www.dbs.com.sg
Open in
urlscan Pro
104.18.28.18
Public Scan
URL:
https://www.dbs.com.sg/sme/dbs-forms/commercial-insurance-solutions?pk_source=google&pk_medium=organic&pk_campaign=seo
Submission: On April 10 via api from SG — Scanned from SG
Submission: On April 10 via api from SG — Scanned from SG
Form analysis
3 forms found in the DOM<form>
<div class="mobile-search-field">
<div class="search-group" id="mobile-search-group"> <input class="mobile-search" autocomplete="off" type="text" placeholder="Search" id="mobile-input-text" maxlength="1000" oncut="searchEvent()">
<a class="btn-close-history" id="mobile-btn-close-history">
<i class="icon" style="padding-right: 12px"></i>
</a>
<button class="btn-search" data-url="#" data-target="_self" href="javascript:void(0);" type="button">
<i class="icon ico-search"></i>
</button>
<div id="search-suggestions-mobile" class="search-suggestions mobile-search">
</div>
</div>
</div>
</form>
Name: _com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_fm — POST https://www.dbs.com.sg/sme/dbs-forms/commercial-insurance-solutions?p_p_id=com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt&p_p_lifecycle=1&p_p_state=normal&p_p_mode=view&_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_javax.portlet.action=addFormInstanceRecord&p_auth=5CDSrSQO
<form
action="https://www.dbs.com.sg/sme/dbs-forms/commercial-insurance-solutions?p_p_id=com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt&p_p_lifecycle=1&p_p_state=normal&p_p_mode=view&_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_javax.portlet.action=addFormInstanceRecord&p_auth=5CDSrSQO"
class="form " data-fm-namespace="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_fm" method="post"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_fm" data-ddmforminstanceid="183874394"> <input class="field form-control"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_formDate" name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_formDate" type="hidden" value="1681116834508">
<input class="field form-control" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_groupId" name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_groupId"
type="hidden" value="276102"> <input class="field form-control" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_formInstanceId"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_formInstanceId" type="hidden" value="183874394"> <input class="field form-control"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_languageId" name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_languageId" type="hidden" value="en_US"> <input
class="field form-control" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_workflowAction" name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_workflowAction"
type="hidden" value="1">
<div id="otpPopup" style="display: none;">
<div class="otp-desc-wrapper"></div>
<div class="row row-custom otp-pop-body"> <span class="icon-custom col-md-1 col-1"> <!-- <i class="icon-lock icon-2x custom-lock-icon" aria-hidden="true"></i> --> <img src="/o/gsmc-theme/images/ico_mobile.png" alt="Icon-Mobile"> </span> <span
class="col-md-10 col-sm-10 col-10">
<div> <span class="otp-span">
<div class="form-group input-text-wrapper"> <input class="field form-control" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_otpnumber"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_otpnumber" placeholder="One Time Password" title="otpnumber" type="number" value=""> </div>
</span> </div>
</span> <span id="timer_div" class="timer-custom col-md-1 col-1"> </span> </div>
<div class="row otp-error error-msg hide">Invalid OTP</div>
<div class="row otp-button-wrapper">
<div class="col-6 otp-submit-wrapper"> <button class="btn btn-submit-otp custom-form-button" id="submit-otp-id" onclick="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_verifyOTP()">SUBMIT</button> </div>
<div class=" col-6"> <button id="resend-otp-id" class="btn btn-resend-otp custom-form-button" onclick="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_resendotp()">RESEND</button> </div>
</div>
</div>
<div id="pop-up-Sign" class="custom-form-pop-up" style="display: none;">
<div class="pop-up-description"> </div>
<div class="modal-body-form"></div>
<div class="email-error error-msg hide">Email/Mobile number is not registered</div>
</div>
<div class="hide dbs-form-type">generic</div>
<div class="ddm-form-basic-info">
<div class="container-fluid-1280">
<h2 class="ddm-form-name">Insurance Enquiry eDM</h2>
</div>
</div>
<div class="container-fluid-1280 ddm-form-builder-app">
<div class="lfr-ddm-form-container" id="IeMmc1X4">
<div class="lfr-ddm-form-container" id="IeMmc1X4">
<div class="ddm-user-view-content lfr-ddm-form-content">
<div class="lfr-ddm-form-pages">
<div class="active lfr-ddm-form-page">
<h3 class="lfr-ddm-form-page-title">Contact Us - DBS Commercial Insurance</h3>
<h4 class="lfr-ddm-form-page-description">Simply leave your contact details here and we will contact you within 2 working days.</h4><label class="required-warning">All fields marked with <svg aria-hidden="true"
class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg> are required.</label>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US" id="yui_patched_v3_18_1_1_1681116835225_5012">
<div class="form-group" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US">
<div class="input-select-wrapper"><label for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US">Nature of Enquiry <svg aria-hidden="true"
class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="form-builder-select-field input-group-container">
<div class="form-control select-field-trigger" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US" tabindex="0">
<div class="option-selected option-selected-placeholder">Choose Options</div><a class="select-arrow-down-container" href="javascript:;" tabindex="-1"><span><i class="icon ico-arrowdown1 icon-animate"></i></span></a>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US">PageURL </label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US">Full Name <svg aria-hidden="true" class="lexicon-icon lexicon-icon-asterisk reference-mark"
viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US" placeholder="Full Name" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US">Company Name <svg aria-hidden="true"
class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US" placeholder="Company Name" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US">Business Email Address <svg aria-hidden="true"
class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US" placeholder="Business Email Address" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-2 col-sm-2 col-4">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US">Country Code <svg aria-hidden="true"
class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US" placeholder="+65" type="text" value="+65"></div>
</div>
</div>
</div>
</div>
<div class="col-md-10 col-sm-10 col-8">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US">Phone Number <svg aria-hidden="true" class="lexicon-icon lexicon-icon-asterisk reference-mark"
viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix hide lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US">
<div class="form-group liferay-ddm-form-field-checkbox-multiple" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" style="display: none;">
<div><label for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US">We'd like to learn more about your Business General Insurance. Which of the following
insurance policies does your company hold? Select the product(s) you’re currently insured for your business: </label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-FireAllRiskInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_FireAllRiskInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_FireAllRiskInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="FireAllRiskInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Fire/All Risk Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-PublicLiabilityInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_PublicLiabilityInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_PublicLiabilityInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="PublicLiabilityInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Public Liability Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-WorkInjuryCompensationInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_WorkInjuryCompensationInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_WorkInjuryCompensationInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="WorkInjuryCompensationInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Work Injury Compensation Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-BurglaryTheftInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_BurglaryTheftInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_BurglaryTheftInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="BurglaryTheftInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Burglary/Theft Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-MoneyInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_MoneyInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_MoneyInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="MoneyInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Money Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-BusinessInterruptionInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_BusinessInterruptionInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_BusinessInterruptionInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="BusinessInterruptionInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Business Interruption Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-FidelityGuaranteeInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_FidelityGuaranteeInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_FidelityGuaranteeInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="FidelityGuaranteeInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Fidelity Guarantee Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-CyberInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_CyberInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_CyberInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="CyberInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Cyber Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-DirectorsAndOfficersInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_DirectorsAndOfficersInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_DirectorsAndOfficersInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="DirectorsAndOfficersInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Directors and Officers Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-ContractorsAllRiskInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_ContractorsAllRiskInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_ContractorsAllRiskInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="ContractorsAllRiskInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Contractors All Risk Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-TravelInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_TravelInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_TravelInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="TravelInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Travel Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-GroupPersonalAccidentInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_GroupPersonalAccidentInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_GroupPersonalAccidentInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="GroupPersonalAccidentInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Group Personal Accident Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-MachineryAllRisksInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_MachineryAllRisksInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_MachineryAllRisksInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="MachineryAllRisksInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Machinery All Risks Insurance </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-TradeMarineCargoInsurance"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_TradeMarineCargoInsurance"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_TradeMarineCargoInsurance"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="TradeMarineCargoInsurance"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Trade Cargo Insurance (Marine Cargo Insurance) </span></span></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-NoneOfTheAbove"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_NoneOfTheAbove"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US_NoneOfTheAbove"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US" type="checkbox" value="NoneOfTheAbove"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">None of the above </span></span></label></div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix hide lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US"
id="yui_patched_v3_18_1_1_1681116835225_5167">
<div class="form-group hide liferay-ddm-form-field-text"
data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US" style="display: none;"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US">Please input the expiry date(s) of your insurance coverage
</label>
<div class="input-group"><textarea class="field form-control" dir="ltr"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US" placeholder="(MM/YYYY)" style="height: 80px;"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-1 col-sm-1 col-2">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US">
<div class="form-group liferay-ddm-form-field-checkbox-multiple" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US">
<div><label for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US"></label></div>
<div class="form-check custom-checkbox custom-control"><label class="form-check-label-option-Yes"
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US_Yes"><input dir="ltr" class="custom-control-input"
id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US_Yes"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US" type="checkbox" value="Yes"><span
class="form-check-description custom-control-label"><span class="custom-control-label-text">Terms and Conditions <svg aria-hidden="true" class="lexicon-icon lexicon-icon-asterisk reference-mark" viewBox="0 0 512 512">
<path class="lexicon-icon-outline" d="M323.6,190l146.7-48.8L512,263.9l-149.2,47.6l93.6,125.2l-104.9,76.3l-96.1-126.4l-93.6,126.4L56.9,435.3l92.3-123.9
L0,263.8l40.4-122.6L188.4,190v-159h135.3L323.6,190L323.6,190z"></path>
</svg></span></span></label></div>
</div>
</div>
</div>
<div class="col-md-11 col-sm-11 col-10">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraphepWwbg$zEEze5ih$0$$en_US">
<div class="form-group liferay-ddm-form-field-paragraph" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraphepWwbg$zEEze5ih$0$$en_US">
<div>
<p>We confirm that we have read, fully understood and accept the <a href="/sme/terms/default.page" target="">Terms and Conditions</a> and <a href="https://www.dbs.com/privacy/default.page" target="">DBS Privacy Policy</a>
relating to the collection, processing, use of personal data.</p>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraph$5XBBVNe5$0$$en_US">
<div class="form-group liferay-ddm-form-field-paragraph" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraph$5XBBVNe5$0$$en_US">
<div>
<p style="font-size: 16px; color: rgb(46, 46, 46); font-weight: normal; letter-spacing: 0px; line-height: 24px;">By providing your business contact information in this form, we may periodically send you electronic direct
mailers on updated information and new services relating to DBS.</p>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US">CMPContactId </label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US">CMPCampaignCode </label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US">CMPCountryCode </label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-12 col-12">
<div class="clearfix lfr-ddm-form-field-container" ref="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US">
<div class="form-group liferay-ddm-form-field-text" data-fieldname="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US"><label
for="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US">CMPForm </label>
<div class="input-group">
<div class="input-group-item"><input class="field form-control" dir="ltr" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US"
name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US" placeholder="" type="text" value=""></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="lfr-ddm-form-pagination-controls" id="yui_patched_v3_18_1_1_1681116835225_5319"><button class="btn btn-primary hide lfr-ddm-form-pagination-prev" type="button" hidden="hidden" style="display: none;"><i class="icon-angle-left"></i>
Previous</button><button class="btn btn-primary hide lfr-ddm-form-pagination-next pull-right" type="button" hidden="hidden" style="display: none;">Next <i class="icon-angle-right"></i></button><button
class="btn btn-primary lfr-ddm-form-submit pull-right" type="submit">Submit</button></div>
</div>
</div>
<script type="text/javascript">
AUI().use('liferay-ddm-form-renderer', function(A) {
var renderForm = function() {
var form = Liferay.component('IeMmc1X4DDMForm', new Liferay.DDM.Renderer.Form({
container: '#IeMmc1X4',
context: '\x7b\x22submitLabel\x22:\x22Submit\x22,\x22templateNamespace\x22:\x22ddm.wizard_form\x22,\x22dataProviderSettings\x22:\x7b\x7d,\x22groupId\x22:\x22276102\x22,\x22readOnly\x22:false,\x22rules\x22:\x5b\x7b\x22condition\x22:\x22contains(getValue(\x27NatureOfEnquiry\x27), \x27CommercialGeneralInsurance\x27)\x22,\x22enable\x22:true,\x22actions\x22:\x5b\x22setVisible(\x27Product\x27, true)\x22\x5d\x7d,\x7b\x22condition\x22:\x22not(isEmpty(getValue(\x27Product\x27)))\x22,\x22enable\x22:true,\x22actions\x22:\x5b\x22setRequired(\x27PleaseInputTheExpiryDateOfYourInsuranceCoverage\x27, true)\x22,\x22setVisible(\x27PleaseInputTheExpiryDateOfYourInsuranceCoverage\x27, true)\x22\x5d\x7d\x5d,\x22viewMode\x22:true,\x22showRequiredFieldsWarning\x22:true,\x22pages\x22:\x5b\x7b\x22showRequiredFieldsWarning\x22:true,\x22description\x22:\x22Simply leave your contact details here and we will contact you within 2 working days.\x22,\x22localizedDescription\x22:\x7b\x22en_US\x22:\x22Simply leave your contact details here and we will contact you within 2 working days.\x22\x7d,\x22rows\x22:\x5b\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22NatureOfEnquiry\x22,\x22predefinedValue\x22:\x5b\x5d,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22select\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x5b\x5d\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:false,\x22instanceId\x22:\x22Zj8fOGmN\x22,\x22strings\x22:\x7b\x22emptyList\x22:\x22No results were found.\x22,\x22search\x22:\x22Search\x22,\x22dynamicallyLoadedData\x22:\x22Dynamically Loaded Data\x22,\x22chooseOptions\x22:\x22Choose Options\x22,\x22chooseAnOption\x22:\x22Choose an Option\x22\x7d,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Commercial General Insurance: Protection for your company assets, operations and people.\x22,\x22value\x22:\x22CommercialGeneralInsurance\x22,\x22selected\x22:\x22false\x22\x7d,\x7b\x22label\x22:\x22Commercial Life Insurance: Protect against the loss of key personnel or guarantors.\x22,\x22value\x22:\x22CommercialLifeInsurance\x22,\x22selected\x22:\x22false\x22\x7d,\x7b\x22label\x22:\x22Group Medical \x26 Employee Benefits: Protection for a group of employees against healthcare expenses.\x22,\x22value\x22:\x22GroupMedicalEmployeeBenefits\x22,\x22selected\x22:\x22false\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22value\x22:\x5b\x5d,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22multiple\x22:true,\x22readOnly\x22:false,\x22label\x22:\x22Nature of Enquiry\x22,\x22visibilityExpression\x22:\x22\x22,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NatureOfEnquiry$Zj8fOGmN$0$$en_US\x22,\x22localizable\x22:true,\x22dataSourceType\x22:\x22manual\x22\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22PageURLDJGWjX\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x227UlGm71q\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22PageURL\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PageURLDJGWjX$7UlGm71q$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22LastNamebEcANc\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:false,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22FwNPO667\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22Full Name\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22match(LastNamebEcANc, \\\x22^\x5bA-Za-z .\x5d+$\\\x22)\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22readOnly\x22:false,\x22label\x22:\x22Full Name\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$LastNamebEcANc$FwNPO667$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22CompanyName9D87ff\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:false,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22USR9KgRm\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22Company Name\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22readOnly\x22:false,\x22label\x22:\x22Company Name\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CompanyName9D87ff$USR9KgRm$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22EmailAddressiPM3AZ\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:false,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22nHsUFo6z\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22Business Email Address\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22match(EmailAddressiPM3AZ, \\\x22^\x5b-0-9a-zA-Z.+_~!$`()\x3d:?\x5d+@\x5b-0-9a-zA-Z.+_\x5d+\x5b.\x5d\x7b1\x7d\x5ba-zA-Z\x5d\x7b2,4\x7d$\\\x22)\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22Please enter valid Email Address.\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22readOnly\x22:false,\x22label\x22:\x22Business Email Address\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$EmailAddressiPM3AZ$nHsUFo6z$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:2,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22PhoneNumber9C9D1l\x22,\x22predefinedValue\x22:\x22+65\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22+65\x22\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22Xl86W3MQ\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22+65\x22,\x22value\x22:\x22+65\x22,\x22validation\x22:\x7b\x22expression\x22:\x22match(PhoneNumber9C9D1l, \\\x22^\x5b+\x5d\x7b1\x7d\x5b0-9\x5d+$\\\x22)\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22Country Code\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PhoneNumber9C9D1l$Xl86W3MQ$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d,\x7b\x22size\x22:10,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22NumberJEpb4V\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:true,\x22valid\x22:false,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x220Bq0ci9Q\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22match(NumberJEpb4V, \\\x22^\x5b0-9\x5d\x7b8,15\x7d$\\\x22)\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22readOnly\x22:false,\x22label\x22:\x22Phone Number\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$NumberJEpb4V$0Bq0ci9Q$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22Product\x22,\x22predefinedValue\x22:\x5b\x5d,\x22showAsSwitcher\x22:false,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22checkbox_multiple\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x5b\x5d\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22instanceId\x22:\x22wP1DMKyQ\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Fire\\\/All Risk Insurance\x22,\x22value\x22:\x22FireAllRiskInsurance\x22\x7d,\x7b\x22label\x22:\x22Public Liability Insurance\x22,\x22value\x22:\x22PublicLiabilityInsurance\x22\x7d,\x7b\x22label\x22:\x22Work Injury Compensation Insurance\x22,\x22value\x22:\x22WorkInjuryCompensationInsurance\x22\x7d,\x7b\x22label\x22:\x22Burglary\\\/Theft Insurance\x22,\x22value\x22:\x22BurglaryTheftInsurance\x22\x7d,\x7b\x22label\x22:\x22Money Insurance\x22,\x22value\x22:\x22MoneyInsurance\x22\x7d,\x7b\x22label\x22:\x22Business Interruption Insurance\x22,\x22value\x22:\x22BusinessInterruptionInsurance\x22\x7d,\x7b\x22label\x22:\x22Fidelity Guarantee Insurance\x22,\x22value\x22:\x22FidelityGuaranteeInsurance\x22\x7d,\x7b\x22label\x22:\x22Cyber Insurance\x22,\x22value\x22:\x22CyberInsurance\x22\x7d,\x7b\x22label\x22:\x22Directors and Officers Insurance\x22,\x22value\x22:\x22DirectorsAndOfficersInsurance\x22\x7d,\x7b\x22label\x22:\x22Contractors All Risk Insurance\x22,\x22value\x22:\x22ContractorsAllRiskInsurance\x22\x7d,\x7b\x22label\x22:\x22Travel Insurance\x22,\x22value\x22:\x22TravelInsurance\x22\x7d,\x7b\x22label\x22:\x22Group Personal Accident Insurance\x22,\x22value\x22:\x22GroupPersonalAccidentInsurance\x22\x7d,\x7b\x22label\x22:\x22Machinery All Risks Insurance\x22,\x22value\x22:\x22MachineryAllRisksInsurance\x22\x7d,\x7b\x22label\x22:\x22Trade Cargo Insurance (Marine Cargo Insurance)\x22,\x22value\x22:\x22TradeMarineCargoInsurance\x22\x7d,\x7b\x22label\x22:\x22None of the above\x22,\x22value\x22:\x22NoneOfTheAbove\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22value\x22:\x5b\x5d,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:false,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22We\x27d like to learn more about your Business General Insurance. Which of the following insurance policies does your company hold? Select the product(s) you’re currently insured for your business:\x22,\x22visibilityExpression\x22:\x22\x22,\x22inline\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$Product$wP1DMKyQ$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22PleaseInputTheExpiryDateOfYourInsuranceCoverage\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22multiline\x22,\x22instanceId\x22:\x22S4iTbECJ\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22(MM\\\/YYYY)\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:false,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22Please input the expiry date(s) of your insurance coverage\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$PleaseInputTheExpiryDateOfYourInsuranceCoverage$S4iTbECJ$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:1,\x22fields\x22:\x5b\x7b\x22evaluable\x22:true,\x22fieldName\x22:\x22TermsAndConditionsOqK25I\x22,\x22predefinedValue\x22:\x5b\x5d,\x22showAsSwitcher\x22:false,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22checkbox_multiple\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x5b\x5d\x7d,\x22enabled\x22:true,\x22required\x22:true,\x22showLabel\x22:false,\x22valid\x22:false,\x22instanceId\x22:\x22x4ETfcMa\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Terms and Conditions\x22,\x22value\x22:\x22Yes\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22value\x22:\x5b\x5d,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22This field is required.\x22,\x22readOnly\x22:false,\x22label\x22:\x22Terms and Conditions\x22,\x22visibilityExpression\x22:\x22\x22,\x22inline\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$TermsAndConditionsOqK25I$x4ETfcMa$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d,\x7b\x22size\x22:11,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22paragraphepWwbg\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22paragraph\x22,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22instanceId\x22:\x22zEEze5ih\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22text\x22:\x7b\x22content\x22:\x22\x3cp\x3eWe confirm that we have read, fully understood and accept the \x3ca href\x3d\\\x22\\\/sme\\\/terms\\\/default.page\\\x22 target\x3d\\\x22\\\x22\x3eTerms and Conditions\x3c\\\/a\x3e\x26nbsp;and \x3ca href\x3d\\\x22https:\\\/\\\/www.dbs.com\\\/privacy\\\/default.page\\\x22 target\x3d\\\x22\\\x22\x3eDBS Privacy Policy\x3c\\\/a\x3e relating to the collection, processing, use of personal data.\x3c\\\/p\x3e\\n\x22,\x22contentDirection\x22:null,\x22contentKind\x22:\x22HTML\x22\x7d,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22\x22,\x22visibilityExpression\x22:\x22\x22,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraphepWwbg$zEEze5ih$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22paragraph\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22paragraph\x22,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22instanceId\x22:\x225XBBVNe5\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22text\x22:\x7b\x22content\x22:\x22\x3cp\x3eBy providing your business contact information in this form, we may periodically send you electronic direct mailers on updated information and new services relating to DBS.\x3c\\\/p\x3e\\n\x22,\x22contentDirection\x22:null,\x22contentKind\x22:\x22HTML\x22\x7d,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22\x22,\x22visibilityExpression\x22:\x22\x22,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$paragraph$5XBBVNe5$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22CMPContactId\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22rpKiOh4j\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22CMPContactId\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPContactId$rpKiOh4j$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22CMPCampaignCode\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22ccBZysKg\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22CMPCampaignCode\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCampaignCode$ccBZysKg$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22CMPCountryCode\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x223aOdNGkO\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22CMPCountryCode\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPCountryCode$3aOdNGkO$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d,\x7b\x22columns\x22:\x5b\x7b\x22size\x22:12,\x22fields\x22:\x5b\x7b\x22fieldName\x22:\x22CMPForm\x22,\x22predefinedValue\x22:\x22\x22,\x22tooltip\x22:\x22\x22,\x22dir\x22:\x22ltr\x22,\x22locale\x22:\x22en_US\x22,\x22type\x22:\x22text\x22,\x22localizedValue\x22:\x7b\x22en_US\x22:\x22\x22\x7d,\x22enabled\x22:true,\x22required\x22:false,\x22showLabel\x22:true,\x22valid\x22:true,\x22displayStyle\x22:\x22singleline\x22,\x22instanceId\x22:\x22T1bNg3Jd\x22,\x22repeatable\x22:false,\x22options\x22:\x5b\x7b\x22label\x22:\x22Option\x22,\x22value\x22:\x22Option\x22\x7d\x5d,\x22tip\x22:\x22\x22,\x22pathThemeImages\x22:\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\x22,\x22placeholder\x22:\x22\x22,\x22value\x22:\x22\x22,\x22validation\x22:\x7b\x22expression\x22:\x22\x22,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22\x7d,\x22visible\x22:true,\x22valueChanged\x22:false,\x22dataType\x22:\x22string\x22,\x22errorMessage\x22:\x22\x22,\x22readOnly\x22:false,\x22label\x22:\x22CMPForm\x22,\x22visibilityExpression\x22:\x22\x22,\x22autocompleteEnabled\x22:false,\x22name\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_ddm$$CMPForm$T1bNg3Jd$0$$en_US\x22,\x22localizable\x22:true\x7d\x5d\x7d\x5d\x7d\x5d,\x22title\x22:\x22Contact Us - DBS Commercial Insurance\x22,\x22enabled\x22:true,\x22localizedTitle\x22:\x7b\x22en_US\x22:\x22Contact Us - DBS Commercial Insurance\x22\x7d\x7d\x5d,\x22strings\x22:\x7b\x22next\x22:\x22Next\x22,\x22previous\x22:\x22Previous\x22\x7d,\x22showSubmitButton\x22:true,\x22requiredFieldsWarningMessageHTML\x22:\x7b\x22content\x22:\x22\x3clabel class\x3d\\\x22required-warning\\\x22\x3eAll fields marked with \x3csvg aria-hidden\x3d\\\x22true\\\x22 class\x3d\\\x22lexicon-icon lexicon-icon-asterisk reference-mark\\\x22\x3e\x3cuse xlink:href\x3d\\\x22https:\\\/\\\/www.dbs.com.sg\\\/o\\\/smeportal-theme\\\/images\\\/lexicon\\\/icons.svg#asterisk\\\x22 \\\/\x3e\x3c\\\/svg\x3e are required.\x3c\\\/label\x3e\x22,\x22contentDirection\x22:null,\x22contentKind\x22:\x22HTML\x22\x7d,\x22containerId\x22:\x22IeMmc1X4\x22,\x22currentPage\x22:\x221\x22,\x22evaluatorURL\x22:\x22\\\/o\\\/dynamic-data-mapping-form-context-provider\\\/\x22,\x22portletNamespace\x22:\x22_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_\x22\x7d',
defaultLanguageId: 'en_US',
evaluatorURL: '\/o\/dynamic-data-mapping-form-context-provider\/',
portletNamespace: '_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_',
readOnly: false,
viewMode: true
}).render());
Liferay.fire('IeMmc1X4DDMForm:render', {
form: form
});
};
if (Liferay.DMMFieldTypesReady) {
renderForm();
} else {
Liferay.onceAfter('DMMFieldTypesReady', function() {
renderForm();
});
}
var destroyFormHandle = function(event) {
var form = Liferay.component('IeMmc1X4DDMForm');
var portlet = event.portlet;
if (form && portlet && portlet.contains(form.get('container'))) {
form.destroy();
Liferay.detach('destroyPortlet', destroyFormHandle);
}
};
Liferay.on('destroyPortlet', destroyFormHandle);
});
</script>
<input class="field form-control" id="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_empty" name="_com_liferay_dynamic_data_mapping_form_web_portlet_DDMFormPortlet_INSTANCE_Gf1jYRuKJFbt_empty"
type="hidden" value="">
</div>
</form>
Name: hrefFm — POST #
<form action="#" class="hide" id="hrefFm" method="post" name="hrefFm"><span></span><input hidden="" type="submit"></form>
Text Content
* Day to Day * Trade * Loans * Treasury * Services * Research * BusinessClass * ATM & Branch * Help & Support * You are in SME Banking * PERSONAL BANKING * DBS * POSB * WEALTH MANAGEMENT * DBS Treasures * DBS Treasures Private Client * DBS Private Bank * DBS VICKERS SECURITIES * DBS Vickers Online * INSTITUTIONAL BANKING * SME Banking * Corporate Banking * FINANCIAL MARKETS * Treasury & Markets * DBS GROUP * About DBS * Portraits of Purpose * You are in SME Banking PERSONAL BANKING DBS POSB WEALTH MANAGEMENT DBS Treasures DBS Treasures Private Client DBS Private Bank DBS VICKERS SECURITIES DBS Vickers Online INSTITUTIONAL BANKING SME Banking Corporate Banking FINANCIAL MARKETS Treasury & Markets DBS GROUP About DBS Portraits of Purpose * ATM & Branch * Help & Support * ATM & Branch * Help & Support * You are in SME Banking * PERSONAL BANKING * DBS * POSB * WEALTH MANAGEMENT * DBS Treasures * DBS Treasures Private Client * DBS Private Bank * DBS VICKERS SECURITIES * DBS Vickers Online * INSTITUTIONAL BANKING * SME Banking * Corporate Banking * FINANCIAL MARKETS * Treasury & Markets * DBS GROUP * About DBS * Portraits of Purpose * You are in SME Banking PERSONAL BANKING DBS POSB WEALTH MANAGEMENT DBS Treasures DBS Treasures Private Client DBS Private Bank DBS VICKERS SECURITIES DBS Vickers Online INSTITUTIONAL BANKING SME Banking Corporate Banking FINANCIAL MARKETS Treasury & Markets DBS GROUP About DBS Portraits of Purpose * ATM & Branch * Help & Support Day to Day Trade Loans Treasury Services Research BusinessClass * Popular Searches * DBS IDEAL, * Open account, * Apply loan, * Working capital loan * Login IDEAL™ Vickers Online iBanking WYSIWYG_Form_Template Commercial Insurance Solutions Form | DBS SME Banking Invalid OTP SUBMIT RESEND Email/Mobile number is not registered generic INSURANCE ENQUIRY EDM CONTACT US - DBS COMMERCIAL INSURANCE SIMPLY LEAVE YOUR CONTACT DETAILS HERE AND WE WILL CONTACT YOU WITHIN 2 WORKING DAYS. All fields marked with are required. Nature of Enquiry Choose Options PageURL Full Name Company Name Business Email Address Country Code Phone Number We'd like to learn more about your Business General Insurance. Which of the following insurance policies does your company hold? Select the product(s) you’re currently insured for your business: Fire/All Risk Insurance Public Liability Insurance Work Injury Compensation Insurance Burglary/Theft Insurance Money Insurance Business Interruption Insurance Fidelity Guarantee Insurance Cyber Insurance Directors and Officers Insurance Contractors All Risk Insurance Travel Insurance Group Personal Accident Insurance Machinery All Risks Insurance Trade Cargo Insurance (Marine Cargo Insurance) None of the above Please input the expiry date(s) of your insurance coverage Terms and Conditions We confirm that we have read, fully understood and accept the Terms and Conditions and DBS Privacy Policy relating to the collection, processing, use of personal data. By providing your business contact information in this form, we may periodically send you electronic direct mailers on updated information and new services relating to DBS. CMPContactId CMPCampaignCode CMPCountryCode CMPForm PreviousNext Submit USEFUL LINKS * About DBS * Investor Relations * Disclaimer & Important Notice * Terms & Conditions Governing Electronic Services OTHERS * Forms * Pricing Guide * Tools * Security & You * Give Feedback CONTACT US * DBS BusinessCare * 1800 222 2200 (in Singapore) / * +65 6222 2200 (Overseas) * Mon to Fri (exclude PH) * 8:30am to 8:30pm MARKETS Singapore * Singapore * Hong Kong * India * Indonesia * Mainland China * Taiwan * Terms & Conditions| * Privacy Policy| * Fair Dealing Commitment| * Compliance with Tax Requirements| * Vulnerability Disclosure Policy| * Security Alerts & News| * ©2023 DBS Bank Ltd| * Co. Reg. No. 196800306E| * * * * You need to enable JavaScript to run this app. FEEDBACK × How would you rate your overall experience on this site? What areas need improvement? Ease of use Ease of navigation Language clarity Look and feel Technical issues Others How can we make your browsing experience better? Enter only letters, numbers or @!$&-/()',. 500 2 of 2 Thank you! We've heard you. Your feedback is valuable to us. Next Submit May I help you? Joy (Virtual Assistant) Deal Details 2023 January SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 February SuMoTuWeThFrSa12345678910111213141516171819202122232425262728 March SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 April SuMoTuWeThFrSa123456789101112131415161718192021222324252627282930 May SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 June SuMoTuWeThFrSa123456789101112131415161718192021222324252627282930 July SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 August SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 September SuMoTuWeThFrSa123456789101112131415161718192021222324252627282930 October SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 November SuMoTuWeThFrSa123456789101112131415161718192021222324252627282930 December SuMoTuWeThFrSa12345678910111213141516171819202122232425262728293031 CancelApply Detail Page