You may order your insurance web site content either online or by calling us during normal business hours. Our phone number is 979-690-9246. This Online Application is on a Secure Server. Click on the seal (on left) for more information on the certificate's authentication. To place an order online, please fill out the order form below and then click on the "Submit" button. Your order will then be sent to ENHANCED web SERVICES for processing. Your order should be confirmed and completed within 1 or 2 business days. You may order by MasterCard, VISA or American Express. Additional changes or additions to any given content you order may take longer than 1 or 2 business days to complete. Online Insurance Web Site Content Order Form: General Information Business Name: Contact Name: Email Address: Phone: Business Address: City:   State:   Zip: Payment Information Please Bill My Credit Card: Card Type: MasterCardVISAAmerican Express Card #: Name on Card: Exp. Date: (enter as mmyy)       This Online Application is on a Secure Server. Click on the seal (on left) for more information on the certificate's authentication. Website/Email Address Information Please give the domain name (URL address) in which this insurance web site content will be hosted: http:// For quote forms and customer service forms orders, please list the email address at your business in which you want client submissions (quote requests and service requests) sent: Do you wish to use the same background color or image from your website for your custom content? Yes   No Do you wish to use a graphic logo from your website for the top of your custom content? Yes   No       If yes, please describe logo or give file name/location on your website: Insurance Glossary Please click here if you would like to order the Online Insurance Glossary   (Cost: $300.00, one time charge)       Online Insurance Glossary   Online Forms Selection Online Insurance Quote Forms Section (Scroll Down to next section for Online Insurance Customer Service Forms) All quote forms are $50 each, one time charge. Please select the forms you wish to purchase: Annuities Commercial Auto Janitorial Professional Liability Automobile Condominium Insurance Life/Health Recreational Vehicle (RV) Aviation Disability Liquor Liability Renters Insurance Boat / Watercraft Flood Long-Term Care Restaurant Brew Pubs General Liability Medical Malpractice Security Guard Business Owners Pkg. (BOP) Group Health Medicare Supplement Simplified EPL Business Homeowners Motorcycle Special Events Church Hotel/Motel Insurance Pet Insurance Umbrella Combo: Ofc Pkg/Prof Liab Inland Marine Pharmacist Insurance Workers' Comp   Online Bond Application Forms Section All bond application forms are $50 each, one time charge. Please select the forms you wish to purchase: Contractors Bond Dishonesty Bond General (Miscellaneous) Bond Janitorial Services Bond License Bond Pension Trust Bond Probate Bond       Online Insurance Customer Service Forms Section All customer service forms are $50 each, one time charge. Please select the forms you wish to purchase: Auto Policy Change Agent Of Record Change Cert. of Ins. Request Auto Loss Notice Property Policy Change Renewal Notice Reminder Auto ID Card Request Property Loss Notice     Online Mortgage Loan Form Section The Mortgage Loan Application form is $75, one time charge. Please select the forms you wish to purchase: Mortgage Loan Application     Content Delivery Your insurance web site content will consist of HTML files which need to be added to your website. This content is "ready to use" with no programming or setup required. How do you wish to receive your content?: Via Email (as an attachment)   Mailed on Diskette (extra $5 shipping/handling)   FTP'ed directly to your Website (extra $25 for this service... FREE for Insurance Headline News pages) (We will FTP to your website if you can provide a username, password, and FTP Address from your ISP. This also includes the addition of links from your existing pages to your new content.) User Name:   Password: FTP Address:   Will Send This Information Later: Additional Info/Comments Click here if you want a representative to call you and discuss your order. Would you like an email sent to you whenever we add new insurance web site content?: Yes     No List here any particular insurance-related content you would like for us to add to our services: Additional Comments: (Please give any additional comments about the design, delivery, etc... for your content package. If you would like to add/change limits and/or deductibles for a given form, etc... please list that form and the amounts here as well.) Submit Your Order Please click on "Submit" to place your order for your insurance content package. You will receive an email within 1 to 2 days verifying your order.