{"id":3269,"date":"2021-10-11T04:11:01","date_gmt":"2021-10-11T04:11:01","guid":{"rendered":"https:\/\/roadtonet.net\/websites\/activehs\/?page_id=3269"},"modified":"2021-10-11T09:22:34","modified_gmt":"2021-10-11T09:22:34","slug":"bugzi-order-form-request","status":"publish","type":"page","link":"https:\/\/roadtonet.net\/websites\/activehs\/bugzi-order-form-request\/","title":{"rendered":"Bugzi Order Form Request"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Banner&#8221; module_class=&#8221;inner-sec&#8221; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; title_text=&#8221;mobile img&#8221; background_image=&#8221;https:\/\/roadtonet.net\/websites\/activehs\/wp-content\/uploads\/2021\/10\/mobile-img.jpg&#8221; sticky_enabled=&#8221;0&#8243; disabled_on=&#8221;off|on|on&#8221;][et_pb_row _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; header_text_align=&#8221;center&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1>BUGZI ORDER FORM REQUEST<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Banner&#8221; module_class=&#8221;inner-sec&#8221; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; title_text=&#8221;New Project&#8221; background_image=&#8221;https:\/\/roadtonet.net\/websites\/activehs\/wp-content\/uploads\/2021\/10\/New-Project.jpg&#8221; sticky_enabled=&#8221;0&#8243; disabled_on=&#8221;on|off|off&#8221;][et_pb_row _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; header_text_align=&#8221;center&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1>BUGZI ORDER FORM REQUEST<\/h1>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;Form&#8221; module_class=&#8221;wiz-sec&#8221; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#f6f6f6&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.10.7&#8243; _module_preset=&#8221;default&#8221; header_2_text_align=&#8221;center&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<h1>Sample Request Order Form for the Bugzi by filling in this form.<\/br>we will contact you in next 48hr.<\/h1>\n<p><div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-3268\"><form id=\"wpforms-form-3268\" class=\"wpforms-validate wpforms-form\" data-formid=\"3268\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/websites\/activehs\/wp-json\/wp\/v2\/pages\/3269\" data-token=\"3311731711365c1545bbb7172c0a818a\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-3268-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_0\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3268-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" placeholder=\"First Name*\" required><label for=\"wpforms-3268-field_0\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3268-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" placeholder=\"Last Name*\" required><label for=\"wpforms-3268-field_0-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-3268-field_3-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"3\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_3\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-3268-field_3\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][3]\" placeholder=\"Phone Number*\" required><\/div><div id=\"wpforms-3268-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-3268-field_1\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][1]\" placeholder=\"Email*\" required><\/div><div id=\"wpforms-3268-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-3268-field_6\">Address<\/label><input type=\"text\" id=\"wpforms-3268-field_6\" class=\"wpforms-field-large\" name=\"wpforms[fields][6]\" placeholder=\"Street Address 1\" ><\/div><div id=\"wpforms-3268-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_7\">Street Address 2<\/label><input type=\"text\" id=\"wpforms-3268-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\" placeholder=\"Street Address 2\" ><\/div><div id=\"wpforms-3268-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_8\">City<\/label><input type=\"text\" id=\"wpforms-3268-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" placeholder=\"City\" ><\/div><div id=\"wpforms-3268-field_9-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"9\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_9\">State\/Province\/Region<\/label><select id=\"wpforms-3268-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>State\/Province\/Region<\/option><option value=\"Alberta\" >Alberta<\/option><option value=\"British Columbia\" >British Columbia<\/option><option value=\"Manitoba\" >Manitoba<\/option><option value=\"New Brunswick\" >New Brunswick<\/option><option value=\"Newfoundland and Labrador\" >Newfoundland and Labrador<\/option><option value=\"Northwest Territories\" >Northwest Territories<\/option><option value=\"Nova Scotia\" >Nova Scotia<\/option><option value=\"Nunavut\" >Nunavut<\/option><option value=\"Ontario\" >Ontario<\/option><option value=\"Prince Edward Island\" >Prince Edward Island<\/option><option value=\"Quebec\" >Quebec<\/option><option value=\"Saskatchewan\" >Saskatchewan<\/option><option value=\"Yukon\" >Yukon<\/option><\/select><\/div><div id=\"wpforms-3268-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_10\">ZIP<\/label><input type=\"text\" id=\"wpforms-3268-field_10\" class=\"wpforms-field-large\" name=\"wpforms[fields][10]\" placeholder=\"Postal\/Zip Code\" ><\/div><div id=\"wpforms-3268-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_2\">Message <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-3268-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" placeholder=\"Enter Your Message*\" required><\/textarea><\/div><div id=\"wpforms-3268-field_5-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"5\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_5\">Checkboxes<\/label><ul id=\"wpforms-3268-field_5\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-3268-field_5_1\" name=\"wpforms[fields][5][]\" value=\"Send a copy of this message to yourself:\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-3268-field_5_1\">Send a copy of this message to yourself:<\/label><\/li><\/ul><\/div><\/div><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"3268\"><input type=\"hidden\" name=\"wpforms[author]\" value=\"1\"><button type=\"submit\" name=\"wpforms[submit]\" class=\"wpforms-submit \" id=\"wpforms-submit-3268\" value=\"wpforms-submit\" aria-live=\"assertive\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\">Submit<\/button><\/div><\/form><\/div>  <!-- .wpforms-container -->[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>BUGZI ORDER FORM REQUESTBUGZI ORDER FORM REQUESTSample Request Order Form for the Bugzi by filling in this form.we will contact you in next 48hr. <div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-3268\"><form id=\"wpforms-form-3268\" class=\"wpforms-validate wpforms-form\" data-formid=\"3268\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/websites\/activehs\/wp-json\/wp\/v2\/pages\/3269\" data-token=\"3311731711365c1545bbb7172c0a818a\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-3268-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_0\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-3268-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" placeholder=\"First Name*\" required><label for=\"wpforms-3268-field_0\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-3268-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" placeholder=\"Last Name*\" required><label for=\"wpforms-3268-field_0-last\" class=\"wpforms-field-sublabel after wpforms-sublabel-hide\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-3268-field_3-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"3\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_3\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-3268-field_3\" class=\"wpforms-field-large wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][3]\" placeholder=\"Phone Number*\" required><\/div><div id=\"wpforms-3268-field_1-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"1\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_1\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-3268-field_1\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][1]\" placeholder=\"Email*\" required><\/div><div id=\"wpforms-3268-field_6-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-3268-field_6\">Address<\/label><input type=\"text\" id=\"wpforms-3268-field_6\" class=\"wpforms-field-large\" name=\"wpforms[fields][6]\" placeholder=\"Street Address 1\" ><\/div><div id=\"wpforms-3268-field_7-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"7\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_7\">Street Address 2<\/label><input type=\"text\" id=\"wpforms-3268-field_7\" class=\"wpforms-field-large\" name=\"wpforms[fields][7]\" placeholder=\"Street Address 2\" ><\/div><div id=\"wpforms-3268-field_8-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"8\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_8\">City<\/label><input type=\"text\" id=\"wpforms-3268-field_8\" class=\"wpforms-field-medium\" name=\"wpforms[fields][8]\" placeholder=\"City\" ><\/div><div id=\"wpforms-3268-field_9-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"9\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_9\">State\/Province\/Region<\/label><select id=\"wpforms-3268-field_9\" class=\"wpforms-field-medium\" name=\"wpforms[fields][9]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>State\/Province\/Region<\/option><option value=\"Alberta\" >Alberta<\/option><option value=\"British Columbia\" >British Columbia<\/option><option value=\"Manitoba\" >Manitoba<\/option><option value=\"New Brunswick\" >New Brunswick<\/option><option value=\"Newfoundland and Labrador\" >Newfoundland and Labrador<\/option><option value=\"Northwest Territories\" >Northwest Territories<\/option><option value=\"Nova Scotia\" >Nova Scotia<\/option><option value=\"Nunavut\" >Nunavut<\/option><option value=\"Ontario\" >Ontario<\/option><option value=\"Prince Edward Island\" >Prince Edward Island<\/option><option value=\"Quebec\" >Quebec<\/option><option value=\"Saskatchewan\" >Saskatchewan<\/option><option value=\"Yukon\" >Yukon<\/option><\/select><\/div><div id=\"wpforms-3268-field_10-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"10\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_10\">ZIP<\/label><input type=\"text\" id=\"wpforms-3268-field_10\" class=\"wpforms-field-large\" name=\"wpforms[fields][10]\" placeholder=\"Postal\/Zip Code\" ><\/div><div id=\"wpforms-3268-field_2-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"2\"><label class=\"wpforms-field-label wpforms-label-hide\" for=\"wpforms-3268-field_2\">Message <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-3268-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" placeholder=\"Enter Your Message*\" required><\/textarea><\/div><div id=\"wpforms-3268-field_5-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"5\"><label class=\"wpforms-field-label wpforms-label-hide\" 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