<% Function DoubleQuotes(str) If NOT IsNull(str) Then DoubleQuotes = Trim(Replace(str,"""",""")) Else DoubleQuotes = "" End Function Function NoTags(str) NoTags = Trim(Replace(Replace(str,">",">"),"<","<")) End Function Function SingleQuotes(str) SingleQuotes = Trim(Replace(str,"'","''")) End Function Function IsValidEmail(Email) ValidFlag = False If (Email <> "") And (InStr(1, Email, "@") > 0) And (InStr(1, Email, ".") > 0) Then atCount = 0 SpecialFlag = False For atLoop = 1 To Len(Email) atChr = Mid(Email, atLoop, 1) If atChr = "@" Then atCount = atCount + 1 If (atChr >= Chr(32)) And (atChr <= Chr(44)) Then SpecialFlag = True If (atChr = Chr(47)) Or (atChr = Chr(96)) Or (atChr >= Chr(123)) Then SpecialFlag = True If (atChr >= Chr(58)) And (atChr <= Chr(63)) Then SpecialFlag = True If (atChr >= Chr(91)) And (atChr <= Chr(94)) Then SpecialFlag = True Next If (atCount = 1) And (SpecialFlag = False) Then BadFlag = False tAry1 = Split(Email, "@") UserName = tAry1(0) DomainName = tAry1(1) If (UserName = "") Or (DomainName = "") Then BadFlag = True If Mid(DomainName, 1, 1) = "." then BadFlag = True If Mid(DomainName, Len(DomainName), 1) = "." then BadFlag = True ValidFlag = True End If End If If BadFlag = True Then ValidFlag = False IsValidEmail = ValidFlag End Function formsubmitted = (Request.Form("formsubmitted")="1") 'Response.Write formsubmitted 'Response.End if formsubmitted AND trim(request.form("name")) <> "" AND trim(request.form("city")) <> "" AND trim(request.form("state")) <> "" AND IsValidEmail(request.form("email")) AND trim(request.form("dwelling")) <> "" AND trim(request.form("content")) <> "" AND trim(request.form("liability")) <> "" then EmailBody = "Name: " & request.form("name") & chr(13) _ & "Address: " & request.form("address") & chr(13) _ & "City: " & request.form("city") & chr(13) _ & "Zip: " & request.form("zip") & chr(13) _ & "State: " & request.form("state") & chr(13) & chr(13)_ & "Email: " & request.form("email") & chr(13) _ & "Phone: " & request.form("phone") & chr(13) _ & "Fax: " & request.form("fax") & chr(13) & chr(13) & chr(13) _ & "Current Insurer: " & request.form("insurer") & chr(13) _ & "Expiration Date: " & request.form("date") & chr(13) & chr(13) _ & "Construction Type: " & request.form("construction") & chr(13) _ & "Distance to hydrant: " & request.form("hydrant") & chr(13) _ & "Smoke detectors: " & request.form("detector") & chr(13) _ & "Fire extinguishers: " & request.form("extinguisher") & chr(13) _ & "Dead bolt locks: " & request.form("deadboltt") & chr(13) & chr(13) _ & "Amount of Insurance Requested" & chr(13) _ & "Dwelling: " & request.form("dwelling") & chr(13) _ & "Contents: " & request.form("content") & chr(13) _ & "Liability: " & request.form("liability") & chr(13) _ & "Deductible: " & request.form("deductible") & chr(13) & chr(13)_ & "Respond by: " & request.form("respond") & chr(13) & chr(13) & chr(13) _ & "Comments/Questions:" & chr(13) _ & request.form("comments") & chr(13) & chr(13) _ & "Submitted: " & FormatDateTime(Date(),2) & " at " & FormatDateTime(Now(),3) & " CST" & chr(13) & chr(13) EmailBody = "The following Home Insurance Quote was submitted through the Frontier Bank site:" & chr(13) & chr(13) & EmailBody '************USING CDONTS*********************************** set objMail = CreateObject("CDONTS.NewMail") objMail.To = "insurance@frontierbk.com;" objMail.BCC = "" objMail.From = trim(request.form("email")) objMail.Subject = "Frontier Bank - Home Owner's Insurance Quote" objMail.Body = EmailBody objMail.Send set objMail = nothing response.redirect("/quote_thanks.asp") end if %> <!--#include virtual="/library/globalpagetitle_ire.htm"--> - Insurance & Real Estate

 

Home Insurance Quote

Fill out and submit the from below to receive a free home owner's quote. Final premium is subject to information verification.

Marked fields (*) are required.

Personal Information
Name:* "><%if formsubmitted AND Trim(Request.Form("name"))="" then Response.Write " Type in your name."%>
Address:* ">
City:* "><%if formsubmitted AND Trim(Request.Form("city"))="" then Response.Write " Field cannot be empty."%>
Zip: ">
State:*
Email:* "><%if formsubmitted AND NOT IsValidEmail(Request.Form("email")) then Response.Write " Type in a valid email."%>
Phone: ">
Fax: ">
Current Insurer: ">
Expiration Date: ">
Construction Type:
Build Year: ">
Distance to hydrant:
Do you have smoke detectors? Yes No
Do you have fire extinguishers? Yes No
Do you have dead bolt locks? Yes No

Amount of Insurance Requested
Dwelling:* "><%if formsubmitted AND Trim(Request.Form("dwelling"))="" then Response.Write " Field cannot be empty."%>
Contents:* "><%if formsubmitted AND Trim(Request.Form("content"))="" then Response.Write " Field cannot be empty."%>
Liability:* "><%if formsubmitted AND Trim(Request.Form("liability"))="" then Response.Write " Field cannot be empty."%>
Deductible:

How would you like us to respond
Please enter any questions or comments below. If you have any items to be scheduled such as jewelry, paintings, silverware, computer equipment, etc., please enter item description and vlaue.