{"id":422,"date":"2015-11-05T22:12:02","date_gmt":"2015-11-05T22:12:02","guid":{"rendered":"http:\/\/site10.das-group.com\/?page_id=422"},"modified":"2021-03-04T19:48:25","modified_gmt":"2021-03-04T19:48:25","slug":"agent-submission","status":"publish","type":"page","link":"https:\/\/www.autoglassservice.com\/agents\/agent-submission\/","title":{"rendered":"Agent Submission"},"content":{"rendered":"<div class=\"title-section\">\n<h1>Agents Submission<\/h1>\n<\/div>\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f3252-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/wp-json\/wp\/v2\/pages\/422\/#wpcf7-f3252-o1\" method=\"post\" class=\"wpcf7-form init\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"3252\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.4\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f3252-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"row_fluid\">\n<h2>Location Selection<\/h2>\n<div class=\"row-fluid\">\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap state\"><select name=\"state\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"Select State\">Select State<\/option><option value=\"AL\">AL<\/option><option value=\"AK\">AK<\/option><option value=\"AZ\">AZ<\/option><option value=\"AR\">AR<\/option><option value=\"CA\">CA<\/option><option value=\"CO\">CO<\/option><option value=\"CT\">CT<\/option><option value=\"DE\">DE<\/option><option value=\"FL\">FL<\/option><option value=\"GA\">GA<\/option><option value=\"HI\">HI<\/option><option value=\"ID\">ID<\/option><option value=\"IL\">IL<\/option><option value=\"IN\">IN<\/option><option value=\"IA\">IA<\/option><option value=\"KS\">KS<\/option><option value=\"KY\">KY<\/option><option value=\"LA\">LA<\/option><option value=\"ME\">ME<\/option><option value=\"MD\">MD<\/option><option value=\"MA\">MA<\/option><option value=\"MI\">MI<\/option><option value=\"MN\">MN<\/option><option value=\"MS\">MS<\/option><option value=\"MO\">MO<\/option><option value=\"MT\">MT<\/option><option value=\"NE\">NE<\/option><option value=\"NV\">NV<\/option><option value=\"NH\">NH<\/option><option value=\"NJ\">NJ<\/option><option value=\"NM\">NM<\/option><option value=\"NY\">NY<\/option><option value=\"NC\">NC<\/option><option value=\"ND\">ND<\/option><option value=\"OH\">OH<\/option><option value=\"OK\">OK<\/option><option value=\"OR\">OR<\/option><option value=\"PA\">PA<\/option><option value=\"RI\">RI<\/option><option value=\"SC\">SC<\/option><option value=\"SD\">SD<\/option><option value=\"TN\">TN<\/option><option value=\"TX\">TX<\/option><option value=\"UT\">UT<\/option><option value=\"VT\">VT<\/option><option value=\"VA\">VA<\/option><option value=\"WA\">WA<\/option><option value=\"WV\">WV<\/option><option value=\"WI\">WI<\/option><option value=\"WY\">WY<\/option><\/select><\/span><\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap city\"><select name=\"city\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"Select City\">Select City<\/option><option value=\"City\">City<\/option><option value=\"City\">City<\/option><option value=\"City\">City<\/option><option value=\"City\">City<\/option><option value=\"City\">City<\/option><option value=\"City\">City<\/option><\/select><\/span><\/div>\n<\/div>\n<h2>Insured's Information<\/h2>\n<div class=\"row-fluid\">\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap your-name\"><input type=\"text\" name=\"your-name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Name\" \/><\/span> <\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap phone-primary\"><input type=\"tel\" name=\"phone-primary\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Phone (Primary)\" \/><\/span> <\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap phone-secondary\"><input type=\"tel\" name=\"phone-secondary\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Phone (Secondary)\" \/><\/span> <\/div>\n<\/div>\n<div class=\"row-fluid\">\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap phone-mobile\"><input type=\"tel\" name=\"phone-mobile\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-tel\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Phone (Mobile)\" \/><\/span><\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap email\"><input type=\"email\" name=\"email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-email\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Email Address\" \/><\/span> <\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap address\"><input type=\"text\" name=\"address\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Insured&#039;s Address\" \/><\/span> <\/div>\n<\/div>\n<h2>Insurance Information<\/h2>\n<div class=\"row-fluid\">\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap insurance-company\"><input type=\"text\" name=\"insurance-company\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Insurance Company\" \/><\/span> <\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap agency\"><input type=\"text\" name=\"agency\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Agency\" \/><\/span> <\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap PolicyNumber\"><input type=\"number\" name=\"PolicyNumber\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"Policy Number\" \/><\/span> <\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap ClaimNumber\"><input type=\"number\" name=\"ClaimNumber\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"Claim Number\" \/><\/span> <\/div>\n<\/div>\n<div class=\"row-fluid\">\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap Deductible\"><input type=\"text\" name=\"Deductible\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Deductible\" \/><\/span><\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap Causeofloss\"><input type=\"text\" name=\"Causeofloss\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Cause of loss\" \/><\/span> <\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap DateofLoss\"><input type=\"date\" name=\"DateofLoss\" value=\"\" class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" placeholder=\"Date of Loss\" \/><\/span><\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap NetworkRefNumber\"><input type=\"number\" name=\"NetworkRefNumber\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"Network Ref. Number\" \/><\/span><\/div>\n<\/div>\n<h2>Vehicle Information<\/h2>\n<div class=\"row-fluid\">\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap year\"><input type=\"number\" name=\"year\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"Year\" \/><\/span><\/div>\n<div class=\"form-control span3\"> <span class=\"wpcf7-form-control-wrap make\"><input type=\"text\" name=\"make\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Make\" \/><\/span><\/div>\n<div class=\"form-control span3\"> <span class=\"wpcf7-form-control-wrap Model\"><input type=\"text\" name=\"Model\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" placeholder=\"Model\" \/><\/span><\/div>\n<div class=\"form-control span3\"><span class=\"wpcf7-form-control-wrap door\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"door\" value=\"2 Door\" \/><span class=\"wpcf7-list-item-label\">2 Door<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"door\" value=\"4 Door\" \/><span class=\"wpcf7-list-item-label\">4 Door<\/span><\/span><\/span><\/span><\/div>\n<\/div>\n<div class=\"row-fluid\">\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap VehicleNumber\"><input type=\"number\" name=\"VehicleNumber\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"Vehicle Number\" \/><\/span><\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap VINNumber\"><input type=\"number\" name=\"VINNumber\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" placeholder=\"VIN Number\" \/><\/span><\/div>\n<div class=\"form-control span4\"> <span class=\"wpcf7-form-control-wrap glass\"><select name=\"glass\" class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\"><option value=\"Choose which glass is broken:\">Choose which glass is broken:<\/option><option value=\"Front Windshield\">Front Windshield<\/option><option value=\"Back Glass\">Back Glass<\/option><option value=\"Driver&#039;s Side Door\">Driver&#039;s Side Door<\/option><option value=\"Passenger Side Door\">Passenger Side Door<\/option><option value=\"Other\">Other<\/option><\/select><\/span><\/div>\n<\/div>\n<div class=\"row-fluid\">\n<div class=\"form-control span12\"><span class=\"wpcf7-form-control-wrap Comments\"><textarea name=\"Comments\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" placeholder=\"Comments\"><\/textarea><\/span><\/div>\n<\/div>\n<h2>Submitted By<\/h2>\n<div class=\"row-fluid\">\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap SubmittedBy\"><input type=\"text\" name=\"SubmittedBy\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Submitted By\" \/><\/span><\/div>\n<div class=\"form-control span4\"> <span class=\"wpcf7-form-control-wrap Phonenumber\"><input type=\"tel\" name=\"Phonenumber\" value=\"Phone number\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/div>\n<div class=\"form-control span4\"><span class=\"wpcf7-form-control-wrap EmailAddress\"><input type=\"email\" name=\"EmailAddress\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"Email Address\" \/><\/span><\/div>\n<\/div>\n<div><span class=\"submit-form\"><input type=\"submit\" value=\"Submit\" class=\"wpcf7-form-control wpcf7-submit btn\" \/><\/span><\/div>\n<\/div>\n<div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div>\n<p><!--\n\n\n<h2>Honest Assessment<\/h2>\n\n\nAt Auto Glass Service, service and safety are our top priorities. As a partner in your success, we are committed to making your insured feel confident that you are providing the best, most cost-effective service while protecting their safety and property.\n\n\n<div class=\"half\">\n\n\n<div>\n\n\n<ul>\n \t\n\n<li>Approved by all Glass Networks<\/li>\n\n\n \t\n\n<li>OEM (Original Equipment Manufacturer) Glass<\/li>\n\n\n \t\n\n<li>One Hour Safe Drive-Away Times<\/li>\n\n\n \t\n\n<li>Honors All Insurance Company Prices<\/li>\n\n\n \t\n\n<li>Certified Technicians<\/li>\n\n\n<\/ul>\n\n\n<\/div>\n\n\n\n\n<div>\n\n\n<ul>\n \t\n\n<li>National Lifetime Warranty<\/li>\n\n\n \t\n\n<li>Same-Day Mobile Service<\/li>\n\n\n \t\n\n<li>Multiple Drive-in Locations<\/li>\n\n\n \t\n\n<li>Online Claim and Online Quote Services<\/li>\n\n\n \t\n\n<li>Class Room and Online Continuing Education Classes<\/li>\n\n\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n\n<h2>What Is... Safe Drive-Away Time<\/h2>\n\n\nThere is no shortcut for a safe windshield installation. Only the best adhesives and proper installation techniques can guarantee the safety performance of a windshield during a collision. Auto Glass Service is committed to providing your customers with a safe, convenient auto glass repair or replacement. That's why we have the 1-Hour Safe Drive-Away Time Guarantee, a promise that because of our advanced Sika Adhesives, your customer's vehicle will provide maximum protection within one hour of the installation. Click here to see the video and hear from Rhonda, an insurance agent who frequently refers her insured to Auto Glass Service.\n\n\n<h2>What is... E-Claims Service<\/h2>\n\n\nYour customer is driving down the road and gets a broken windshield or someone hits a golf ball through their glass. Of course, they have their agent on speed dial and call you immediately. They ask you to recommend a good glass shop but can't write down a phone number because they're driving. No problem. Click here to submit a claim. All we need is the customer name, phone number, policy number, agency name, and which glass is broken (because it's not always the windshield) and we'll contact your valued policy holder right away.\n\n\n<h2>Dealing With... Glass Network Call Centers<\/h2>\n\n\nMany insurance companies outsource auto glass claims processing to remote call centers that may be owned by or have special relationships with glass companies.\n\nWhat happens when you refer your valued clients to a call center? A recent JD Power Survey indicates that policy holders that interact with their agents have a higher satisfaction rate and improved loyalty than those that were sent to call centers. Find the nearest location to you.\n\n\n<h2>What is... Our Commitment to Convenience<\/h2>\n\n\nAuto Glass Service is committed to being convenient. Order service online or by phone, seven days a week. In most cases, a Auto Glass Service technician can service your insured's vehicle the same day, either with our convenient drive-in service or fast mobile service. With our One-Hour Safe Drive Away Time Guarantee, we make the whole process quick and painless - so our customers can get on with their lives. We are committed to providing safe and convenient auto glass installation to every customer.\n\n\n<h2>What is... AGRSS validation<\/h2>\n\n\nAGRSS, the Auto Glass Replacement Safety Standard, is the only recognized standard in the auto glass industy. This standard was developed with the help of the American National Standards Institute (ANSI) in an effort to reduce the number of fatalities and injuries caused by improperly replaced auto glass. AGRSS registered glass shops like Auto Glass Service agree to follow strict installation procedures and document all facets of the installation procedure on every replacement. In order to prove compliance with AGRSS, member shops allow an independent third party to validate their compliance with the Standard. Auto Glass Service has passed every AGRSS validation with a 100% score! See the video about the AGRSS validation process ensuring that your insured's auto glass is installed by technicians that go through rigorous training and testing.\n\n--><\/p>\n","protected":false},"excerpt":{"rendered":"Agents Submission","protected":false},"author":2,"featured_media":0,"parent":4182,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-form-agent-new.php","meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v15.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\r\n<meta name=\"description\" content=\"Use Auto Glass Services, E Claim service to submit a claim for your insured customers needing windshield repair or any auto glass repair or replacement.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/www.autoglassservice.com\/agents\/agent-submission\/\" \/>\r\n<meta property=\"og:locale\" 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