www.cesarvalencia.com Open in urlscan Pro
198.185.159.144  Public Scan

Form analysis
1 forms found in the DOM

POST https://icosahedron-accordion-98mm.squarespace.com

<form data-form-id="666f57370d2c1b4a016cef17" data-success-redirect="" data-dynamic-strings="" autocomplete="on" method="POST" action="https://icosahedron-accordion-98mm.squarespace.com" novalidate="" onsubmit="return (function (form) {
  Y.use('squarespace-form-submit', 'node', function usingFormSubmit(Y) {
    (new Y.Squarespace.FormSubmit(form)).submit({
      formId: '666f57370d2c1b4a016cef17',
      collectionId: '666f54cb416ed27ad8264836',
      objectName: 'ef92192f1fc13055bc5e'
    });
  });
  return false;
})(this);">
  <div class="field-list clear">
    <fieldset id="name-yui_3_17_2_1_1656615088309_7771" class="form-item fields name required">
      <legend class="title"> Name <span class="required" aria-hidden="true">*</span>
      </legend>
      <div class="field first-name">
        <label class="caption">
          <input class="field-element field-control" name="fname" x-autocompletetype="given-name" type="text" spellcheck="false" maxlength="30" data-title="First" aria-required="true">
          <span class="caption-text">First Name</span>
        </label>
      </div>
      <div class="field last-name">
        <label class="caption">
          <input class="field-element field-control" name="lname" x-autocompletetype="surname" type="text" spellcheck="false" maxlength="30" data-title="Last" aria-required="true">
          <span class="caption-text">Last Name</span>
        </label>
      </div>
    </fieldset>
    <div id="text-yui_3_17_2_1_1656615088309_7773" class="form-item field text required">
      <label class="title" for="text-yui_3_17_2_1_1656615088309_7773-field"> DOT # <span class="required" aria-hidden="true">*</span>
      </label>
      <input class="field-element text" type="text" id="text-yui_3_17_2_1_1656615088309_7773-field" aria-required="true">
    </div>
    <div id="email-yui_3_17_2_1_1656615088309_7772" class="form-item field email required">
      <label class="title" for="email-yui_3_17_2_1_1656615088309_7772-field"> Email <span class="required" aria-hidden="true">*</span>
      </label>
      <input class="field-element" id="email-yui_3_17_2_1_1656615088309_7772-field" name="email" type="email" autocomplete="email" spellcheck="false" aria-required="true">
    </div>
    <fieldset id="phone-333bcc54-6633-404f-8994-d9bead443d93" class="form-item fields phone required">
      <legend class="title"> Phone <span class="required" aria-hidden="true">*</span>
      </legend>
      <div class="field text three-digits">
        <label class="caption">
          <input class="field-element" x-autocompletetype="phone-area-code" type="text" maxlength="3" data-title="Areacode" aria-required="true">
          <span class="caption-text">(###)</span>
        </label>
      </div>
      <div class="field text three-digits">
        <label class="caption">
          <input class="field-element" x-autocompletetype="phone-local-prefix" type="text" maxlength="3" data-title="Prefix" aria-required="true">
          <span class="caption-text">###</span>
        </label>
      </div>
      <div class="field text four-digits">
        <label class="caption">
          <input class="field-element" x-autocompletetype="phone-local-suffix" type="text" maxlength="4" data-title="Line" aria-required="true">
          <span class="caption-text">####</span>
        </label>
      </div>
    </fieldset>
  </div>
  <div class="captcha-container
        align-left
        
        
        " data-theme="light"></div>
  <div data-animation-role="button" class="
          form-button-wrapper
          
        ">
    <input class="button sqs-system-button sqs-editable-button sqs-button-element--primary" type="submit" value="Submit">
  </div>
  <div class="hidden form-submission-text">
    <h2 style="white-space:pre-wrap;">Thank you! </h2>
    <h2 style="white-space:pre-wrap;">I’m looking forward to chatting with you soon.</h2>
  </div>
  <div class="hidden form-submission-html" data-submission-html=""></div>
</form>

Text Content

0
Skip to Content


Cesar Valencia

GET IN TOUCH
Open Menu Close Menu

Open Menu Close Menu

Cesar Valencia

GET IN TOUCH
GET IN TOUCH


TRUCKING INSURANCE
MADE EASY


AUTO LIABILITY


-


MOTOR TRUCK CARGO


-


PHYSICAL DAMAGE


-


GENERAL LIABILITY


-


AUTO LIABILITY - MOTOR TRUCK CARGO - PHYSICAL DAMAGE - GENERAL LIABILITY - AUTO
LIABILITY - MOTOR TRUCK CARGO - PHYSICAL DAMAGE - GENERAL LIABILITY -



GET A QUOTE


Name *
First Name
Last Name
DOT # *
Email *
Phone *
(###)
###
####




THANK YOU!


I’M LOOKING FORWARD TO CHATTING WITH YOU SOON.




LET’S CONNECT

Call/Text: (423) 279-8117