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height: 100%; width: auto!important; }*/ <" + "/style> <" + "/head> <body class=\"one-nav-enable\" > <main class=\"l-document-content-area public_mode web\"> <div id=\"web\" class=\"document-content-area--inner-content\"> <div class=\"form_wrap_outer\"> <div class=\"form_wrap_inner\"> <form name=\"DC Homeland Security Emergency Management Agency Waiver Process for Exemption to Business Closure\" id=\"CO20031000143328369\" method=\"post\" action=\"https://dcgov.seamlessdocs.com/f/DCHomelandSecurityEmergencyManagementAgencyWaiverProcessforExemptiontoBusinessClosure\" class=\"odoform iframe form-horizontal container-fluid\" accept-charset=\"utf-8\"> <input type=\"hidden\" name=\"form_id\" value=\"CO20031000143328369\"> <input type=\"hidden\" name=\"master_account_id\" value=\"MA17011000023068069\"> <input type=\"hidden\" name=\"application_id\" value=\"\"> <input type=\"hidden\" name=\"requestedClass\" value=\"OdoFormsForms\"> <input type=\"hidden\" name=\"requestedMethod\" value=\"submit\"> <input type=\"hidden\" name=\"thankyou_url\" value=\"\"> <input type=\"hidden\" name=\"embed_type\" value=\"iframe\"> <input type=\"hidden\" name=\"uuid\" value=\"lauWwEI9ykiDbEzapP2zwsoQ\"> <fieldset class=\"section fieldset\"> <div class=\"item control-group\" > <div style=\"text-align:center;\"><h2 class=\"\" id=\"h2_h7POBi\" align=\"center\" type=\"\" style=\"\">Waiver Process for Exemption to Business Closure<" + "/h2><" + "/div> <" + "/div> <div class=\"item control-group\" > <div style=\"text-align:center;\"><h2 class=\"\" id=\"h2_is7OS1\" align=\"center\" type=\"\" style=\"\">DC Homeland Security Emergency Management Agency<" + "/h2><" + "/div> <" + "/div> <div class=\"item control-group\" > <div class=\"\" id=\"div_Z6EfiH\" type=\"\" style=\"\"><p><span style=\"font-size:16px\"><span style=\"text-decoration:underline\"><strong>Contact Information<" + "/strong><" + "/span><" + "/span><" + "/p><" + "/div> <" + "/div> <div class=\"item control-group\" aria-required=\"true\"> <label for=\"input_RsMxXk\" class=\"control-label span2 field_label\" id=\"input_RsMxXk_label\"data-required=\"true\">Business Name<" + "/label> <input name=\"input_RsMxXk\" type=\"text\" value=\"\" class=\" validate[\'required\']\" id=\"input_RsMxXk\" name=\"input_RsMxXk\" maxlength=\"\" validationRegex=\"\" placeholder=\"\" style=\"width:320px;:width:320px;;\" aria-required=\"true\"> <" + "/div> <div class=\"item control-group\" aria-required=\"true\"> <label for=\"input_ciz8Xx\" class=\"control-label span2 field_label\" id=\"input_ciz8Xx_label\"data-required=\"true\">Business Description<" + "/label> <input name=\"input_ciz8Xx\" type=\"text\" value=\"\" class=\" validate[\'required\']\" id=\"input_ciz8Xx\" name=\"input_ciz8Xx\" maxlength=\"\" validationRegex=\"\" placeholder=\"\" style=\"width:320px;:width:320px;;\" aria-required=\"true\"> <" + "/div> <div class=\"item control-group\" > <p id=\"grp_VfdsMo_label\" class=\"field_label group_label\">Full Address<" + "/h5> <div class=\"element_group\"> <div class=\"inline_group address1\"> <div class=\"inline_group_item \"><label for=\"grp_VfdsMo-street_address\" class=\" field_label\" id=\"grp_VfdsMo-street_address_label\">Street Address<" + "/label><input name=\"grp_VfdsMo[street_address]\" id=\"grp_VfdsMo-street_address\" name=\"grp_VfdsMo[street_address]\" type=\"text\" value=\"\" class=\"\" inline_group=\"address1\" style=\"width:320px;:width:320px;;\"><" + "/div> <" + "/div> <div class=\"inline_group address2\"> <div class=\"inline_group_item \"><input name=\"grp_VfdsMo[address2]\" id=\"grp_VfdsMo-address2\" name=\"grp_VfdsMo[address2]\" type=\"text\" value=\"\" class=\"\" inline_group=\"address2\" aria-label=\"address2\" style=\"width:320px;:width:320px;;\"><" + "/div> <" + "/div> <div class=\"inline_group citystatezip\"> <div class=\"inline_group_item \"><label for=\"grp_VfdsMo-city\" class=\" field_label\" id=\"grp_VfdsMo-city_label\">City<" + "/label><input 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group_label\">Full Name<" + "/h5> <div class=\"element_group\"> <div class=\"inline_group name\"> <div class=\"inline_group_item \"><label for=\"grp_srfc10-first_name\" class=\" field_label\" id=\"grp_srfc10-first_name_label\">First Name<" + "/label><input name=\"grp_srfc10[first_name]\" id=\"grp_srfc10-first_name\" name=\"grp_srfc10[first_name]\" type=\"text\" value=\"\" class=\"\" inline_group=\"name\" style=\"width:150px;:width:150px;;\"><" + "/div> <div class=\"inline_group_item \"><label for=\"grp_srfc10-last_name\" class=\" field_label\" id=\"grp_srfc10-last_name_label\">Last Name<" + "/label><input name=\"grp_srfc10[last_name]\" id=\"grp_srfc10-last_name\" name=\"grp_srfc10[last_name]\" type=\"text\" value=\"\" class=\"\" inline_group=\"name\" style=\"width:150px;:width:150px;;\"><" + "/div> <" + "/div> <" + "/div> <" + "/div> <div class=\"item control-group\" > <label for=\"input_cqwXQP\" class=\"control-label span2 field_label\" id=\"input_cqwXQP_label\">Email<" + "/label> <input name=\"input_cqwXQP\" type=\"email\" id=\"input_cqwXQP\" name=\"input_cqwXQP\" placeholder=\"example@domain.com\" style=\"width:320px;:width:320px;;\" class=\" validate[\'email\']\"> <" + "/div> <div class=\"item control-group\" > <label for=\"input_LZtv0f\" class=\"control-label span2 field_label\" id=\"input_LZtv0f_label\">Phone Number<" + "/label> <input name=\"input_LZtv0f\" type=\"tel\" id=\"input_LZtv0f\" name=\"input_LZtv0f\" placeholder=\"xxx-xxx-xxxx\" style=\"width:320px;:width:320px;;\" class=\" validate[\'phone\']\"> <" + "/div> <div class=\"item control-group\" > <label for=\"input_GVAc15\" class=\"control-label span2 field_label\" id=\"input_GVAc15_label\">Number of Employees?<" + "/label> <input name=\"input_GVAc15\" type=\"text\" id=\"input_GVAc15\" name=\"input_GVAc15\" style=\"width:320px;:width:320px;;\"> <" + "/div> <div class=\"item control-group\" > <label for=\"textarea_CrRcFb\" class=\"control-label span2 field_label\" id=\"textarea_CrRcFb_label\">Please explain how the on-site operation of this business is necessary to the business activity of an essential business. (justification)<" + "/label> <textarea name=\"textarea_CrRcFb\" id=\"textarea_CrRcFb\" name=\"textarea_CrRcFb\" type=\"\" style=\"width:320px;height:100px;:width:320px;height:100px;;\"><" + "/textarea> <" + "/div> <div class=\"item control-group\" > <p id=\"plugin_hfoCMQ_label\" class=\"field_label group_label\">Does the business have a plan to meet DC Health and CDC recommended guidelines to maintain employee safety during the COVID-19 pandemic?<" + "/h5> <div style=\"text-align:left;\"> <" + "script> if (typeof toggleOtherOption !== \'object\') { var toggleOtherOption = function(option, name) { var other_option_text = option.getNext().getElement(\'[name^=\'+name+\']\'); if (!option.checked) { other_option_text.set(\'value\', \'\').set(\'disabled\', true); } else { other_option_text.removeAttribute(\'disabled\'); other_option_text.focus(); if (option.type.toLowerCase() == \'radio\') { var group_options = other_option_text.getParent(\'.option_wrapper\').getElements(\'[name^=\'+name+\']\'); group_options.addEvent(\'click\', function(e) { toggleOtherOption(option, name); }); } } }; } <" + "/script> <div id=\"plugin_hfoCMQ_wrapper\" class=\"option_wrapper\"> <div class=\"option_item\"> <input name=\"plugin_hfoCMQ\" type=\"radio\" class=\"\" id=\"option_wGlzhe\" value=\"Yes\" calculation_field=\"\" > <label class=\"option_label radio_label\" for=\"option_wGlzhe\">Yes<" + "/label> <" + "/div> <div class=\"option_item\"> <input name=\"plugin_hfoCMQ\" type=\"radio\" class=\"\" id=\"option_Fh8I9C\" value=\"No\" calculation_field=\"\" > <label class=\"option_label radio_label\" for=\"option_Fh8I9C\">No<" + "/label> <" + "/div> <" + "/div> <" + "/div> <" + "/div> <div class=\"item control-group\" > <label for=\"textarea_ry16IE\" class=\"control-label span2 field_label\" id=\"textarea_ry16IE_label\">Please Explain<" + "/label> <textarea name=\"textarea_ry16IE\" id=\"textarea_ry16IE\" name=\"textarea_ry16IE\" type=\"\" style=\"width:320px;height:100px;:width:320px;height:100px;;\"><" + "/textarea> <" + "/div> <div class=\"item control-group\" > <label for=\"input_6TOPTF\" class=\"control-label span2 field_label\" id=\"input_6TOPTF_label\">How many employees would be in the business’ office or physical location in order to do the critical work?<" + "/label> <input name=\"input_6TOPTF\" type=\"text\" id=\"input_6TOPTF\" name=\"input_6TOPTF\" style=\"width:320px;:width:320px;;\"> <" + "/div> <div class=\"item control-group\" > <label for=\"textarea_uSdXM1\" class=\"control-label span2 field_label\" id=\"textarea_uSdXM1_label\">Please Explain<" + "/label> <textarea name=\"textarea_uSdXM1\" id=\"textarea_uSdXM1\" name=\"textarea_uSdXM1\" type=\"\" style=\"width:320px;height:100px;:width:320px;height:100px;;\"><" + "/textarea> <" + "/div> <div class=\"item control-group\" > <label for=\"g-recaptcha-response\" class=\"label-508a-hidden\">Recaptcha Response<" + "/label> <" + "style> div.captcha_warning { border: 1px solid red; color: rgb(189,0,0); font-size: 0.8em; padding: 0.8em; line-height: normal; display: none; } div.captcha_warning.show { margin-bottom: 15px; } #g-recaptcha-response { display: block !important; visibility: hidden !important; height: 80px !important; margin-top: -80px !important; } <" + "/style> <" + "script src=\'//www.google.com/recaptcha/api.js\'><" + "/script> <" + "script> var reCaptchaObj = {}; function fireRecaptcha(e){ var captchaField = $(\'g-recaptcha-response\'); if(captchaField) { var captchaValue = $(\'g-recaptcha-response\').value; } else { var captchaValue = false; } if (!captchaValue) { $$(\"span.captcha_warning\").addClass( \'show\' ); reCaptchaObj.isvalid = false; } if (!reCaptchaObj.isvalid){ $(\'g-recaptcha-response\').addClass( \"validate[\'required\']\" ); fc_manager.fc.register( $(\'g-recaptcha-response\') ); } else{ $$(\"span.captcha_warning\").removeClass( \'show\' ); fc_manager.fc.form.removeEvent(\'submit\', fireRecaptcha); } } var form = $(\'web\').getElement(\'form.odoform\'); if (!spreedlyData) { form.addEvent(\'submit\', fireRecaptcha); } <" + "/script> <div class=\"captcha_warning\">Be sure to verify that you are not a robot by using the Captcha tool at the below.<" + "/div> <div class=\"g-recaptcha\" data-sitekey=\"6LdH5P4SAAAAAOZN2cR2bLtClStFtq77Ixh7Nh_b\"><" + "/div> <a href=\"javascript:;\" onclick=\"grecaptcha.reset();\" onkeypress=\"grecaptcha.reset();\">Having reCaptcha issues? 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