{"id":6084,"date":"2024-09-27T09:20:04","date_gmt":"2024-09-27T13:20:04","guid":{"rendered":"https:\/\/gulfinsuranceltd.com\/forms\/?page_id=6084"},"modified":"2024-09-27T09:20:06","modified_gmt":"2024-09-27T13:20:06","slug":"standard-fire-survey-report","status":"publish","type":"page","link":"https:\/\/gulfinsuranceltd.com\/forms\/standard-fire-survey-report\/","title":{"rendered":"Standard Fire Survey Report"},"content":{"rendered":"<p style=\"text-align: center;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/uploads\/2019\/08\/Gulf-Revised-Logo-300x140.png\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" srcset=\"https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/uploads\/2019\/08\/Gulf-Revised-Logo-300x140.png 300w, https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/uploads\/2019\/08\/Gulf-Revised-Logo-768x358.png 768w, https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/uploads\/2019\/08\/Gulf-Revised-Logo-1024x477.png 1024w\" alt=\"\" width=\"300\" height=\"140\" \/><\/p>\n<h2 style=\"text-align: center;\">Standard Fire Survey Report<\/h2>\n<p style=\"text-align: center;\"><script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_110' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_110'  action='\/forms\/wp-json\/wp\/v2\/pages\/6084' data-formid='110' novalidate autocomplete=\"off\">\n                        <div class='gform-body gform_body'><ul id='gform_fields_110' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_110_576\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_576\"><label class='gfield_label gform-field-label' for='input_110_576' >Client&#039;s Name:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_576' id='input_110_576' type='text' value='' class='medium'   tabindex='49'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_577\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_577\"><label class='gfield_label gform-field-label' for='input_110_577' >Risk Location:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_577' id='input_110_577' type='text' value='' class='medium'   tabindex='50'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_578\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_578\"><label class='gfield_label gform-field-label' for='input_110_578' >Requested By:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_578' id='input_110_578' type='text' value='' class='medium'   tabindex='51'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_579\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_579\"><label class='gfield_label gform-field-label' for='input_110_579' >Agent\/Broker:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_579' id='input_110_579' type='text' value='' class='medium'   tabindex='52'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_590\"  class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_590\"><label class='gfield_label gform-field-label' for='input_110_590' >Sum Insured:<\/label><div class='ginput_container ginput_container_number'><input autocomplete=\"off\"  name='input_590' id='input_110_590' type='number' step='any'   value='' class='medium' tabindex='53'     aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_110_582\"  class=\"gfield gfield--type-text custom-input exclude field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_582\"><label class='gfield_label gform-field-label screen-reader-text' for='input_110_582' ><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_582' id='input_110_582' type='text' value='' class='small'   tabindex='54'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_584\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_584\"><label class='gfield_label gform-field-label' for='input_110_584' >The Building<\/label><div class='ginput_container ginput_container_fileupload'><input autocomplete=\"off\"  type='hidden' name='MAX_FILE_SIZE' value='16777216' \/><input autocomplete=\"off\"  name='input_584' id='input_110_584' type='file' class='medium' aria-describedby=\"gfield_upload_rules_110_584\" onchange='javascript:gformValidateFileSize( this, 16777216 );' tabindex='55' \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_110_584'>Max. file size: 16 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_110_584'><\/div><\/div><\/li><li id=\"field_110_586\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_110_586\"><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='gform_browse_button_110_586' >Images Upload<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_110_586' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_110_586&quot;,&quot;container&quot;:&quot;gform_multifile_upload_110_586&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_110_586&quot;,&quot;filelist&quot;:&quot;gform_preview_110_586&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/?gf_page=6188febf653bfa9&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;16777216b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:110,&quot;field_id&quot;:586},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;6&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_110_586&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_110_586' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_110_586' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_110_586\" tabindex='56' >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_110_586'>Max. file size: 16 MB, Max. files: 6.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_110_586'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_110_586' class='ginput_preview_list'><\/div><\/li><li id=\"field_110_587\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_587\"><div id=\"uploadedImagesContainer\"><\/div>\n\n<script>\n    document.addEventListener('DOMContentLoaded', function() {\n        const fileInput = document.querySelector('input[type=\"file\"][name=\"IMAGES_ADDON\"]'); \/\/ Adjust the name attribute based on your form field\n        const uploadedImagesContainer = document.getElementById('uploadedImagesContainer');\n\n        fileInput.addEventListener('change', function(event) {\n            const files = event.target.files;\n            uploadedImagesContainer.innerHTML = ''; \/\/ Clear previous images\n\n            for (let i = 0; i < files.length; i++) {\n                const file = files[i];\n                const reader = new FileReader();\n\n                reader.onload = function(e) {\n                    const img = document.createElement('img');\n                    img.src = e.target.result;\n                    img.style.width = '100px'; \/\/ Set your desired width\n                    img.style.margin = '5px'; \/\/ Add some margin for spacing\n                    uploadedImagesContainer.appendChild(img);\n                };\n\n                reader.readAsDataURL(file);\n            }\n        });\n    });\n<\/script>\n<\/li><li id=\"field_110_581\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_581\">\n<\/br>\n\n<p>This Survey Report has been prepared based on information obtained from \n    <span id=\"inline-input-placeholder\">{Field ID:582}<\/span>\n\n    and therefore we can make no warranty either express or implied as to the accuracy of the data. We shall not be liable for any loss or damage arising from or in connection with the data and opinions given in this report. This report is strictly for insurance purposes.\n<\/p>\n<\/li><li id=\"field_110_583\"  class=\"gfield gfield--type-html gf-hidden exclude d-none gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_583\">\n\n<style>\n\n    \/* Centering the title *\/\n    .center-title {\n        text-align: center;\n        margin-bottom: 10px; \/* Space between title and content *\/\n    }\n\n\/* Hide the label of the input field *\/\n.custom-input .gfield_label {\n    display: none;\n}\n\n\/* Ensure the input field container stays inline *\/\n.custom-input {\n    display: inline-block !important;\n    margin: 0 !important;\n    padding: 0 !important;\n    vertical-align: middle; \/* Align with text *\/\n}\n\n\/* Ensure the input field itself is inline and aligned *\/\n.custom-input .ginput_container {\n    display: inline-block !important;\n    margin: 0 !important;\n    padding: 0 !important;\n    vertical-align: middle;\n}\n\n\/* Style the input field to match *\/\n.custom-input input {\n    border: 1px solid #ccc;\n    border-radius: 4px;\n    padding: 3px;\n    width: 150px; \/* Adjust width to your preference *\/\n    display: inline-block;\n    vertical-align: middle; \/* Align with the text *\/\n    margin: 0 !important; \/* Ensure no extra margin is added *\/\n    padding: 0 5px !important;\n}\n\n\/* Ensure the placeholder for the input is inline *\/\n#inline-input-placeholder {\n    display: inline !important;\n    vertical-align: middle;\n}\n<\/style>\n\n<script>\ndocument.addEventListener('DOMContentLoaded', function() {\n    \/\/ Move the input field to the inline position\n    var inputField = document.querySelector('.custom-input');\n    var placeholder = document.getElementById('inline-input-placeholder');\n    \n    if (inputField && placeholder) {\n        placeholder.appendChild(inputField);\n    }\n});\n<\/script>\n<\/li><li id=\"field_110_655\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_655\"><br><\/li><li id=\"field_110_589\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_589\"><h2 class=\"gsection_title\">Details of Building<\/h2><\/li><li id=\"field_110_592\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_592\"><label class='gfield_label gform-field-label' for='input_110_592' >Year Constructed or age of building:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_592' id='input_110_592' type='text' value='' class='medium'   tabindex='57'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_593\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_593\"><label class='gfield_label gform-field-label' for='input_110_593' >External Walls:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_593' id='input_110_593' type='text' value='' class='medium'   tabindex='58'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_594\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_594\"><label class='gfield_label gform-field-label' for='input_110_594' >Interior Partitions:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_594' id='input_110_594' type='text' value='' class='medium'   tabindex='59'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_595\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_595\"><label class='gfield_label gform-field-label' for='input_110_595' >Structure of Roof:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_595' id='input_110_595' type='text' value='' class='medium'   tabindex='60'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_596\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_596\"><label class='gfield_label gform-field-label' for='input_110_596' >How is the roof secured?<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_596' id='input_110_596' type='text' value='' class='medium'   tabindex='61'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_597\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_597\"><label class='gfield_label gform-field-label' for='input_110_597' >No of Storeys including Basement:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_597' id='input_110_597' type='text' value='' class='medium'   tabindex='62'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_598\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_598\"><label class='gfield_label gform-field-label' for='input_110_598' >Type floors including basement:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_598' id='input_110_598' type='text' value='' class='medium'   tabindex='63'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_603\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_603\"><br><label for=\"staircase\"><strong>Staircase\/s:<\/strong><\/label>\n<\/li><li id=\"field_110_604\"  class=\"gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_604\"><label class='gfield_label gform-field-label'  >Is the structure in good state of repair?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_604'>\n\t\t\t<li class='gchoice gchoice_110_604_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_604' type='radio' value='Yes'  id='choice_110_604_0' tabindex='64'   \/>\n\t\t\t\t<label for='choice_110_604_0' id='label_110_604_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_604_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_604' type='radio' value='No'  id='choice_110_604_1' tabindex='65'   \/>\n\t\t\t\t<label for='choice_110_604_1' id='label_110_604_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_110_604'>See comments for more details<\/div><\/li><li id=\"field_110_605\"  class=\"gfield gfield--type-radio gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_605\"><label class='gfield_label gform-field-label'  >Is the building specially designed for its present occupation?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_605'>\n\t\t\t<li class='gchoice gchoice_110_605_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_605' type='radio' value='Yes'  id='choice_110_605_0' tabindex='66'   \/>\n\t\t\t\t<label for='choice_110_605_0' id='label_110_605_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_605_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_605' type='radio' value='No'  id='choice_110_605_1' tabindex='67'   \/>\n\t\t\t\t<label for='choice_110_605_1' id='label_110_605_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_606\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_606\"><label class='gfield_label gform-field-label' for='input_110_606' >Occupation:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_606' id='input_110_606' type='text' value='' class='medium'   tabindex='68'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_656\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_656\"><br><\/li><li id=\"field_110_607\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_607\"><h2 class=\"gsection_title\">Details of Power Sources<\/h2><\/li><li id=\"field_110_608\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_608\"><label class='gfield_label gform-field-label' for='input_110_608' >Method of Wiring:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_608' id='input_110_608' type='text' value='' class='medium'   tabindex='69'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_609\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_609\"><label class='gfield_label gform-field-label' for='input_110_609' >Age and Condition:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_609' id='input_110_609' type='text' value='' class='medium'   tabindex='70'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_610\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_610\"><label class='gfield_label gform-field-label' for='input_110_610' >How often inspected and by whom?<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_610' id='input_110_610' type='text' value='' class='medium'   tabindex='71'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_657\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_657\"><br><\/li><li id=\"field_110_611\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_611\"><h2 class=\"gsection_title\">Inflammable Substances<\/h2><\/li><li id=\"field_110_612\"  class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_612\"><label class='gfield_label gform-field-label'  >Are there any inflammable substances on the premises?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_612'>\n\t\t\t<li class='gchoice gchoice_110_612_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_612' type='radio' value='Yes'  id='choice_110_612_0' tabindex='72'   \/>\n\t\t\t\t<label for='choice_110_612_0' id='label_110_612_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_612_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_612' type='radio' value='No'  id='choice_110_612_1' tabindex='73'   \/>\n\t\t\t\t<label for='choice_110_612_1' id='label_110_612_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_613\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_613\"><label class='gfield_label gform-field-label' for='input_110_613' >Type:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_613' id='input_110_613' type='text' value='' class='medium'   tabindex='74'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_614\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_614\"><label class='gfield_label gform-field-label' for='input_110_614' >Quantity:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_614' id='input_110_614' type='text' value='' class='medium'   tabindex='75'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_615\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_615\"><label class='gfield_label gform-field-label' for='input_110_615' >How and where stored:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_615' id='input_110_615' type='text' value='' class='medium'   tabindex='76'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_616\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_616\"><label class='gfield_label gform-field-label' for='input_110_616' >Use:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_616' id='input_110_616' type='text' value='' class='medium'   tabindex='77'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_658\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_658\"><br><\/li><li id=\"field_110_617\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_617\"><h2 class=\"gsection_title\">Fire Extinguishing Appliances<\/h2><\/li><li id=\"field_110_618\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_618\"><label class='gfield_label gform-field-label' for='input_110_618' >Distance from nearest Fire Station.<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_618' id='input_110_618' type='text' value='' class='medium'   tabindex='78'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_619\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_619\"><label class='gfield_label gform-field-label' for='input_110_619' >Distance from nearest Hydrant.<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_619' id='input_110_619' type='text' value='' class='medium'   tabindex='79'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_620\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_620\"><label class='gfield_label gform-field-label' for='input_110_620' >Source of Water Supply?<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_620' id='input_110_620' type='text' value='' class='medium'   tabindex='80'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_622\"  class=\"gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_622\"><label class='gfield_label gform-field-label'  >Is it consistent and pressure good?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_622'>\n\t\t\t<li class='gchoice gchoice_110_622_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_622' type='radio' value='Yes'  id='choice_110_622_0' tabindex='81'   \/>\n\t\t\t\t<label for='choice_110_622_0' id='label_110_622_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_622_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_622' type='radio' value='No'  id='choice_110_622_1' tabindex='82'   \/>\n\t\t\t\t<label for='choice_110_622_1' id='label_110_622_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_623\"  class=\"gfield gfield--type-radio gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_623\"><label class='gfield_label gform-field-label'  >Is this a flood prone area?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_623'>\n\t\t\t<li class='gchoice gchoice_110_623_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_623' type='radio' value='Yes'  id='choice_110_623_0' tabindex='83'   \/>\n\t\t\t\t<label for='choice_110_623_0' id='label_110_623_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_623_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_623' type='radio' value='No'  id='choice_110_623_1' tabindex='84'   \/>\n\t\t\t\t<label for='choice_110_623_1' id='label_110_623_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_621\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_621\"><label class='gfield_label gform-field-label' for='input_110_621' >Details of water tanks.<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_621' id='input_110_621' type='text' value='' class='medium'   tabindex='85'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_624\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_624\"><label class='gfield_label gform-field-label' for='input_110_624' >Details of fire alarms.<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_624' id='input_110_624' type='text' value='' class='medium'   tabindex='86'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_626\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_626\"><br><label for=\"staircase\"><strong>Hand Extinguishers::<\/strong><\/label>\n<\/li><li id=\"field_110_627\"  class=\"gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_627\"><label class='gfield_label gform-field-label'  >Are they serviced regularly?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_627'>\n\t\t\t<li class='gchoice gchoice_110_627_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_627' type='radio' value='Yes'  id='choice_110_627_0' tabindex='87'   \/>\n\t\t\t\t<label for='choice_110_627_0' id='label_110_627_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_627_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_627' type='radio' value='No'  id='choice_110_627_1' tabindex='88'   \/>\n\t\t\t\t<label for='choice_110_627_1' id='label_110_627_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_628\"  class=\"gfield gfield--type-radio gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_628\"><label class='gfield_label gform-field-label'  >Are employees educated in the use of these extinguishers?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_628'>\n\t\t\t<li class='gchoice gchoice_110_628_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_628' type='radio' value='Yes'  id='choice_110_628_0' tabindex='89'   \/>\n\t\t\t\t<label for='choice_110_628_0' id='label_110_628_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_628_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_628' type='radio' value='No'  id='choice_110_628_1' tabindex='90'   \/>\n\t\t\t\t<label for='choice_110_628_1' id='label_110_628_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_659\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_659\"><br><\/li><li id=\"field_110_629\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_629\"><h2 class=\"gsection_title\">Supervision and Management<\/h2><\/li><li id=\"field_110_631\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_631\"><label class='gfield_label gform-field-label' for='input_110_631' >Number of employees:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_631' id='input_110_631' type='text' value='' class='medium'   tabindex='91'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_630\"  class=\"gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_630\"><label class='gfield_label gform-field-label'  >Is smoking permitted in any part of the premises?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_630'>\n\t\t\t<li class='gchoice gchoice_110_630_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_630' type='radio' value='Yes'  id='choice_110_630_0' tabindex='92'   \/>\n\t\t\t\t<label for='choice_110_630_0' id='label_110_630_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_630_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_630' type='radio' value='No'  id='choice_110_630_1' tabindex='93'   \/>\n\t\t\t\t<label for='choice_110_630_1' id='label_110_630_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_632\"  class=\"gfield gfield--type-radio gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_632\"><label class='gfield_label gform-field-label'  >Are any of the buildings congested or overcrowded?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_632'>\n\t\t\t<li class='gchoice gchoice_110_632_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_632' type='radio' value='Yes'  id='choice_110_632_0' tabindex='94'   \/>\n\t\t\t\t<label for='choice_110_632_0' id='label_110_632_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_632_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_632' type='radio' value='No'  id='choice_110_632_1' tabindex='95'   \/>\n\t\t\t\t<label for='choice_110_632_1' id='label_110_632_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_633\"  class=\"gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_633\"><label class='gfield_label gform-field-label'  >Are the premises thoroughly clean and tidy?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_633'>\n\t\t\t<li class='gchoice gchoice_110_633_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_633' type='radio' value='Yes'  id='choice_110_633_0' tabindex='96'   \/>\n\t\t\t\t<label for='choice_110_633_0' id='label_110_633_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_633_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_633' type='radio' value='No'  id='choice_110_633_1' tabindex='97'   \/>\n\t\t\t\t<label for='choice_110_633_1' id='label_110_633_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_634\"  class=\"gfield gfield--type-radio gfield--type-choice gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_634\"><label class='gfield_label gform-field-label'  >Do watchmen patrol the premises?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_634'>\n\t\t\t<li class='gchoice gchoice_110_634_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_634' type='radio' value='Yes'  id='choice_110_634_0' tabindex='98'   \/>\n\t\t\t\t<label for='choice_110_634_0' id='label_110_634_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_634_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_634' type='radio' value='No'  id='choice_110_634_1' tabindex='99'   \/>\n\t\t\t\t<label for='choice_110_634_1' id='label_110_634_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_635\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_635\"><label class='gfield_label gform-field-label' for='input_110_635' >Details of storage and disposal of domestic or trade garbage.<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_635' id='input_110_635' type='text' value='' class='medium'   tabindex='100'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_636\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_636\"><label class='gfield_label gform-field-label' for='input_110_636' >How long has the business been established?<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_636' id='input_110_636' type='text' value='' class='medium'   tabindex='101'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_660\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_660\"><br><\/li><li id=\"field_110_637\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_637\"><h2 class=\"gsection_title\">Loss Experience<\/h2><\/li><li id=\"field_110_638\"  class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_638\"><label class='gfield_label gform-field-label'  >Has the Insured ever sustained any loss?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_110_638'>\n\t\t\t<li class='gchoice gchoice_110_638_0'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_638' type='radio' value='Yes'  id='choice_110_638_0' tabindex='102'   \/>\n\t\t\t\t<label for='choice_110_638_0' id='label_110_638_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_110_638_1'>\n\t\t\t\t<input autocomplete=\"off\"  name='input_638' type='radio' value='No'  id='choice_110_638_1' tabindex='103'   \/>\n\t\t\t\t<label for='choice_110_638_1' id='label_110_638_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_110_639\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gf_left_third gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_639\"><label class='gfield_label gform-field-label' for='input_110_639' >Date of Loss:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input autocomplete=\"off\"  name='input_639' id='input_110_639' type='text' value='' class='datepicker gform-datepicker dmy datepicker_with_icon gdatepicker_with_icon' tabindex='104'  placeholder='dd\/mm\/yyyy' aria-describedby=\"input_110_639_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_110_639_date_format' class='screen-reader-text'>DD slash MM slash YYYY<\/span>\n                        <\/div>\n                        <input autocomplete=\"off\"  type='hidden' id='gforms_calendar_icon_input_110_639' class='gform_hidden' value='https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_110_640\"  class=\"gfield gfield--type-text gf_left_half expandable-input gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_640\"><label class='gfield_label gform-field-label' for='input_110_640' >Cause of Loss<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_640' id='input_110_640' type='text' value='' class='medium'   tabindex='105'  aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_642\"  class=\"gfield gfield--type-number gf_right_half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_642\"><label class='gfield_label gform-field-label' for='input_110_642' >Amount of Loss<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input autocomplete=\"off\"  name='input_642' id='input_110_642' type='number' step='any'   value='' class='medium' tabindex='106'    aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_110_661\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_661\"><br><\/li><li id=\"field_110_643\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_643\"><h2 class=\"gsection_title\">Details of Surrounding Risks<\/h2><\/li><li id=\"field_110_644\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_644\"><label class='gfield_label gform-field-label' for='input_110_644' >Northern side:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_644' id='input_110_644' type='text' value='' class='medium'   tabindex='107'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_645\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_645\"><label class='gfield_label gform-field-label' for='input_110_645' >Southern side:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_645' id='input_110_645' type='text' value='' class='medium'   tabindex='108'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_646\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_646\"><label class='gfield_label gform-field-label' for='input_110_646' >Eastern side:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_646' id='input_110_646' type='text' value='' class='medium'   tabindex='109'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_647\"  class=\"gfield gfield--type-text expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_647\"><label class='gfield_label gform-field-label' for='input_110_647' >Western side:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_647' id='input_110_647' type='text' value='' class='medium'   tabindex='110'   aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_110_662\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_662\"><br><\/li><li id=\"field_110_648\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_648\"><h2 class=\"gsection_title\">General Remarks<\/h2><\/li><li id=\"field_110_649\"  class=\"gfield gfield--type-textarea expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_649\"><label class='gfield_label gform-field-label screen-reader-text' for='input_110_649' ><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_649' id='input_110_649' class='textarea medium' tabindex='111'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_110_650\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_650\"><label class='gfield_label gform-field-label' for='gform_browse_button_110_650' >File<\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_110_650' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_110_650&quot;,&quot;container&quot;:&quot;gform_multifile_upload_110_650&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_110_650&quot;,&quot;filelist&quot;:&quot;gform_preview_110_650&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/?gf_page=6188febf653bfa9&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/gulfinsuranceltd.com\\\/forms\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed 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class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_110_650' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_110_650\" tabindex='112' >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_110_650'>Max. file size: 16 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_110_650'><\/ul> <!-- Leave <ul> empty to support CSS :empty selector. --><\/div><div id='gform_preview_110_650' class='ginput_preview_list'><\/div><\/li><li id=\"field_110_651\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_651\"><h2 class=\"gsection_title\">Recommendations<\/h2><\/li><li id=\"field_110_652\"  class=\"gfield gfield--type-textarea expandable-input field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_652\"><label class='gfield_label gform-field-label screen-reader-text' for='input_110_652' ><\/label><div class='ginput_container ginput_container_textarea'><textarea autocomplete=\"off\"  name='input_652' id='input_110_652' class='textarea medium' tabindex='113'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_110_551\"  class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon sizesmall exclude gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden\"  data-js-reload=\"field_110_551\"><div class='admin-hidden-markup'><i class='gform-icon gform-icon--hidden'><\/i><span>Hidden<\/span><\/div><label class='gfield_label gform-field-label' for='input_110_551' >Date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input autocomplete=\"off\"  name='input_551' id='input_110_551' type='text' value='31\/10\/2026' class='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon' tabindex='114'  placeholder='mm\/dd\/yyyy' aria-describedby=\"input_110_551_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_110_551_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input autocomplete=\"off\"  type='hidden' id='gforms_calendar_icon_input_110_551' class='gform_hidden' value='https:\/\/gulfinsuranceltd.com\/forms\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_110_654\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_110_654\"><label class='gfield_label gform-field-label' for='input_110_654' >Risk Control Surveyor:<\/label><div class='ginput_container ginput_container_text'><input autocomplete=\"off\"  name='input_654' id='input_110_654' type='text' value='Lawrence Johnson' class='medium'   tabindex='115'   aria-invalid=\"false\"   \/> <\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_110' class='gform_button button' value='Submit Report' tabindex='116' onclick='if(window[\"gf_submitting_110\"]){return false;}  if( !jQuery(\"#gform_110\")[0].checkValidity || jQuery(\"#gform_110\")[0].checkValidity()){window[\"gf_submitting_110\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_110\"]){return false;} if( !jQuery(\"#gform_110\")[0].checkValidity || 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