payments.kovalevinsurance.com
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44.202.80.156
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URL:
https://payments.kovalevinsurance.com/
Submission: On July 13 via automatic, source certstream-suspicious — Scanned from CA
Submission: On July 13 via automatic, source certstream-suspicious — Scanned from CA
Form analysis 1 forms found in the DOM
POST
<form class="form-horizontal form-pay" method="POST" id="cc-payment-form">
<input id="csrf_token" name="csrf_token" type="hidden" value="IjliMWI1ZTZkY2M1N2VhNzMzMzIxZTE2ZTM1OWZjNmM4YzJiNTRkZjMi.ZpI65Q.NruWYw6ikU9eqJhKjNv9OJZmL4g">
<label for="id_plumb" class="sr-only">Plumb ID</label>
<input style="display: none" name="plumb" id="id_plumb" class="id_plumb">
<label for="id_name_here" class="sr-only">ID Name Here(do not change)</label>
<input style="display: none" name="name_here" id="id_name_here">
<label for="id_payment_type" class="sr-only">ID Payment Type(do not change)</label>
<input style="display: none" name="payment_type" id="id_payment_type">
<label for="id_payment_method_nonce" class="sr-only">ID Payment Method(do not change)</label>
<input style="display: none" name="payment_method_nonce" id="id_payment_method_nonce">
<div class="pay-fieldset">
<div class="row">
<div class="col-md-6 col-res pr-0-desk">
<!--PAYER-->
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="payer">PAYER <span class="required-field">*</span></label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="payer" name="payer" placeholder="Enter Payer Name" required="" type="text" value="">
</div>
</div>
<!--END PAYER-->
</div>
<div class="col-md-6 col-res pl-0-desk">
<!--EMAIL ADDRESS-->
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="email">EMAIL ADDRESS <span class="required-field">*</span></label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="email" name="email" placeholder="Enter Email Address" required="" type="email" value="">
</div>
</div>
<!--EMAIL ADDRESS-->
</div>
</div>
<div class="row">
<div class="col-md-6 col-res pr-0-desk">
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="named_insured">NAMED INSURED <span class="required-field">*</span></label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="named_insured" name="named_insured" placeholder="Enter Named Insured" required="" type="text" value="">
</div>
</div>
</div>
<div class="col-md-6 col-res pl-0-desk">
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="policy_number">POLICY # (Optional)</label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="policy_number" name="policy_number" placeholder="Enter Policy #" type="text" value="">
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-md-6 col-res pr-0-desk">
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="account_rep">Name of Kovalev Insurance Account Representative <span class="required-field">*</span></label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="account_rep" name="account_rep" placeholder="Enter Kovalev Representative" required="" type="text" value="">
</div>
</div>
<!--END ACCOUNT REP-->
</div>
<!-- /.col-md-6 -->
</div>
<!-- /.row -->
<div class="row">
<div class="col-md-12">
<div class="form-group">
<label class="col-md-12 control-label plr-0-res" for="comments">COMMENTS</label>
<div class="col-md-12 plr-0-res">
<textarea class="form-control comments-payment blue-border" id="comments" name="comments" placeholder="Enter Comments"></textarea>
</div>
</div>
<!--END COMMENTS-->
</div>
<!-- /.col-md-12 -->
</div>
<!-- /.row -->
<div class="row">
<div class="col-md-6 col-res pr-0-desk">
<!--AMOUNT-->
<div class="form-group mb-0-res">
<label class="col-md-12 control-label plr-0-res" for="amount">AMOUNT <span class="required-field">*</span></label>
<div class="col-md-12 plr-0-res">
<input class="form-control input-md blue-border" id="amount" name="amount" placeholder="0.00" required="" step="0.01" type="number" value="">
</div>
</div>
<!--END AMOUNT-->
</div>
</div>
<!-- /.row -->
</div>
<!-- <hr class="pay-divider" /> -->
<hr class="pay-divider">
<!--PAYMENT TYPE-->
<div class="row">
<!--PAYMENT BOXES-->
<div class="credit-card-payment col-md-6 col-res">
<!--CREDIT CARD-->
<div id="creditCardTrigger" class="payment-boxes payment-box-left transform-payment-boxes shadow-selected tabOneTrigger">
<i class="fa fa-credit-card fa-credit-card-payment"></i>
<h3 class="credit-card-title text-center secondary-title">Credit Card</h3>
<hr class="pay-divider-two">
<div class="row">
<div class="col-md-7 col-payment-res">
<span class="box-text-left grey-text-payment">Amount</span>
<span class="bold-text box-text-left highlighted-item-pay-two">Fee (3.1% + $.49) </span>
<span class="box-text-left grey-text-payment">Total</span>
</div>
<div class="col-md-5 col-payment-res">
<span class="box-text-right grey-text-payment" id="id_credit_card_amount">$0.00</span>
<span class="highlighted-item-pay-two box-text-right bold-text" id="id_credit_card_fee">$0.00</span>
<span class="box-text-right grey-text-payment" id="id_credit_card_total">$0.00</span>
</div>
</div>
</div>
<!--END CREDIT CARD-->
<div class="tabOneRes tabResHide"></div>
</div>
<!--END PAYMENT BOXES-->
<div class="credit-card-payment col-md-6 col-res">
<!--ACH-->
<div id="achTrigger" class="payment-boxes payment-box-right tabTwoTrigger">
<i class="fa fa-university fa-bank-payment" aria-hidden="true"></i>
<h3 class="credit-card-title text-center secondary-title">ACH</h3>
<hr class="pay-divider-two">
<div class="row">
<div class="col-md-6 col-payment-res">
<span class="box-text-left grey-text-payment">Amount</span>
<span class="bold-text box-text-left highlighted-item-pay">Fee</span>
<span class="box-text-left grey-text-payment">Total</span>
</div>
<div class="col-md-6 col-payment-res">
<span class="box-text-right grey-text-payment" id="id_ach_amount">$0.00</span>
<span class="highlighted-item-pay box-text-right bold-text" id="id_ach_fee">$5.00</span>
<span class="box-text-right grey-text-payment" id="id_ach_total">$0.00</span>
</div>
</div>
</div>
<!--END ACH-->
<div class="tabTwoRes tabResHide"></div>
</div>
<!--PAYMENT-->
<div class="col-md-12 col-res">
<!--PAYMENT INFORMATION-->
<!--CREDIT CARD FORM-->
<div id="creditCardForm" class="tabOne">
<div class="row">
<div class="col-md-12">
<h2 class="text-center secondary-title-payment mb-25 payment-info-title"> PAYMENT INFORMATION </h2>
</div>
<div class="col-md-6 col-res">
<!--CREDIT CARD NUMBER-->
<div class="form-group">
<p class="col-md-12 control-label pl-0-desk white-font mb-1 ml-3" for="credit_card_name">NAME ON CARD <span class="required-field">*</span>
</p>
<div class="col-md-12 pr-0-desk">
<input class="form-control input-md cc-fields" id="credit_card_name" name="credit_card_name" placeholder="Name on Card" style="color: #666666;" type="text" value="">
</div>
</div>
<!--END CREDIT CARD NUMBER-->
<!--CREDIT CARD NUMBER-->
<div class="form-group">
<p class="col-md-12 control-label pl-0-desk white-font mb-1 ml-3"> CREDIT CARD NUMBER <span class="required-field">*</span></p>
<div class="col-md-12 pr-0-desk">
<div id="card-number" class="form-control input-md cc-fields"><iframe src="https://assets.braintreegateway.com/web/3.44.2/html/hosted-fields-frame.min.html#111820a2-f145-47d2-a301-2b7f3fe66664" frameborder="0" allowtransparency="true"
scrolling="no" type="number" name="braintree-hosted-field-number" title="Secure Credit Card Frame - Credit Card Number" id="braintree-hosted-field-number" style="border: none; width: 100%; height: 100%; float: left;"></iframe>
<div style="clear: both;"></div>
</div>
</div>
</div>
<!--END CREDIT CARD NUMBER-->
</div>
<div class="col-lg-6 col-res">
<!--YEAR-->
<div class="form-group">
<p class="col-md-12 control-label pl-0-desk white-font mb-1"> Expiration Date (MM/YYYY) <span class="required-field">*</span></p>
<div class="col-md-12 pl-0-desk">
<div id="expiration-date" class="form-control input-md cc-fields"><iframe src="https://assets.braintreegateway.com/web/3.44.2/html/hosted-fields-frame.min.html#111820a2-f145-47d2-a301-2b7f3fe66664" frameborder="0"
allowtransparency="true" scrolling="no" type="expirationDate" name="braintree-hosted-field-expirationDate" title="Secure Credit Card Frame - Expiration Date" id="braintree-hosted-field-expirationDate"
style="border: none; width: 100%; height: 100%; float: left;"></iframe>
<div style="clear: both;"></div>
</div>
</div>
</div>
<!--END YEAR-->
<!--CVC-->
<div class="form-group">
<p class="col-md-12 control-label pl-0-desk white-font mb-1"> CVV <span class="required-field">*</span><a href="/static/images/credit-card-logos/cvv.png" title="cvv-tooltip" id="cvv-tooltip" style="font-size: .5em; color: white;" data-lightbox="image-1"> What's
This?</a></p>
<div class="col-md-12 pl-0-desk">
<div id="cvv" class="form-control input-md cc-fields"><iframe src="https://assets.braintreegateway.com/web/3.44.2/html/hosted-fields-frame.min.html#111820a2-f145-47d2-a301-2b7f3fe66664" frameborder="0" allowtransparency="true"
scrolling="no" type="cvv" name="braintree-hosted-field-cvv" title="Secure Credit Card Frame - CVV" id="braintree-hosted-field-cvv" style="border: none; width: 100%; height: 100%; float: left;"></iframe>
<div style="clear: both;"></div>
</div>
</div>
</div>
<!--END CVC-->
<!--POSTAL CODE-->
<div class="form-group">
<p class="col-md-12 control-label pl-0-desk white-font mb-1"> POSTAL CODE <span class="required-field">*</span></p>
<div class="col-md-12 pl-0-desk">
<div id="postal-code" class="form-control input-md cc-fields"><iframe src="https://assets.braintreegateway.com/web/3.44.2/html/hosted-fields-frame.min.html#111820a2-f145-47d2-a301-2b7f3fe66664" frameborder="0" allowtransparency="true"
scrolling="no" type="postalCode" name="braintree-hosted-field-postalCode" title="Secure Credit Card Frame - Postal Code" id="braintree-hosted-field-postalCode"
style="border: none; width: 100%; height: 100%; float: left;"></iframe>
<div style="clear: both;"></div>
</div>
</div>
</div>
<!--END POSTAL CODE-->
</div>
</div>
</div>
<!--END CREDIT CARD FORM-->
<!--ACH FORM-->
<div id="achForm" class="tabTwo" style="display: none;">
<div class="col-md-12">
<h2 class="text-center secondary-title-payment mb-25 payment-info-title"> PAYMENT INFORMATION </h2>
</div>
<!--ACH INFO-->
<div class="col-md-12">
<div class="ach-info">
<p><i class="fa fa-exclamation-circle" aria-hidden="true"></i> ACH transactions can take up to 5 business days to clear. If your payment is time-sensitive, we recommend using the credit card payment option.</p>
</div>
</div>
<!--END ACH INFO-->
<!--CHECKBOXES-->
<div class="form-group">
<div class="col-md-12">
<p class="col-md-12 control-label pr-0-desk" style="padding-left: 0; color:white; margin-bottom: 7px;"> ACCOUNT TYPE <span class="required-field">*</span></p>
<label class="radio-inline radio-payment" for="corporate_checking">
<input type="radio" name="corporate_personal" id="corporate_checking" value="business checking" onclick="toggleAchNames('business');" class="ach-fields check-radio-payment" required=""> Business Checking </label>
<label class="radio-inline radio-payment" for="corporate_savings">
<input type="radio" name="corporate_personal" id="corporate_savings" value="business savings" onclick="toggleAchNames('business');" class="ach-fields check-radio-payment" required=""> Business Savings </label>
<label class="radio-inline radio-payment" for="personal_checking">
<input type="radio" name="corporate_personal" id="personal_checking" value="personal checking" onclick="toggleAchNames('personal');" class="ach-fields check-radio-payment" required=""> Personal Checking </label>
<label class="radio-inline radio-payment" for="personal_savings">
<input type="radio" name="corporate_personal" id="personal_savings" value="personal savings" onclick="toggleAchNames('personal');" class="ach-fields check-radio-payment" required=""> Personal Savings </label>
</div>
</div>
<!--END CHECKBOXES-->
<div class="row">
<div class="col-md-6 col-res">
<!--ROUTING NUMBER-->
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="routing_number">ROUTING NUMBER <span class="required-field">*</span></label>
<div class="col-md-12 pr-0-desk">
<input id="routing_number" name="routing_number" type="text" placeholder="Routing Number" class="form-control input-md ach-fields">
</div>
</div>
<!--END ROUTING NUMBER-->
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="billing-street-address">STREET <span class="required-field">*</span></label>
<div class="col-md-12 pr-0-desk">
<input id="billing-street-address" name="billing-street-address" type="text" placeholder="Street Address" class="form-control input-md ach-fields">
</div>
</div>
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="billing-extended-address">STREET 2</label>
<div class="col-md-12 pr-0-desk">
<input id="billing-extended-address" name="billing-extended-address" type="text" placeholder="Street Address 2" class="form-control input-md ach-fields">
</div>
</div>
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="billing-locality">CITY <span class="required-field">*</span></label>
<div class="col-md-12 pr-0-desk">
<input id="billing-locality" name="billing-locality" type="text" placeholder="City" class="form-control input-md ach-fields">
</div>
</div>
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="billing-region">STATE (i.e. MA) <span class="required-field">*</span></label>
<div class="col-md-12 pr-0-desk">
<input id="billing-region" name="billing-region" type="text" placeholder="State" class="form-control input-md ach-fields" maxlength="2">
</div>
</div>
<div class="form-group">
<label class="col-md-12 control-label pr-0-desk" for="billing-postal-code">POSTAL CODE <span class="required-field">*</span></label>
<div class="col-md-12 pr-0-desk">
<input id="billing-postal-code" name="billing-postal-code" type="text" placeholder="Postal Code" class="form-control input-md ach-fields">
</div>
</div>
</div>
<div class="col-md-6 col-res">
<!--ACCOUNT NUMBER-->
<div class="form-group">
<label class="col-md-12 control-label pl-0-desk" for="account_number">ACCOUNT NUMBER <span class="required-field">*</span></label>
<div class="col-md-12 pl-0-desk">
<input id="account_number" name="account_number" type="text" placeholder="Account Number" class="form-control input-md ach-fields">
</div>
</div>
<!--END ACCOUNT NUMBER-->
<div id="ach-personal-names">
<div class="form-group">
<label class="col-md-12 control-label pl-0-desk" for="first-name">FIRST NAME <span class="required-field">*</span></label>
<div class="col-md-12 pl-0-desk">
<input id="first-name" name="first-name" type="text" placeholder="First Name" class="form-control input-md ach-fields-personal">
</div>
</div>
<div class="form-group">
<label class="col-md-12 control-label pl-0-desk" for="last-name">LAST NAME <span class="required-field">*</span></label>
<div class="col-md-12 pl-0-desk">
<input id="last-name" name="last-name" type="text" placeholder="Last Name" class="form-control input-md ach-fields-personal">
</div>
</div>
</div>
<div id="ach-business-name" style="display: none;">
<div class="form-group">
<label class="col-md-12 control-label pl-0-desk" for="business-name">BUSINESS NAME <span class="required-field">*</span></label>
<div class="col-md-12 pl-0-desk">
<input id="business-name" name="business-name" type="text" placeholder="Business Name" class="form-control input-md ach-fields-business">
</div>
</div>
</div>
<!--END CONFIRM ACCOUNT NUMBER-->
</div>
</div>
</div>
<!--END ACH FORM-->
</div>
<!--END PAYMENT TYPE-->
</div>
<!--END PAYMENT-->
<!-- <hr class="pay-divider" /> -->
<!--END PAYMENT INFORMATION-->
<hr class="pay-divider">
<!-- SUBMIT -->
<div class="form-group">
<div class="col-md-12 plr-0-res mt-15">
<div id="form-recaptcha">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-lulzao2xl3rb" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LerTpMUAAAAAB8lSB_DAPsHASOqNH5VbGqfqrux&co=aHR0cHM6Ly9wYXltZW50cy5rb3ZhbGV2aW5zdXJhbmNlLmNvbTo0NDM.&hl=en&v=-80zvSY9h4i8O-ocN2P5qTJk&theme=light&size=normal&cb=nhmr2g95whxh"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<p class="primary-text warning-text-payment text-center" style="padding-top: 20px;" id="approval-text"> Please make sure to click the "I'm not a robot" checkbox.<br><br> By clicking "Checkout", I authorize Kovalev Insurance to charge my account
for the amount specified and the associated fees.<br><br>
<span style="font-size:120%; font-weight: bold;">Only click the Checkout button once to prevent duplicate billing.</span>
</p>
<div id="error-messages" class="text-center"></div>
<button type="button" class="btn btn-default btn-submit-payment primary-text" id="cc-pay-button">Checkout with CC </button>
<button type="button" class="btn btn-default btn-submit-payment primary-text" id="ach-pay-button" style="display: none;">Checkout with ACH </button>
</div>
</div>
<!--END SUBMIT-->
</form>Text Content
skip to main content PAY KOVALEV INSURANCE BY CREDIT CARD OR ACH PLEASE ENTER YOUR PAYMENT INFORMATION BELOW Plumb ID ID Name Here(do not change) ID Payment Type(do not change) ID Payment Method(do not change) PAYER * EMAIL ADDRESS * NAMED INSURED * POLICY # (Optional) Name of Kovalev Insurance Account Representative * COMMENTS AMOUNT * -------------------------------------------------------------------------------- CREDIT CARD -------------------------------------------------------------------------------- Amount Fee (3.1% + $.49) Total $0.00 $0.00 $0.00 ACH -------------------------------------------------------------------------------- Amount Fee Total $0.00 $5.00 $0.00 PAYMENT INFORMATION NAME ON CARD * CREDIT CARD NUMBER * Expiration Date (MM/YYYY) * CVV * What's This? POSTAL CODE * PAYMENT INFORMATION ACH transactions can take up to 5 business days to clear. If your payment is time-sensitive, we recommend using the credit card payment option. ACCOUNT TYPE * Business Checking Business Savings Personal Checking Personal Savings ROUTING NUMBER * STREET * STREET 2 CITY * STATE (i.e. MA) * POSTAL CODE * ACCOUNT NUMBER * FIRST NAME * LAST NAME * BUSINESS NAME * -------------------------------------------------------------------------------- Please make sure to click the "I'm not a robot" checkbox. By clicking "Checkout", I authorize Kovalev Insurance to charge my account for the amount specified and the associated fees. Only click the Checkout button once to prevent duplicate billing. Checkout with CC Checkout with ACH Contact Us * 617.562.6060 Copyright © 2024 Kovalev Insurance Agency, Inc | All Rights Reserved | Created by Plumb