Custom Quote Request Form

[de_fb_form title="Get a Quote" form_id="Get a Quote" is_ajax_submit="on" success_hide_form="on" message_position="after_title" use_custom_email="off" custom_contact_email="kiah.husted@newageindustrial.com, daniel.schwindt@newageindustrial.com" replyto_name="name" replyto_email="email" email_title="New Submission - Get a Quote" save_to_database="on" _builder_version="4.24.2" _module_preset="default" _unique_id="3e82e495-9a6d-4136-adc1-a0e21d4deaa3" success_notice_text_font="|600|||||||" success_notice_text_text_color="#23428E" success_notice_text_font_size="16px" custom_button="on" button_text_color="#FFFFFF" button_bg_color="#F7941D" button_border_color="#F7941D" hover_enabled="0" locked="off" global_colors_info="{}" use_honeypot_captcha="off" google_recaptcha="on" recaptcha_sitekey_type="recaptcha_3" recaptcha_sitekey_v3="6LcHHU4pAAAAADsJMR-gyBnGqvopT0T-xjn3_Xw5" recaptcha_seckey_v3="6LcHHU4pAAAAAItT3RA_9hkWk2tTDgoXLVG0Nzap" sticky_enabled="0"][de_fb_form_field field_title="Contact Name" admin_title="Name" field_id="name" required_mark="on" field_grid_column="et_pb_column_1_2" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="Company" admin_title="Company" field_id="company" required_mark="on" field_grid_column="et_pb_column_1_2" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="Email" admin_title="Email" field_id="email" field_type="email" required_mark="on" field_grid_column="et_pb_column_1_2" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="Phone" admin_title="Phone" field_id="phone" required_mark="on" field_grid_column="et_pb_column_1_2" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="Industry" admin_title="Industry" field_id="industry" field_type="radio" radio_options="%91{%22value%22:%22Foodservice%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22Material Handling%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22Supermarket%22,%22checked%22:0,%22dragID%22:1}%93" required_mark="on" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="City & State" admin_title="City and State" field_id="city_state" select_options="%91{%22value%22:%22%22,%22checked%22:0,%22dragID%22:-1}%93" required_mark="on" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="How can we help? Please provide relevant model numbers and quantities needed." admin_title="How can we help?" field_id="message" field_type="text" required_mark="on" field_label_position="top" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][de_fb_form_field field_title="Page Visited" admin_title="Page Visited" field_id="page_visited" field_type="hidden" hidden_value="page_url" select_options="%91{%22value%22:%22%22,%22checked%22:0,%22dragID%22:-1}%93" _builder_version="4.24.2" _module_preset="default" global_colors_info="{}"][/de_fb_form_field][/de_fb_form]