newempireis.com Open in urlscan Pro
45.79.172.101 Public Scan

Back to summary

Submitted URL:
https://www.newempiregroup.com/electronic-delivery-confirmation/
Effective URL:
https://newempireis.com/electronic-delivery-confirmation/
Submission: On November 15 via api (November 15th 2021, 2:09:42 pm UTC) from US — Scanned from DE

Form analysis
3 forms found in the DOM

GET https://newempireis.com/

<form class="search-form" action="https://newempireis.com/" method="get">
  <span class="search-text-wrap">
    <label for="s" class="screen-reader-text">Search …</label>
    <input name="s" class="search-field" type="text" autocomplete="off" value="" placeholder="Search …">
  </span>
  <span id="close" class="close"><span class="ast-icon icon-close"></span></span>
</form>

POST /electronic-delivery-confirmation/

<form method="post" enctype="multipart/form-data" id="gform_25" action="/electronic-delivery-confirmation/">
  <div class="gform_body gform-body">
    <ul id="gform_fields_25" class="gform_fields top_label form_sublabel_below description_below">
      <li id="field_25_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_1">Agency Name<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_1" id="input_25_1" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_3" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_3">Agency Address<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_3" id="input_25_3" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_4" class="gfield gf_left_third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_4">City<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_4" id="input_25_4" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_5" class="gfield gf_middle_third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_5">State<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_select"><span class="pp-gf-select-custom"><select name="input_5" id="input_25_5" class="medium gfield_select" aria-required="true" aria-invalid="false">
              <option value=""></option>
              <option value="Alabama">Alabama</option>
              <option value="Alaska">Alaska</option>
              <option value="Arizona">Arizona</option>
              <option value="Arkansas">Arkansas</option>
              <option value="California">California</option>
              <option value="Colorado">Colorado</option>
              <option value="Connecticut">Connecticut</option>
              <option value="Delaware">Delaware</option>
              <option value="District of Columbia">District of Columbia</option>
              <option value="Florida">Florida</option>
              <option value="Georgia">Georgia</option>
              <option value="Hawaii">Hawaii</option>
              <option value="Idaho">Idaho</option>
              <option value="Illinois">Illinois</option>
              <option value="Indiana">Indiana</option>
              <option value="Iowa">Iowa</option>
              <option value="Kansas">Kansas</option>
              <option value="Kentucky">Kentucky</option>
              <option value="Louisiana">Louisiana</option>
              <option value="Maine">Maine</option>
              <option value="Maryland">Maryland</option>
              <option value="Massachusetts">Massachusetts</option>
              <option value="Michigan">Michigan</option>
              <option value="Minnesota">Minnesota</option>
              <option value="Mississippi">Mississippi</option>
              <option value="Missouri">Missouri</option>
              <option value="Montana">Montana</option>
              <option value="Nebraska">Nebraska</option>
              <option value="Nevada">Nevada</option>
              <option value="New Hampshire">New Hampshire</option>
              <option value="New Jersey">New Jersey</option>
              <option value="New Mexico">New Mexico</option>
              <option value="New York">New York</option>
              <option value="North Carolina">North Carolina</option>
              <option value="North Dakota">North Dakota</option>
              <option value="Ohio">Ohio</option>
              <option value="Oklahoma">Oklahoma</option>
              <option value="Oregon">Oregon</option>
              <option value="Pennsylvania">Pennsylvania</option>
              <option value="Rhode Island">Rhode Island</option>
              <option value="South Carolina">South Carolina</option>
              <option value="South Dakota">South Dakota</option>
              <option value="Tennessee">Tennessee</option>
              <option value="Texas">Texas</option>
              <option value="Utah">Utah</option>
              <option value="Vermont">Vermont</option>
              <option value="Virginia">Virginia</option>
              <option value="Washington">Washington</option>
              <option value="West Virginia">West Virginia</option>
              <option value="Wisconsin">Wisconsin</option>
              <option value="Wyoming">Wyoming</option>
            </select></span></div>
      </li>
      <li id="field_25_6" class="gfield gf_right_third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_6">Zip Code<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_6" id="input_25_6" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_7" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
        <div style="padding-top:30px; font-face:raleway; font-size:18px; font-weight:700;"><b>Conditional Renewal Notices</b></div>
      </li>
      <li id="field_25_8" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_8">Contact Name<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_8" id="input_25_8" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_10" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_10">Contact Email<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_10" id="input_25_10" type="text" value="" class="medium" aria-required="true" aria-invalid="false">
        </div>
      </li>
      <li id="field_25_11" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible">
        <div style="padding-top:30px; font-face:raleway; font-size:18px; font-weight:700;"><b>Monthly Accounting Statements</b></div>
      </li>
      <li id="field_25_12" class="gfield gf_left_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_12">Contact Name<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_text"><input name="input_12" id="input_25_12" type="text" value="" class="medium" aria-required="true" aria-invalid="false"> </div>
      </li>
      <li id="field_25_13" class="gfield gf_right_half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_25_13">Contact Email<span class="gfield_required"><span
              class="gfield_required gfield_required_asterisk">*</span></span></label>
        <div class="ginput_container ginput_container_email">
          <input name="input_13" id="input_25_13" type="text" value="" class="medium" aria-required="true" aria-invalid="false">
        </div>
      </li>
    </ul>
  </div>
  <div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_25" class="gform_button button" value="Submit" onclick="if(window[&quot;gf_submitting_25&quot;]){return false;}  window[&quot;gf_submitting_25&quot;]=true;  "
      onkeypress="if( event.keyCode == 13 ){ if(window[&quot;gf_submitting_25&quot;]){return false;} window[&quot;gf_submitting_25&quot;]=true;  jQuery(&quot;#gform_25&quot;).trigger(&quot;submit&quot;,[true]); }">
    <input type="hidden" class="gform_hidden" name="is_submit_25" value="1">
    <input type="hidden" class="gform_hidden" name="gform_submit" value="25">
    <input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
    <input type="hidden" class="gform_hidden" name="state_25" value="WyJbXSIsIjI4YmUxY2JiNjNlMmRkNjc0MWJkMzE4ODIzOWUzNTAxIl0=">
    <input type="hidden" class="gform_hidden" name="gform_target_page_number_25" id="gform_target_page_number_25" value="0">
    <input type="hidden" class="gform_hidden" name="gform_source_page_number_25" id="gform_source_page_number_25" value="1">
    <input type="hidden" name="gform_field_values" value="">
  </div>
</form>

Name: Questions Form — POST

<form class="elementor-form" method="post" name="Questions Form">
  <input type="hidden" name="post_id" value="12502">
  <input type="hidden" name="form_id" value="4b4e627b">
  <input type="hidden" name="referer_title" value="Electronic Delivery Confirmation - New Empire Insurance Services">
  <input type="hidden" name="queried_id" value="12406">
  <div class="elementor-form-fields-wrapper elementor-labels-">
    <div class="elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50">
      <label for="form-field-name" class="elementor-field-label elementor-screen-only">Name</label><input size="1" type="text" name="form_fields[name]" id="form-field-name" class="elementor-field elementor-size-md  elementor-field-textual"
        placeholder="Name">
    </div>
    <div class="elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_1 elementor-col-50">
      <label for="form-field-field_1" class="elementor-field-label elementor-screen-only">Agency</label><input size="1" type="text" name="form_fields[field_1]" id="form-field-field_1" class="elementor-field elementor-size-md  elementor-field-textual"
        placeholder="Agency">
    </div>
    <div class="elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-50 elementor-field-required">
      <label for="form-field-email" class="elementor-field-label elementor-screen-only">Email</label><input size="1" type="email" name="form_fields[email]" id="form-field-email" class="elementor-field elementor-size-md  elementor-field-textual"
        placeholder="Email" required="required" aria-required="true">
    </div>
    <div class="elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_2 elementor-col-50">
      <label for="form-field-field_2" class="elementor-field-label elementor-screen-only">Phone Number</label><input size="1" type="text" name="form_fields[field_2]" id="form-field-field_2"
        class="elementor-field elementor-size-md  elementor-field-textual" placeholder="Phone Number">
    </div>
    <div class="elementor-field-type-textarea elementor-field-group elementor-column elementor-field-group-message elementor-col-100">
      <label for="form-field-message" class="elementor-field-label elementor-screen-only">Message</label><textarea class="elementor-field-textual elementor-field  elementor-size-md" name="form_fields[message]" id="form-field-message" rows="4"
        placeholder="How Can We Help?"></textarea>
    </div>
    <div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons">
      <button type="submit" class="elementor-button elementor-size-md">
        <span>
          <span class=" elementor-button-icon">
          </span>
          <span class="elementor-button-text">Submit</span>
        </span>
      </button>
    </div>
  </div>
</form>

Text Content

Skip to content
  866-431-8100
Search …
Main Menu
 * About UsMenu Toggle
   * Our Company
   * Meet Our Team
 * BrokersMenu Toggle
   * ResourcesMenu Toggle
     * Applications
     * Press Releases
   * For BrokersMenu Toggle
     * Getting Appointed
     * NEW Online Portal
     * Request Loss Runs
 * Claims
 * NEG Blog
 * Contact Us
 * 

OUR PROGRAMS
 * Commercial Umbrella
 * CondoPak
 * Recover (Environmental)

Menu
 * Commercial Umbrella
 * CondoPak
 * Recover (Environmental)


AGENCY ELECTRONIC DELIVERY


As of April 15, 2020, New Empire Group will be adding Conditional Renewal
Notices (broker copy only) and Monthly Accounting Statements to the list of
Electronically Transmitted Documents.

To ensure that they are received please provide the contact name and email below
for all users responsible for electronic deliveries.

Agency Electronic Delivery Notice Confirmation Form

 * Agency Name*
   
 * Agency Address*
   
 * City*
   
 * State*
   AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of
   ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
   HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
   DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth
   DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest
   VirginiaWisconsinWyoming
 * Zip Code*
   
 * Conditional Renewal Notices
 * Contact Name*
   
 * Contact Email*
   
 * Monthly Accounting Statements
 * Contact Name*
   
 * Contact Email*
   




“I’ve worked with them and love the people and the service they provide. Other
agencies should be doing business with them. 5 STARS ALL DAY!”

Christopher Paradiso
(Stafford Springs, CT)


Questions? Let us know.
Name
Agency
Email
Phone Number
Message
Submit

About New Empire Insurance Services
New Empire Insurance Services is an award-winning national Insurance Program
Administrator that specializes in insurance programs for real estate.

For Brokers
Get Appointed
Applications
Resources
Claims
About Us
Our Company
Our Team
NEG Community
Stay Connected
Facebook-f Linkedin-in Instagram Twitter
© 2021 New Empire Insurance Services. All rights reserved.   Terms   Privacy
Scroll to Top

Notifications