     aria-invalid=\"false\" ><option value='Est\u00e1ndar: $50 \/ d\u00eda ($1,500 m\u00e1ximo)' >Est\u00e1ndar: $50 \/ d\u00eda ($1,500 m\u00e1ximo)<\/option><option value='Intermedio: $75 \/ d\u00eda ($2,250 m\u00e1ximo)' >Intermedio: $75 \/ d\u00eda ($2,250 m\u00e1ximo)<\/option><option value='Premium: $100 \/ d\u00eda ($3,000 m\u00e1ximo)' >Premium: $100 \/ d\u00eda ($3,000 m\u00e1ximo)<\/option><\/select><\/div><\/div><div id=\"field_97_225\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_97_225'><span class='gform-field-label__text'>Valor de equipamiento adicional<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_225' id='input_97_225' type='text' step='any'   value='' class='large'    placeholder='$0'  aria-invalid=\"false\"  \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_97' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous'  \/>Previous<\/button> <button type='submit' id='gform_submit_button_97' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit'  \/>Enviar<\/button> <button type='button'  id='gform_save_97_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Save Draft<\/button><input type='hidden' name='gform_ajax' value='form_id=97&amp;title=&amp;description=1&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=0cb0defc7924816a6093320ab060f197' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_97' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_97' id='gform_theme_97' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_97' id='gform_style_settings_97' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_97' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='97' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_97' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_97' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' 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