<% Dim smtpServer Dim INSMailer smtpServer= "soccemsmtp.em.ohio.gov" Set INSmailer = CreateObject("CDO.Message") INSMailer.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/sendusing") = 2 INSMailer.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/smtpserver") = smtpServer INSMailer.Configuration.Fields.Item("http://schemas.microsoft.com/cdo/configuration/smtpserverport") = 25 INSMailer.Configuration.Fields.Update IF Request.Form("CertCmplReq") <> "" THEN From = "webmaster@insurance.ohio.gov" SendTo = "risk.assessment@insurance.ohio.gov" Message = "Thank you for contacting the Ohio Department of Insurance. Your online Certificate of Compliance Request has been received and will be forwarded to the Office of Financial Regulation Services." Subject = "Online Certificate of Compliance Request" Body = Body & "" Body = Body & "" Body = Body & "Certificate of Compliance Request" Body = Body & "" Body = Body & "" Body = Body & "" Body = Body & "" Body = Body & "" Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & "" Body = Body & " " Body = Body & "" Body = Body & "" Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtContactAddr2")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & "" Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & "" Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & " " Body = Body & "" Body = Body & " " If Len(Request.Form("txtContactPhone")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & "" Body = Body & " " If Len(Request.Form("txtContactEmail")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & "" Body = Body & " " Body = Body & "" Body = Body & "" Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingName")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingCompName")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingAddr1")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingAddr2")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingCity")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("cmbBillingState")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & " " If Len(Request.Form("txtBillingZip")) > 0 Then Body = Body & " " Else Body = Body & " " End If Body = Body & " " Body = Body & " " Body = Body & "
Insurer Information
Insurer Name" &Request.Form("txtInsurerName") & "
Tax ID# or NAIC#" &Request.Form("txtInsurerNumber") & "
Number of Copies" &Request.Form("txtNumberCopies") & "
Additional Requests" & replace(trim(Request.Form("txtAddComp")),chr(13),"
") & "
  
Contact Information
Name" &Request.Form("txtContactName") & "
Company Name" &Request.Form("txtContactCompName") & "
Address1" &Request.Form("txtContactAddr1") & "
Address2" &Request.Form("txtContactAddr2") & " 
City" &Request.Form("txtContactCity") & "
State" & Request.Form("cmbContactState") & "
Zip" & Request.Form("txtContactZip") & "
Daytime Phone #" &Request.Form("txtContactPhone") & " 
Email Address" &Request.Form("txtContactEmail") & " 
  
Billing Information
Name" &Request.Form("txtBillingName") & " 
Company Name" &Request.Form("txtBillingCompName") & " 
Address1" &Request.Form("txtBillingAddr1") & " 
Address2" &Request.Form("txtBillingAddr2") & " 
City" &Request.Form("txtBillingCity") & " 
State" &Request.Form("cmbBillingState") & " 
Zip" &Request.Form("txtBillingZip") & " 
" Body = Body & "" Body = Body & "" INSmailer.From = From INSmailer.To = SendTo INSmailer.Subject = Subject INSmailer.HTMLBody = Body INSmailer.Send END IF Set INSmailer = Nothing %> Ohio Dept of Insurance - Online Certificate of Compliance Request

Ohio Department of Insurance ODI Services

 Online Certificate of Compliance Request
Your request has been sent.