{"id":1128,"date":"2020-12-18T13:41:51","date_gmt":"2020-12-18T13:41:51","guid":{"rendered":"http:\/\/airconrd.com\/main\/?page_id=1128"},"modified":"2020-12-18T13:51:18","modified_gmt":"2020-12-18T13:51:18","slug":"aplicacion-distribuidor-autorizado","status":"publish","type":"page","link":"https:\/\/airconrd.com\/main\/aplicacion-distribuidor-autorizado\/","title":{"rendered":"Aplicaci\u00f3n Distribuidor Autorizado"},"content":{"rendered":"<p>[vc_row][vc_column][vc_column_text]<div class=\"forminator-ui forminator-custom-form forminator-custom-form-1119 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1119\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-1119\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1119 forminator-design--default  forminator_ajax\"\n\t\t\t\taction=\"\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"1119\"\n\t\t\t\t\n\t\t\t\tdata-design=\"default\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tdata-grid=\"open\"\n\t\t\t\t\n\t\t\t\t\n\t\t\t\tstyle=\"display: none;\"\n\t\t\t><div class=\"forminator-response-message\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"section-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Formulario Aplicaci&oacute;n Distribuidores Autorizados Rep&uacute;blica Dominicana<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Tipo de Solicitud <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-1-1-6a32cbf6f30d5\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"comercial\" id=\"forminator-field-checkbox-1-1-6a32cbf6f30d5\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Comercial<\/span><\/label><label for=\"forminator-field-checkbox-1-2-6a32cbf6f30d5\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"tcnico-independiente\" id=\"forminator-field-checkbox-1-2-6a32cbf6f30d5\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>T\u00e9cnico Independiente<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1\" class=\"forminator-label\">RNC<\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2\" class=\"forminator-label\">RPE<\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Informaci&oacute;n General<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3\" class=\"forminator-label\">Raz\u00f3n Social <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-4\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4\" class=\"forminator-label\">Nombre <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"name-1\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1\" class=\"forminator-label\">Apellidos <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"\" id=\"forminator-field-name-1\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-16\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-16\" class=\"forminator-label\">C\u00e9dula de Identidad <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\" id=\"forminator-field-text-16\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-6\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6\" class=\"forminator-label\">No. Licencia T\u00e9cnico <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7\" class=\"forminator-label\">Tel\u00e9fono Comercial <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-8\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8\" class=\"forminator-label\">Residencial<\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-9\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9\" class=\"forminator-label\">M\u00f3vil <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-row\"><div class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-street_address-address-1\" class=\"forminator-label\">Direcci\u00f3n <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"address-1-street_address\" placeholder=\"\" id=\"forminator-field-street_address-address-1\" class=\"forminator-input\" data-required=\"1\" aria-required=\"true\" value=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-address_line-address-1\" class=\"forminator-label\">Apartmento<\/label><input type=\"text\" name=\"address-1-address_line\" placeholder=\"\" id=\"forminator-field-address_line-address-1\" class=\"forminator-input\" data-required=\"\" aria-required=\"false\" value=\"\" \/><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-1\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"select-1-field-field\" class=\"forminator-label\">Provincia<\/label><div class=\"forminator-multiselect\"><label for=\"select-1-field-1-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"gran-santo-domingo\" id=\"select-1-field-1-6a32cbf6f3200\" data-calculation=\"0\"  \/>Gran Santo Domingo<\/label><label for=\"select-1-field-2-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"azua\" id=\"select-1-field-2-6a32cbf6f3200\" data-calculation=\"0\"  \/>Azua<\/label><label for=\"select-1-field-3-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"baoruco\" id=\"select-1-field-3-6a32cbf6f3200\" data-calculation=\"0\"  \/>Baoruco<\/label><label for=\"select-1-field-4-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"barahona\" id=\"select-1-field-4-6a32cbf6f3200\" data-calculation=\"0\"  \/>Barahona<\/label><label for=\"select-1-field-5-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"dajabn\" id=\"select-1-field-5-6a32cbf6f3200\" data-calculation=\"0\"  \/>Dajab\u00f3n<\/label><label for=\"select-1-field-6-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"duarte\" id=\"select-1-field-6-6a32cbf6f3200\" data-calculation=\"0\"  \/>Duarte<\/label><label for=\"select-1-field-7-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"elias-pia\" id=\"select-1-field-7-6a32cbf6f3200\" data-calculation=\"0\"  \/>Elias Pi\u00f1a<\/label><label for=\"select-1-field-8-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"el-seibo\" id=\"select-1-field-8-6a32cbf6f3200\" data-calculation=\"0\"  \/>El Seibo<\/label><label for=\"select-1-field-9-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"espaillat\" id=\"select-1-field-9-6a32cbf6f3200\" data-calculation=\"0\"  \/>Espaillat<\/label><label for=\"select-1-field-10-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"hato-mayor\" id=\"select-1-field-10-6a32cbf6f3200\" data-calculation=\"0\"  \/>Hato Mayor<\/label><label for=\"select-1-field-11-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"hermanas-mirabal\" id=\"select-1-field-11-6a32cbf6f3200\" data-calculation=\"0\"  \/>Hermanas Mirabal<\/label><label for=\"select-1-field-12-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"independencia\" id=\"select-1-field-12-6a32cbf6f3200\" data-calculation=\"0\"  \/>Independencia<\/label><label for=\"select-1-field-13-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"la-altagracia\" id=\"select-1-field-13-6a32cbf6f3200\" data-calculation=\"0\"  \/>La Altagracia<\/label><label for=\"select-1-field-14-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"la-romana\" id=\"select-1-field-14-6a32cbf6f3200\" data-calculation=\"0\"  \/>La Romana<\/label><label for=\"select-1-field-15-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"la-vega\" id=\"select-1-field-15-6a32cbf6f3200\" data-calculation=\"0\"  \/>La Vega<\/label><label for=\"select-1-field-16-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"mara-trinidad-snchez\" id=\"select-1-field-16-6a32cbf6f3200\" data-calculation=\"0\"  \/>Mar\u00eda Trinidad S\u00e1nchez<\/label><label for=\"select-1-field-17-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"monseor-nouel\" id=\"select-1-field-17-6a32cbf6f3200\" data-calculation=\"0\"  \/>Monse\u00f1or Nouel<\/label><label for=\"select-1-field-18-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"montecristi\" id=\"select-1-field-18-6a32cbf6f3200\" data-calculation=\"0\"  \/>Montecristi<\/label><label for=\"select-1-field-19-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"monte-plata\" id=\"select-1-field-19-6a32cbf6f3200\" data-calculation=\"0\"  \/>Monte Plata<\/label><label for=\"select-1-field-20-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"pedernales\" id=\"select-1-field-20-6a32cbf6f3200\" data-calculation=\"0\"  \/>Pedernales<\/label><label for=\"select-1-field-21-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"peravia\" id=\"select-1-field-21-6a32cbf6f3200\" data-calculation=\"0\"  \/>Peravia<\/label><label for=\"select-1-field-22-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"puerto-plata\" id=\"select-1-field-22-6a32cbf6f3200\" data-calculation=\"0\"  \/>Puerto Plata<\/label><label for=\"select-1-field-23-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"saman\" id=\"select-1-field-23-6a32cbf6f3200\" data-calculation=\"0\"  \/>Saman\u00e1<\/label><label for=\"select-1-field-24-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"san-cristbal\" id=\"select-1-field-24-6a32cbf6f3200\" data-calculation=\"0\"  \/>San Crist\u00f3bal<\/label><label for=\"select-1-field-25-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"san-jos-de-ocoa\" id=\"select-1-field-25-6a32cbf6f3200\" data-calculation=\"0\"  \/>San Jos\u00e9 de Ocoa<\/label><label for=\"select-1-field-26-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"san-juan\" id=\"select-1-field-26-6a32cbf6f3200\" data-calculation=\"0\"  \/>San Juan<\/label><label for=\"select-1-field-27-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"san-pedro-de-macoris\" id=\"select-1-field-27-6a32cbf6f3200\" data-calculation=\"0\"  \/>San Pedro de Macoris<\/label><label for=\"select-1-field-28-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"snchez-ramrez\" id=\"select-1-field-28-6a32cbf6f3200\" data-calculation=\"0\"  \/>S\u00e1nchez Ram\u00edrez<\/label><label for=\"select-1-field-29-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"santiago\" id=\"select-1-field-29-6a32cbf6f3200\" data-calculation=\"0\"  \/>Santiago<\/label><label for=\"select-1-field-30-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"santiago-rodrguez\" id=\"select-1-field-30-6a32cbf6f3200\" data-calculation=\"0\"  \/>Santiago Rodr\u00edguez<\/label><label for=\"select-1-field-31-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"santo-domingo\" id=\"select-1-field-31-6a32cbf6f3200\" data-calculation=\"0\"  \/>Santo Domingo<\/label><label for=\"select-1-field-32-6a32cbf6f3200\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-1[]\" value=\"valverde\" id=\"select-1-field-32-6a32cbf6f3200\" data-calculation=\"0\"  \/>Valverde<\/label><input type='hidden' name='select-1-multiselect-default-values' class='multiselect-default-values' value='{\"0\":\"gran-santo-domingo\"}' \/><\/div><\/div><\/div><div id=\"select-2\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"select-2-field-field\" class=\"forminator-label\">Municipio<\/label><div class=\"forminator-multiselect\"><label for=\"select-2-field-1-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"distrito-nacional\" id=\"select-2-field-1-6a32cbf6f3247\" data-calculation=\"0\"  \/>Distrito Nacional<\/label><label for=\"select-2-field-2-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"santo-domingo-este\" id=\"select-2-field-2-6a32cbf6f3247\" data-calculation=\"0\"  \/>Santo Domingo Este<\/label><label for=\"select-2-field-3-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"santo-domingo-oeste\" id=\"select-2-field-3-6a32cbf6f3247\" data-calculation=\"0\"  \/>Santo Domingo Oeste<\/label><label for=\"select-2-field-4-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"santo-domingo-norte\" id=\"select-2-field-4-6a32cbf6f3247\" data-calculation=\"0\"  \/>Santo Domingo Norte<\/label><label for=\"select-2-field-5-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"boca-chica\" id=\"select-2-field-5-6a32cbf6f3247\" data-calculation=\"0\"  \/>Boca Chica<\/label><label for=\"select-2-field-6-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-antonio-de-guerra\" id=\"select-2-field-6-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Antonio de Guerra<\/label><label for=\"select-2-field-7-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-alcarrizos\" id=\"select-2-field-7-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los Alcarrizos<\/label><label for=\"select-2-field-8-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pedro-band\" id=\"select-2-field-8-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pedro Band<\/label><label for=\"select-2-field-9-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"azua-compostela\" id=\"select-2-field-9-6a32cbf6f3247\" data-calculation=\"0\"  \/>Azua Compostela<\/label><label for=\"select-2-field-10-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"estebana\" id=\"select-2-field-10-6a32cbf6f3247\" data-calculation=\"0\"  \/>Esteban\u00eda<\/label><label for=\"select-2-field-11-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"guayabal\" id=\"select-2-field-11-6a32cbf6f3247\" data-calculation=\"0\"  \/>Guayabal<\/label><label for=\"select-2-field-12-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-charcas\" id=\"select-2-field-12-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Charcas<\/label><label for=\"select-2-field-13-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-yayas-de-viajama\" id=\"select-2-field-13-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Yayas de Viajama<\/label><label for=\"select-2-field-14-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"padre-de-las-casas\" id=\"select-2-field-14-6a32cbf6f3247\" data-calculation=\"0\"  \/>Padre de las Casas<\/label><label for=\"select-2-field-15-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"peralta\" id=\"select-2-field-15-6a32cbf6f3247\" data-calculation=\"0\"  \/>Peralta<\/label><label for=\"select-2-field-16-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pueblo-viejo\" id=\"select-2-field-16-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pueblo Viejo<\/label><label for=\"select-2-field-17-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-yegua\" id=\"select-2-field-17-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana Yegua<\/label><label for=\"select-2-field-18-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"tbara-arriba\" id=\"select-2-field-18-6a32cbf6f3247\" data-calculation=\"0\"  \/>T\u00e1bara Arriba<\/label><label for=\"select-2-field-19-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"neiba\" id=\"select-2-field-19-6a32cbf6f3247\" data-calculation=\"0\"  \/>Neiba<\/label><label for=\"select-2-field-20-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"galvn\" id=\"select-2-field-20-6a32cbf6f3247\" data-calculation=\"0\"  \/>Galv\u00e1n<\/label><label for=\"select-2-field-21-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-ros\" id=\"select-2-field-21-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los R\u00edos<\/label><label for=\"select-2-field-22-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"tamayo\" id=\"select-2-field-22-6a32cbf6f3247\" data-calculation=\"0\"  \/>Tamayo<\/label><label for=\"select-2-field-23-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-jaragua\" id=\"select-2-field-23-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Jaragua<\/label><label for=\"select-2-field-24-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"barahona\" id=\"select-2-field-24-6a32cbf6f3247\" data-calculation=\"0\"  \/>Barahona<\/label><label for=\"select-2-field-25-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cabral\" id=\"select-2-field-25-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cabral<\/label><label for=\"select-2-field-26-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-peon\" id=\"select-2-field-26-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Pe\u00f1on<\/label><label for=\"select-2-field-27-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"enriquillo\" id=\"select-2-field-27-6a32cbf6f3247\" data-calculation=\"0\"  \/>Enriquillo<\/label><label for=\"select-2-field-28-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"fundacin\" id=\"select-2-field-28-6a32cbf6f3247\" data-calculation=\"0\"  \/>Fundaci\u00f3n<\/label><label for=\"select-2-field-29-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jaquimeyes\" id=\"select-2-field-29-6a32cbf6f3247\" data-calculation=\"0\"  \/>Jaquimeyes<\/label><label for=\"select-2-field-30-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"la-cinaga\" id=\"select-2-field-30-6a32cbf6f3247\" data-calculation=\"0\"  \/>La Ci\u00e9naga<\/label><label for=\"select-2-field-31-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-salinas\" id=\"select-2-field-31-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Salinas<\/label><label for=\"select-2-field-32-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"paraso\" id=\"select-2-field-32-6a32cbf6f3247\" data-calculation=\"0\"  \/>Para\u00edso<\/label><label for=\"select-2-field-33-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"polo\" id=\"select-2-field-33-6a32cbf6f3247\" data-calculation=\"0\"  \/>Polo<\/label><label for=\"select-2-field-34-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"vicente-noble\" id=\"select-2-field-34-6a32cbf6f3247\" data-calculation=\"0\"  \/>Vicente Noble<\/label><label for=\"select-2-field-35-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"dajabn\" id=\"select-2-field-35-6a32cbf6f3247\" data-calculation=\"0\"  \/>Dajab\u00f3n<\/label><label for=\"select-2-field-36-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-pino\" id=\"select-2-field-36-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Pino<\/label><label for=\"select-2-field-37-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"loma-de-cabrera\" id=\"select-2-field-37-6a32cbf6f3247\" data-calculation=\"0\"  \/>Loma de Cabrera<\/label><label for=\"select-2-field-38-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"partido\" id=\"select-2-field-38-6a32cbf6f3247\" data-calculation=\"0\"  \/>Partido<\/label><label for=\"select-2-field-39-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"restauracin\" id=\"select-2-field-39-6a32cbf6f3247\" data-calculation=\"0\"  \/>Restauraci\u00f3n<\/label><label for=\"select-2-field-40-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-francisco-de-macors\" id=\"select-2-field-40-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Francisco de Macor\u00eds<\/label><label for=\"select-2-field-41-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"arenoso\" id=\"select-2-field-41-6a32cbf6f3247\" data-calculation=\"0\"  \/>Arenoso<\/label><label for=\"select-2-field-42-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"castillo\" id=\"select-2-field-42-6a32cbf6f3247\" data-calculation=\"0\"  \/>Castillo<\/label><label for=\"select-2-field-43-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"eugenio-maria-de-hostos\" id=\"select-2-field-43-6a32cbf6f3247\" data-calculation=\"0\"  \/>Eugenio Maria de Hostos<\/label><label for=\"select-2-field-44-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-guranas\" id=\"select-2-field-44-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Gu\u00e1ranas<\/label><label for=\"select-2-field-45-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pimentel\" id=\"select-2-field-45-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pimentel<\/label><label for=\"select-2-field-46-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-riva\" id=\"select-2-field-46-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Riva<\/label><label for=\"select-2-field-47-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"comedor\" id=\"select-2-field-47-6a32cbf6f3247\" data-calculation=\"0\"  \/>Comedor<\/label><label for=\"select-2-field-48-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bnica\" id=\"select-2-field-48-6a32cbf6f3247\" data-calculation=\"0\"  \/>B\u00e1nica<\/label><label for=\"select-2-field-49-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-llano\" id=\"select-2-field-49-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Llano<\/label><label for=\"select-2-field-50-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"hondo-valle\" id=\"select-2-field-50-6a32cbf6f3247\" data-calculation=\"0\"  \/>Hondo Valle<\/label><label for=\"select-2-field-51-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"juan-santiago\" id=\"select-2-field-51-6a32cbf6f3247\" data-calculation=\"0\"  \/>Juan Santiago<\/label><label for=\"select-2-field-52-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pedro-santana\" id=\"select-2-field-52-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pedro Santana<\/label><label for=\"select-2-field-53-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-seibo\" id=\"select-2-field-53-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Seibo<\/label><label for=\"select-2-field-54-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"miches\" id=\"select-2-field-54-6a32cbf6f3247\" data-calculation=\"0\"  \/>Miches<\/label><label for=\"select-2-field-55-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"moca\" id=\"select-2-field-55-6a32cbf6f3247\" data-calculation=\"0\"  \/>Moca<\/label><label for=\"select-2-field-56-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cayetano-germosn\" id=\"select-2-field-56-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cayetano Germos\u00e9n<\/label><label for=\"select-2-field-57-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"gaspar-hernndez\" id=\"select-2-field-57-6a32cbf6f3247\" data-calculation=\"0\"  \/>Gaspar Hern\u00e1ndez<\/label><label for=\"select-2-field-58-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jamao-al-norte\" id=\"select-2-field-58-6a32cbf6f3247\" data-calculation=\"0\"  \/>Jamao al Norte<\/label><label for=\"select-2-field-59-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"hato-mayor-del-rey\" id=\"select-2-field-59-6a32cbf6f3247\" data-calculation=\"0\"  \/>Hato Mayor del Rey<\/label><label for=\"select-2-field-60-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-valle\" id=\"select-2-field-60-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Valle<\/label><label for=\"select-2-field-61-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-de-la-mar\" id=\"select-2-field-61-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana de la Mar<\/label><label for=\"select-2-field-62-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"salcedo\" id=\"select-2-field-62-6a32cbf6f3247\" data-calculation=\"0\"  \/>Salcedo<\/label><label for=\"select-2-field-63-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"tenares\" id=\"select-2-field-63-6a32cbf6f3247\" data-calculation=\"0\"  \/>Tenares<\/label><label for=\"select-2-field-64-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-tapia\" id=\"select-2-field-64-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Tapia<\/label><label for=\"select-2-field-65-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jiman\" id=\"select-2-field-65-6a32cbf6f3247\" data-calculation=\"0\"  \/>Jiman\u00ed<\/label><label for=\"select-2-field-66-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cristbal\" id=\"select-2-field-66-6a32cbf6f3247\" data-calculation=\"0\"  \/>Crist\u00f3bal<\/label><label for=\"select-2-field-67-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"duverg\" id=\"select-2-field-67-6a32cbf6f3247\" data-calculation=\"0\"  \/>Duverg\u00e9<\/label><label for=\"select-2-field-68-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"la-descubierta\" id=\"select-2-field-68-6a32cbf6f3247\" data-calculation=\"0\"  \/>La Descubierta<\/label><label for=\"select-2-field-69-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"mella\" id=\"select-2-field-69-6a32cbf6f3247\" data-calculation=\"0\"  \/>Mella<\/label><label for=\"select-2-field-70-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"poster-ro\" id=\"select-2-field-70-6a32cbf6f3247\" data-calculation=\"0\"  \/>Poster R\u00edo<\/label><label for=\"select-2-field-71-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"higey\" id=\"select-2-field-71-6a32cbf6f3247\" data-calculation=\"0\"  \/>Hig\u00fcey<\/label><label for=\"select-2-field-72-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-rafael-del-yuma\" id=\"select-2-field-72-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Rafael del Yuma<\/label><label for=\"select-2-field-73-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"la-romana\" id=\"select-2-field-73-6a32cbf6f3247\" data-calculation=\"0\"  \/>La Romana<\/label><label for=\"select-2-field-74-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"guaymate\" id=\"select-2-field-74-6a32cbf6f3247\" data-calculation=\"0\"  \/>Guaymate<\/label><label for=\"select-2-field-75-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-hermosa\" id=\"select-2-field-75-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Hermosa<\/label><label for=\"select-2-field-76-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"la-concepcin-de-la-vega\" id=\"select-2-field-76-6a32cbf6f3247\" data-calculation=\"0\"  \/>La Concepci\u00f3n de la Vega<\/label><label for=\"select-2-field-77-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"constanza\" id=\"select-2-field-77-6a32cbf6f3247\" data-calculation=\"0\"  \/>Constanza<\/label><label for=\"select-2-field-78-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jarabacoa\" id=\"select-2-field-78-6a32cbf6f3247\" data-calculation=\"0\"  \/>Jarabacoa<\/label><label for=\"select-2-field-79-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jima-abajo\" id=\"select-2-field-79-6a32cbf6f3247\" data-calculation=\"0\"  \/>Jima Abajo<\/label><label for=\"select-2-field-80-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"nagua\" id=\"select-2-field-80-6a32cbf6f3247\" data-calculation=\"0\"  \/>Nagua<\/label><label for=\"select-2-field-81-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cabrera\" id=\"select-2-field-81-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cabrera<\/label><label for=\"select-2-field-82-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-factor\" id=\"select-2-field-82-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Factor<\/label><label for=\"select-2-field-83-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"ro-san-juan\" id=\"select-2-field-83-6a32cbf6f3247\" data-calculation=\"0\"  \/>R\u00edo San Juan<\/label><label for=\"select-2-field-84-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bonao\" id=\"select-2-field-84-6a32cbf6f3247\" data-calculation=\"0\"  \/>Bonao<\/label><label for=\"select-2-field-85-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"maimn\" id=\"select-2-field-85-6a32cbf6f3247\" data-calculation=\"0\"  \/>Maim\u00f3n<\/label><label for=\"select-2-field-86-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"piedra-blanca\" id=\"select-2-field-86-6a32cbf6f3247\" data-calculation=\"0\"  \/>Piedra Blanca<\/label><label for=\"select-2-field-87-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"montecristi\" id=\"select-2-field-87-6a32cbf6f3247\" data-calculation=\"0\"  \/>Montecristi<\/label><label for=\"select-2-field-88-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"castauela\" id=\"select-2-field-88-6a32cbf6f3247\" data-calculation=\"0\"  \/>Casta\u00f1uela<\/label><label for=\"select-2-field-89-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"guayubn\" id=\"select-2-field-89-6a32cbf6f3247\" data-calculation=\"0\"  \/>Guayub\u00edn<\/label><label for=\"select-2-field-90-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-matas-de-santa-cruz\" id=\"select-2-field-90-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Matas de Santa Cruz<\/label><label for=\"select-2-field-91-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pepillo-salcedo\" id=\"select-2-field-91-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pepillo Salcedo<\/label><label for=\"select-2-field-92-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-vsquez\" id=\"select-2-field-92-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa V\u00e1squez<\/label><label for=\"select-2-field-93-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"monte-plata\" id=\"select-2-field-93-6a32cbf6f3247\" data-calculation=\"0\"  \/>Monte Plata<\/label><label for=\"select-2-field-94-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bayaguana\" id=\"select-2-field-94-6a32cbf6f3247\" data-calculation=\"0\"  \/>Bayaguana<\/label><label for=\"select-2-field-95-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"peralvillo\" id=\"select-2-field-95-6a32cbf6f3247\" data-calculation=\"0\"  \/>Peralvillo<\/label><label for=\"select-2-field-96-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-grande-de-boy\" id=\"select-2-field-96-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana Grande de Boy\u00e1<\/label><label for=\"select-2-field-97-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"yamas\" id=\"select-2-field-97-6a32cbf6f3247\" data-calculation=\"0\"  \/>Yamas\u00e1<\/label><label for=\"select-2-field-98-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pedernales\" id=\"select-2-field-98-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pedernales<\/label><label for=\"select-2-field-99-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"oviedo\" id=\"select-2-field-99-6a32cbf6f3247\" data-calculation=\"0\"  \/>Oviedo<\/label><label for=\"select-2-field-100-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"ban\" id=\"select-2-field-100-6a32cbf6f3247\" data-calculation=\"0\"  \/>Ban\u00ed<\/label><label for=\"select-2-field-101-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"nizao\" id=\"select-2-field-101-6a32cbf6f3247\" data-calculation=\"0\"  \/>Nizao<\/label><label for=\"select-2-field-102-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"puerto-plata\" id=\"select-2-field-102-6a32cbf6f3247\" data-calculation=\"0\"  \/>Puerto Plata<\/label><label for=\"select-2-field-103-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"altamira\" id=\"select-2-field-103-6a32cbf6f3247\" data-calculation=\"0\"  \/>Altamira<\/label><label for=\"select-2-field-104-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"guananico\" id=\"select-2-field-104-6a32cbf6f3247\" data-calculation=\"0\"  \/>Guananico<\/label><label for=\"select-2-field-105-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"imbert\" id=\"select-2-field-105-6a32cbf6f3247\" data-calculation=\"0\"  \/>Imbert<\/label><label for=\"select-2-field-106-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-hidalgos\" id=\"select-2-field-106-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los Hidalgos<\/label><label for=\"select-2-field-107-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"lupern\" id=\"select-2-field-107-6a32cbf6f3247\" data-calculation=\"0\"  \/>Luper\u00f3n<\/label><label for=\"select-2-field-108-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sosa\" id=\"select-2-field-108-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sos\u00faa<\/label><label for=\"select-2-field-109-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-isabela\" id=\"select-2-field-109-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Isabela<\/label><label for=\"select-2-field-110-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-montellano\" id=\"select-2-field-110-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Montellano<\/label><label for=\"select-2-field-111-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"saman\" id=\"select-2-field-111-6a32cbf6f3247\" data-calculation=\"0\"  \/>Saman\u00e1<\/label><label for=\"select-2-field-112-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-terrenas\" id=\"select-2-field-112-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Terrenas<\/label><label for=\"select-2-field-113-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"snchez\" id=\"select-2-field-113-6a32cbf6f3247\" data-calculation=\"0\"  \/>S\u00e1nchez<\/label><label for=\"select-2-field-114-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-cristbal\" id=\"select-2-field-114-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Crist\u00f3bal<\/label><label for=\"select-2-field-115-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bajos-de-haina\" id=\"select-2-field-115-6a32cbf6f3247\" data-calculation=\"0\"  \/>Bajos de Haina<\/label><label for=\"select-2-field-116-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cambita-garabito\" id=\"select-2-field-116-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cambita Garabito<\/label><label for=\"select-2-field-117-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-cacaos\" id=\"select-2-field-117-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los Cacaos<\/label><label for=\"select-2-field-118-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-grande-de-palenque\" id=\"select-2-field-118-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana Grande de Palenque<\/label><label for=\"select-2-field-119-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-gregorio-de-nigua\" id=\"select-2-field-119-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Gregorio de Nigua<\/label><label for=\"select-2-field-120-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-altagracia\" id=\"select-2-field-120-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Altagracia<\/label><label for=\"select-2-field-121-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"yaguate\" id=\"select-2-field-121-6a32cbf6f3247\" data-calculation=\"0\"  \/>Yaguate<\/label><label for=\"select-2-field-122-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-jos-de-ocoa\" id=\"select-2-field-122-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Jos\u00e9 de Ocoa<\/label><label for=\"select-2-field-123-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"rancho-arriba\" id=\"select-2-field-123-6a32cbf6f3247\" data-calculation=\"0\"  \/>Rancho Arriba<\/label><label for=\"select-2-field-124-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-larga\" id=\"select-2-field-124-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana Larga<\/label><label for=\"select-2-field-125-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-juan-de-la-maguana\" id=\"select-2-field-125-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Juan de la Maguana<\/label><label for=\"select-2-field-126-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bochecho\" id=\"select-2-field-126-6a32cbf6f3247\" data-calculation=\"0\"  \/>Bochech\u00edo<\/label><label for=\"select-2-field-127-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"el-cercado\" id=\"select-2-field-127-6a32cbf6f3247\" data-calculation=\"0\"  \/>El Cercado<\/label><label for=\"select-2-field-128-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"juan-de-herrera\" id=\"select-2-field-128-6a32cbf6f3247\" data-calculation=\"0\"  \/>Juan de Herrera<\/label><label for=\"select-2-field-129-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"las-matas-de-farfn\" id=\"select-2-field-129-6a32cbf6f3247\" data-calculation=\"0\"  \/>Las Matas de Farf\u00e1n<\/label><label for=\"select-2-field-130-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"vallejuelo\" id=\"select-2-field-130-6a32cbf6f3247\" data-calculation=\"0\"  \/>Vallejuelo<\/label><label for=\"select-2-field-131-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-pedro-de-macors\" id=\"select-2-field-131-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Pedro de Macor\u00eds<\/label><label for=\"select-2-field-132-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"consuelo\" id=\"select-2-field-132-6a32cbf6f3247\" data-calculation=\"0\"  \/>Consuelo<\/label><label for=\"select-2-field-133-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"guayacanes\" id=\"select-2-field-133-6a32cbf6f3247\" data-calculation=\"0\"  \/>Guayacanes<\/label><label for=\"select-2-field-134-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"quisqueya\" id=\"select-2-field-134-6a32cbf6f3247\" data-calculation=\"0\"  \/>Quisqueya<\/label><label for=\"select-2-field-135-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"ramn-santana\" id=\"select-2-field-135-6a32cbf6f3247\" data-calculation=\"0\"  \/>Ram\u00f3n Santana<\/label><label for=\"select-2-field-136-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-jos-de-los-llanos\" id=\"select-2-field-136-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Jos\u00e9 de los Llanos<\/label><label for=\"select-2-field-137-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cotu\" id=\"select-2-field-137-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cotu\u00ed<\/label><label for=\"select-2-field-138-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"cevicos\" id=\"select-2-field-138-6a32cbf6f3247\" data-calculation=\"0\"  \/>Cevicos<\/label><label for=\"select-2-field-139-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"fantino\" id=\"select-2-field-139-6a32cbf6f3247\" data-calculation=\"0\"  \/>Fantino<\/label><label for=\"select-2-field-140-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"la-mata\" id=\"select-2-field-140-6a32cbf6f3247\" data-calculation=\"0\"  \/>La Mata<\/label><label for=\"select-2-field-141-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"santiago\" id=\"select-2-field-141-6a32cbf6f3247\" data-calculation=\"0\"  \/>Santiago<\/label><label for=\"select-2-field-142-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"bison\" id=\"select-2-field-142-6a32cbf6f3247\" data-calculation=\"0\"  \/>Bison\u00f3<\/label><label for=\"select-2-field-143-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"jnico\" id=\"select-2-field-143-6a32cbf6f3247\" data-calculation=\"0\"  \/>J\u00e1nico<\/label><label for=\"select-2-field-144-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"licey-al-medio\" id=\"select-2-field-144-6a32cbf6f3247\" data-calculation=\"0\"  \/>Licey al Medio<\/label><label for=\"select-2-field-145-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pual\" id=\"select-2-field-145-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pu\u00f1al<\/label><label for=\"select-2-field-146-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"sabana-iglesia\" id=\"select-2-field-146-6a32cbf6f3247\" data-calculation=\"0\"  \/>Sabana Iglesia<\/label><label for=\"select-2-field-147-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-jos-de-las-matas\" id=\"select-2-field-147-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Jos\u00e9 de las Matas<\/label><label for=\"select-2-field-148-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"tamboril\" id=\"select-2-field-148-6a32cbf6f3247\" data-calculation=\"0\"  \/>Tamboril<\/label><label for=\"select-2-field-149-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"villa-gonzlez\" id=\"select-2-field-149-6a32cbf6f3247\" data-calculation=\"0\"  \/>Villa Gonz\u00e1lez<\/label><label for=\"select-2-field-150-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-ignacio-de-sabaneta\" id=\"select-2-field-150-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Ignacio de Sabaneta<\/label><label for=\"select-2-field-151-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-almcigos\" id=\"select-2-field-151-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los Alm\u00e1cigos<\/label><label for=\"select-2-field-152-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"moncin\" id=\"select-2-field-152-6a32cbf6f3247\" data-calculation=\"0\"  \/>Monci\u00f3n<\/label><label for=\"select-2-field-153-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"santo-domingo-este\" id=\"select-2-field-153-6a32cbf6f3247\" data-calculation=\"0\"  \/>Santo Domingo Este<\/label><label for=\"select-2-field-154-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"boca-chica\" id=\"select-2-field-154-6a32cbf6f3247\" data-calculation=\"0\"  \/>Boca Chica<\/label><label for=\"select-2-field-155-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"los-alcarrizos\" id=\"select-2-field-155-6a32cbf6f3247\" data-calculation=\"0\"  \/>Los Alcarrizos<\/label><label for=\"select-2-field-156-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"pedro-brand\" id=\"select-2-field-156-6a32cbf6f3247\" data-calculation=\"0\"  \/>Pedro Brand<\/label><label for=\"select-2-field-157-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-antonio-de-guerra\" id=\"select-2-field-157-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Antonio de Guerra<\/label><label for=\"select-2-field-158-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-antonio-de-norte\" id=\"select-2-field-158-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Antonio de Norte<\/label><label for=\"select-2-field-159-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"san-antonio-de-oeste\" id=\"select-2-field-159-6a32cbf6f3247\" data-calculation=\"0\"  \/>San Antonio de Oeste<\/label><label for=\"select-2-field-160-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"mao\" id=\"select-2-field-160-6a32cbf6f3247\" data-calculation=\"0\"  \/>Mao<\/label><label for=\"select-2-field-161-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"esperanza\" id=\"select-2-field-161-6a32cbf6f3247\" data-calculation=\"0\"  \/>Esperanza<\/label><label for=\"select-2-field-162-6a32cbf6f3247\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-2[]\" value=\"laguna-salada\" id=\"select-2-field-162-6a32cbf6f3247\" data-calculation=\"0\"  \/>Laguna Salada<\/label><input type='hidden' name='select-2-multiselect-default-values' class='multiselect-default-values' value='{\"0\":\"distrito-nacional\"}' \/><\/div><\/div><\/div><div id=\"select-3\" class=\"forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"select-3-field-field\" class=\"forminator-label\">Distrito Municipal<\/label><div class=\"forminator-multiselect\"><label for=\"select-3-field-1-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-luis\" id=\"select-3-field-1-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Luis<\/label><label for=\"select-3-field-2-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-victoria\" id=\"select-3-field-2-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Victoria<\/label><label for=\"select-3-field-3-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-caleta\" id=\"select-3-field-3-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Caleta<\/label><label for=\"select-3-field-4-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-viejo\" id=\"select-3-field-4-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato Viejo<\/label><label for=\"select-3-field-5-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"palmarejo-villa-linda\" id=\"select-3-field-5-6a32cbf6f3341\" data-calculation=\"0\"  \/>Palmarejo \u2013 Villa Linda<\/label><label for=\"select-3-field-6-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pantoja\" id=\"select-3-field-6-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pantoja<\/label><label for=\"select-3-field-7-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-guayiga\" id=\"select-3-field-7-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Guayiga<\/label><label for=\"select-3-field-8-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cuaba\" id=\"select-3-field-8-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Cuaba<\/label><label for=\"select-3-field-9-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"barreras\" id=\"select-3-field-9-6a32cbf6f3341\" data-calculation=\"0\"  \/>Barreras<\/label><label for=\"select-3-field-10-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"barro-arriba\" id=\"select-3-field-10-6a32cbf6f3341\" data-calculation=\"0\"  \/>Barro Arriba<\/label><label for=\"select-3-field-11-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"clavellina\" id=\"select-3-field-11-6a32cbf6f3341\" data-calculation=\"0\"  \/>Clavellina<\/label><label for=\"select-3-field-12-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"emma-balaguer-viuda-vallejo\" id=\"select-3-field-12-6a32cbf6f3341\" data-calculation=\"0\"  \/>Emma Balaguer Viuda Vallejo<\/label><label for=\"select-3-field-13-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-barasla-estancia\" id=\"select-3-field-13-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Bar\u00edas-La Estancia<\/label><label for=\"select-3-field-14-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-lomas\" id=\"select-3-field-14-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Lomas<\/label><label for=\"select-3-field-15-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"los-jovillos\" id=\"select-3-field-15-6a32cbf6f3341\" data-calculation=\"0\"  \/>Los Jovillos<\/label><label for=\"select-3-field-16-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"puerto-viejo\" id=\"select-3-field-16-6a32cbf6f3341\" data-calculation=\"0\"  \/>Puerto Viejo<\/label><label for=\"select-3-field-17-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hatillo\" id=\"select-3-field-17-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hatillo<\/label><label for=\"select-3-field-18-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"palmar-de-ocoa\" id=\"select-3-field-18-6a32cbf6f3341\" data-calculation=\"0\"  \/>Palmar de Ocoa<\/label><label for=\"select-3-field-19-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villarpando\" id=\"select-3-field-19-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villarpando<\/label><label for=\"select-3-field-20-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-nuevocorts\" id=\"select-3-field-20-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato Nuevo-Cort\u00e9s<\/label><label for=\"select-3-field-21-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-siembra\" id=\"select-3-field-21-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Siembra<\/label><label for=\"select-3-field-22-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-lagunas\" id=\"select-3-field-22-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Lagunas<\/label><label for=\"select-3-field-23-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"los-fros\" id=\"select-3-field-23-6a32cbf6f3341\" data-calculation=\"0\"  \/>Los Fr\u00edos<\/label><label for=\"select-3-field-24-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-rosario\" id=\"select-3-field-24-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Rosario<\/label><label for=\"select-3-field-25-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"proyecto-4\" id=\"select-3-field-25-6a32cbf6f3341\" data-calculation=\"0\"  \/>Proyecto 4<\/label><label for=\"select-3-field-26-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"ganadero\" id=\"select-3-field-26-6a32cbf6f3341\" data-calculation=\"0\"  \/>Ganadero<\/label><label for=\"select-3-field-27-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"proyecto-2c\" id=\"select-3-field-27-6a32cbf6f3341\" data-calculation=\"0\"  \/>Proyecto 2-C<\/label><label for=\"select-3-field-28-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"amiama-gmez\" id=\"select-3-field-28-6a32cbf6f3341\" data-calculation=\"0\"  \/>Amiama G\u00f3mez<\/label><label for=\"select-3-field-29-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"los-toros\" id=\"select-3-field-29-6a32cbf6f3341\" data-calculation=\"0\"  \/>Los Toros<\/label><label for=\"select-3-field-30-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"tbara-abajo\" id=\"select-3-field-30-6a32cbf6f3341\" data-calculation=\"0\"  \/>T\u00e1bara Abajo<\/label><label for=\"select-3-field-31-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-palmar\" id=\"select-3-field-31-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Palmar<\/label><label for=\"select-3-field-32-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-salado\" id=\"select-3-field-32-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Salado<\/label><label for=\"select-3-field-33-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-clavellinas\" id=\"select-3-field-33-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Clavellinas<\/label><label for=\"select-3-field-34-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cabeza-de-toro\" id=\"select-3-field-34-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cabeza de Toro<\/label><label for=\"select-3-field-35-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"mena\" id=\"select-3-field-35-6a32cbf6f3341\" data-calculation=\"0\"  \/>Mena<\/label><label for=\"select-3-field-36-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"monserrat\" id=\"select-3-field-36-6a32cbf6f3341\" data-calculation=\"0\"  \/>Monserrat<\/label><label for=\"select-3-field-37-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"santa-brbarael-6\" id=\"select-3-field-37-6a32cbf6f3341\" data-calculation=\"0\"  \/>Santa B\u00e1rbara-El 6<\/label><label for=\"select-3-field-38-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"santana\" id=\"select-3-field-38-6a32cbf6f3341\" data-calculation=\"0\"  \/>Santana<\/label><label for=\"select-3-field-39-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"uvilla\" id=\"select-3-field-39-6a32cbf6f3341\" data-calculation=\"0\"  \/>Uvilla<\/label><label for=\"select-3-field-40-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-cachn\" id=\"select-3-field-40-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Cach\u00f3n<\/label><label for=\"select-3-field-41-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-guzara\" id=\"select-3-field-41-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Gu\u00e1zara<\/label><label for=\"select-3-field-42-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-central\" id=\"select-3-field-42-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villa Central<\/label><label for=\"select-3-field-43-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-dulce\" id=\"select-3-field-43-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo Dulce<\/label><label for=\"select-3-field-44-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pescadera\" id=\"select-3-field-44-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pescader\u00eda<\/label><label for=\"select-3-field-45-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"palo-alto\" id=\"select-3-field-45-6a32cbf6f3341\" data-calculation=\"0\"  \/>Palo Alto<\/label><label for=\"select-3-field-46-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"bahoruco\" id=\"select-3-field-46-6a32cbf6f3341\" data-calculation=\"0\"  \/>Bahoruco<\/label><label for=\"select-3-field-47-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"los-patos\" id=\"select-3-field-47-6a32cbf6f3341\" data-calculation=\"0\"  \/>Los Patos<\/label><label for=\"select-3-field-48-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"canoa\" id=\"select-3-field-48-6a32cbf6f3341\" data-calculation=\"0\"  \/>Canoa<\/label><label for=\"select-3-field-49-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"fondo-negro\" id=\"select-3-field-49-6a32cbf6f3341\" data-calculation=\"0\"  \/>Fondo Negro<\/label><label for=\"select-3-field-50-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"quita-coraza\" id=\"select-3-field-50-6a32cbf6f3341\" data-calculation=\"0\"  \/>Quita Coraza<\/label><label for=\"select-3-field-51-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"caongo\" id=\"select-3-field-51-6a32cbf6f3341\" data-calculation=\"0\"  \/>Ca\u00f1ongo<\/label><label for=\"select-3-field-52-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"manuel-bueno\" id=\"select-3-field-52-6a32cbf6f3341\" data-calculation=\"0\"  \/>Manuel Bueno<\/label><label for=\"select-3-field-53-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"capotillo\" id=\"select-3-field-53-6a32cbf6f3341\" data-calculation=\"0\"  \/>Capotillo<\/label><label for=\"select-3-field-54-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"santiago-de-la-cruz\" id=\"select-3-field-54-6a32cbf6f3341\" data-calculation=\"0\"  \/>Santiago de la Cruz<\/label><label for=\"select-3-field-55-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cenov\" id=\"select-3-field-55-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cenov\u00ed<\/label><label for=\"select-3-field-56-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jaya\" id=\"select-3-field-56-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jaya<\/label><label for=\"select-3-field-57-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-pea\" id=\"select-3-field-57-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Pe\u00f1a<\/label><label for=\"select-3-field-58-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"presidente-don-antonio-guzmn-fernndez\" id=\"select-3-field-58-6a32cbf6f3341\" data-calculation=\"0\"  \/>Presidente Don Antonio Guzm\u00e1n Fern\u00e1ndez<\/label><label for=\"select-3-field-59-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"aguacate\" id=\"select-3-field-59-6a32cbf6f3341\" data-calculation=\"0\"  \/>Aguacate<\/label><label for=\"select-3-field-60-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-coles\" id=\"select-3-field-60-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Coles<\/label><label for=\"select-3-field-61-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-grande\" id=\"select-3-field-61-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Grande<\/label><label for=\"select-3-field-62-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"agua-santa-del-yuna\" id=\"select-3-field-62-6a32cbf6f3341\" data-calculation=\"0\"  \/>Agua Santa del Yuna<\/label><label for=\"select-3-field-63-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"barraquito\" id=\"select-3-field-63-6a32cbf6f3341\" data-calculation=\"0\"  \/>Barraquito<\/label><label for=\"select-3-field-64-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cristo-rey-de-guaraguao\" id=\"select-3-field-64-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cristo Rey de Guaraguao<\/label><label for=\"select-3-field-65-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-tranas\" id=\"select-3-field-65-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las T\u00e1ranas<\/label><label for=\"select-3-field-66-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guayabo\" id=\"select-3-field-66-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guayabo<\/label><label for=\"select-3-field-67-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-larga\" id=\"select-3-field-67-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Larga<\/label><label for=\"select-3-field-68-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-cruz\" id=\"select-3-field-68-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Cruz<\/label><label for=\"select-3-field-69-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-higero\" id=\"select-3-field-69-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Hig\u00fcero<\/label><label for=\"select-3-field-70-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guanito\" id=\"select-3-field-70-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guanito<\/label><label for=\"select-3-field-71-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"rancho-de-la-guardia\" id=\"select-3-field-71-6a32cbf6f3341\" data-calculation=\"0\"  \/>Rancho de la Guardia<\/label><label for=\"select-3-field-72-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"ro-limpio\" id=\"select-3-field-72-6a32cbf6f3341\" data-calculation=\"0\"  \/>R\u00edo Limpio<\/label><label for=\"select-3-field-73-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pedro-snchez\" id=\"select-3-field-73-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pedro S\u00e1nchez<\/label><label for=\"select-3-field-74-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-franciscovicentillo\" id=\"select-3-field-74-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Francisco-Vicentillo<\/label><label for=\"select-3-field-75-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"santa-luca\" id=\"select-3-field-75-6a32cbf6f3341\" data-calculation=\"0\"  \/>Santa Luc\u00eda<\/label><label for=\"select-3-field-76-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-cedro\" id=\"select-3-field-76-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Cedro<\/label><label for=\"select-3-field-77-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-gina\" id=\"select-3-field-77-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Gina<\/label><label for=\"select-3-field-78-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"canca-la-reina\" id=\"select-3-field-78-6a32cbf6f3341\" data-calculation=\"0\"  \/>Canca La Reina<\/label><label for=\"select-3-field-79-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-higerito\" id=\"select-3-field-79-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Hig\u00fcerito<\/label><label for=\"select-3-field-80-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jos-contreras\" id=\"select-3-field-80-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jos\u00e9 Contreras<\/label><label for=\"select-3-field-81-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"juan-lpez\" id=\"select-3-field-81-6a32cbf6f3341\" data-calculation=\"0\"  \/>Juan L\u00f3pez<\/label><label for=\"select-3-field-82-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-ortega\" id=\"select-3-field-82-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Ortega<\/label><label for=\"select-3-field-83-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-lagunas\" id=\"select-3-field-83-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Lagunas<\/label><label for=\"select-3-field-84-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"monte-de-la-jagua\" id=\"select-3-field-84-6a32cbf6f3341\" data-calculation=\"0\"  \/>Monte de la Jagua<\/label><label for=\"select-3-field-85-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-vctor\" id=\"select-3-field-85-6a32cbf6f3341\" data-calculation=\"0\"  \/>San V\u00edctor<\/label><label for=\"select-3-field-86-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"joba-arriba\" id=\"select-3-field-86-6a32cbf6f3341\" data-calculation=\"0\"  \/>Joba Arriba<\/label><label for=\"select-3-field-87-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"veragua\" id=\"select-3-field-87-6a32cbf6f3341\" data-calculation=\"0\"  \/>Veragua<\/label><label for=\"select-3-field-88-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-magante\" id=\"select-3-field-88-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villa Magante<\/label><label for=\"select-3-field-89-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guayabo-dulce\" id=\"select-3-field-89-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guayabo Dulce<\/label><label for=\"select-3-field-90-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"mata-palacio\" id=\"select-3-field-90-6a32cbf6f3341\" data-calculation=\"0\"  \/>Mata Palacio<\/label><label for=\"select-3-field-91-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"yerba-buena\" id=\"select-3-field-91-6a32cbf6f3341\" data-calculation=\"0\"  \/>Yerba Buena<\/label><label for=\"select-3-field-92-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"elupina-cordero-de-las-caitas\" id=\"select-3-field-92-6a32cbf6f3341\" data-calculation=\"0\"  \/>Elupina Cordero de Las Ca\u00f1itas<\/label><label for=\"select-3-field-93-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jamao-afuera\" id=\"select-3-field-93-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jamao Afuera<\/label><label for=\"select-3-field-94-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"blanco\" id=\"select-3-field-94-6a32cbf6f3341\" data-calculation=\"0\"  \/>Blanco<\/label><label for=\"select-3-field-95-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"boca-de-cachn\" id=\"select-3-field-95-6a32cbf6f3341\" data-calculation=\"0\"  \/>Boca de Cach\u00f3n<\/label><label for=\"select-3-field-96-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-limn\" id=\"select-3-field-96-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Lim\u00f3n<\/label><label for=\"select-3-field-97-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"batey-8\" id=\"select-3-field-97-6a32cbf6f3341\" data-calculation=\"0\"  \/>Batey 8<\/label><label for=\"select-3-field-98-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"vengan-a-ver\" id=\"select-3-field-98-6a32cbf6f3341\" data-calculation=\"0\"  \/>Vengan a Ver<\/label><label for=\"select-3-field-99-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-colonia\" id=\"select-3-field-99-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Colonia<\/label><label for=\"select-3-field-100-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guayabal\" id=\"select-3-field-100-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guayabal<\/label><label for=\"select-3-field-101-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-otra-banda\" id=\"select-3-field-101-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Otra Banda<\/label><label for=\"select-3-field-102-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"lagunas-de-nisibn\" id=\"select-3-field-102-6a32cbf6f3341\" data-calculation=\"0\"  \/>Lagunas de Nisib\u00f3n<\/label><label for=\"select-3-field-103-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"vernpunta-cana\" id=\"select-3-field-103-6a32cbf6f3341\" data-calculation=\"0\"  \/>Ver\u00f3n-Punta Cana<\/label><label for=\"select-3-field-104-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"bayahibe\" id=\"select-3-field-104-6a32cbf6f3341\" data-calculation=\"0\"  \/>Bayahibe<\/label><label for=\"select-3-field-105-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"boca-de-yuma\" id=\"select-3-field-105-6a32cbf6f3341\" data-calculation=\"0\"  \/>Boca de Yuma<\/label><label for=\"select-3-field-106-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"caleta\" id=\"select-3-field-106-6a32cbf6f3341\" data-calculation=\"0\"  \/>Caleta<\/label><label for=\"select-3-field-107-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cumayasa\" id=\"select-3-field-107-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cumayasa<\/label><label for=\"select-3-field-108-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-ranchito\" id=\"select-3-field-108-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Ranchito<\/label><label for=\"select-3-field-109-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"ro-verde-arriba\" id=\"select-3-field-109-6a32cbf6f3341\" data-calculation=\"0\"  \/>R\u00edo Verde Arriba<\/label><label for=\"select-3-field-110-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-sabina\" id=\"select-3-field-110-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Sabina<\/label><label for=\"select-3-field-111-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"tireo\" id=\"select-3-field-111-6a32cbf6f3341\" data-calculation=\"0\"  \/>Tireo<\/label><label for=\"select-3-field-112-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"buena-vista\" id=\"select-3-field-112-6a32cbf6f3341\" data-calculation=\"0\"  \/>Buena Vista<\/label><label for=\"select-3-field-113-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"manabao\" id=\"select-3-field-113-6a32cbf6f3341\" data-calculation=\"0\"  \/>Manabao<\/label><label for=\"select-3-field-114-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"rincn\" id=\"select-3-field-114-6a32cbf6f3341\" data-calculation=\"0\"  \/>Rinc\u00f3n<\/label><label for=\"select-3-field-115-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-al-medio\" id=\"select-3-field-115-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo al Medio<\/label><label for=\"select-3-field-116-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-gordas\" id=\"select-3-field-116-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Gordas<\/label><label for=\"select-3-field-117-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-jos-de-matanzas\" id=\"select-3-field-117-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Jos\u00e9 de Matanzas<\/label><label for=\"select-3-field-118-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-salado\" id=\"select-3-field-118-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo Salado<\/label><label for=\"select-3-field-119-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-entrada\" id=\"select-3-field-119-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Entrada<\/label><label for=\"select-3-field-120-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-pozo\" id=\"select-3-field-120-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Pozo<\/label><label for=\"select-3-field-121-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-toromasipedro\" id=\"select-3-field-121-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo Toro-Masipedro<\/label><label for=\"select-3-field-122-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-salvialos-quemados\" id=\"select-3-field-122-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Salvia-Los Quemados<\/label><label for=\"select-3-field-123-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jayaco\" id=\"select-3-field-123-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jayaco<\/label><label for=\"select-3-field-124-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"juma-bejucal\" id=\"select-3-field-124-6a32cbf6f3341\" data-calculation=\"0\"  \/>Juma Bejucal<\/label><label for=\"select-3-field-125-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-del-puerto\" id=\"select-3-field-125-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana del Puerto<\/label><label for=\"select-3-field-126-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"juan-adrin\" id=\"select-3-field-126-6a32cbf6f3341\" data-calculation=\"0\"  \/>Juan Adri\u00e1n<\/label><label for=\"select-3-field-127-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-sonador\" id=\"select-3-field-127-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villa Sonador<\/label><label for=\"select-3-field-128-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"palo-verde\" id=\"select-3-field-128-6a32cbf6f3341\" data-calculation=\"0\"  \/>Palo Verde<\/label><label for=\"select-3-field-129-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cana-chapetn\" id=\"select-3-field-129-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cana Chapet\u00f3n<\/label><label for=\"select-3-field-130-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hatillo-palma\" id=\"select-3-field-130-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hatillo Palma<\/label><label for=\"select-3-field-131-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-elisa\" id=\"select-3-field-131-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villa Elisa<\/label><label for=\"select-3-field-132-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"boy\" id=\"select-3-field-132-6a32cbf6f3341\" data-calculation=\"0\"  \/>Boy\u00e1<\/label><label for=\"select-3-field-133-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"chirino\" id=\"select-3-field-133-6a32cbf6f3341\" data-calculation=\"0\"  \/>Chirino<\/label><label for=\"select-3-field-134-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"don-juan\" id=\"select-3-field-134-6a32cbf6f3341\" data-calculation=\"0\"  \/>Don Juan<\/label><label for=\"select-3-field-135-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"gonzalo\" id=\"select-3-field-135-6a32cbf6f3341\" data-calculation=\"0\"  \/>Gonzalo<\/label><label for=\"select-3-field-136-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"majagual\" id=\"select-3-field-136-6a32cbf6f3341\" data-calculation=\"0\"  \/>Majagual<\/label><label for=\"select-3-field-137-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"los-botados\" id=\"select-3-field-137-6a32cbf6f3341\" data-calculation=\"0\"  \/>Los Botados<\/label><label for=\"select-3-field-138-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jos-francisco-pea-gmez\" id=\"select-3-field-138-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jos\u00e9 Francisco Pe\u00f1a G\u00f3mez<\/label><label for=\"select-3-field-139-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"juancho\" id=\"select-3-field-139-6a32cbf6f3341\" data-calculation=\"0\"  \/>Juancho<\/label><label for=\"select-3-field-140-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"catalina\" id=\"select-3-field-140-6a32cbf6f3341\" data-calculation=\"0\"  \/>Catalina<\/label><label for=\"select-3-field-141-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-carretn\" id=\"select-3-field-141-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Carret\u00f3n<\/label><label for=\"select-3-field-142-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-limonal\" id=\"select-3-field-142-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Limonal<\/label><label for=\"select-3-field-143-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-baras\" id=\"select-3-field-143-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Bar\u00edas<\/label><label for=\"select-3-field-144-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"matanzas\" id=\"select-3-field-144-6a32cbf6f3341\" data-calculation=\"0\"  \/>Matanzas<\/label><label for=\"select-3-field-145-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"paya\" id=\"select-3-field-145-6a32cbf6f3341\" data-calculation=\"0\"  \/>Paya<\/label><label for=\"select-3-field-146-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-buey\" id=\"select-3-field-146-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Buey<\/label><label for=\"select-3-field-147-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-fundacin\" id=\"select-3-field-147-6a32cbf6f3341\" data-calculation=\"0\"  \/>Villa Fundaci\u00f3n<\/label><label for=\"select-3-field-148-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"villa-sombrero\" id=\"select-3-field-148-6a32cbf6f3341\" data-calculation=\"0\"  \/> Villa Sombrero<\/label><label for=\"select-3-field-149-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pizarrete\" id=\"select-3-field-149-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pizarrete<\/label><label for=\"select-3-field-150-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"santana\" id=\"select-3-field-150-6a32cbf6f3341\" data-calculation=\"0\"  \/>Santana<\/label><label for=\"select-3-field-151-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"maimn\" id=\"select-3-field-151-6a32cbf6f3341\" data-calculation=\"0\"  \/>Maim\u00f3n<\/label><label for=\"select-3-field-152-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"ysica-arriba\" id=\"select-3-field-152-6a32cbf6f3341\" data-calculation=\"0\"  \/>Y\u00e1sica Arriba<\/label><label for=\"select-3-field-153-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"ro-grande\" id=\"select-3-field-153-6a32cbf6f3341\" data-calculation=\"0\"  \/>R\u00edo Grande<\/label><label for=\"select-3-field-154-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"navas\" id=\"select-3-field-154-6a32cbf6f3341\" data-calculation=\"0\"  \/>Navas<\/label><label for=\"select-3-field-155-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"belloso\" id=\"select-3-field-155-6a32cbf6f3341\" data-calculation=\"0\"  \/>Belloso<\/label><label for=\"select-3-field-156-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"estrecho\" id=\"select-3-field-156-6a32cbf6f3341\" data-calculation=\"0\"  \/>Estrecho<\/label><label for=\"select-3-field-157-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-isabela\" id=\"select-3-field-157-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Isabela<\/label><label for=\"select-3-field-158-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cabarete\" id=\"select-3-field-158-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cabarete<\/label><label for=\"select-3-field-159-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabaneta-de-ysica\" id=\"select-3-field-159-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabaneta de Y\u00e1sica<\/label><label for=\"select-3-field-160-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"estero-hondo\" id=\"select-3-field-160-6a32cbf6f3341\" data-calculation=\"0\"  \/>Estero Hondo<\/label><label for=\"select-3-field-161-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"gualete\" id=\"select-3-field-161-6a32cbf6f3341\" data-calculation=\"0\"  \/>Gualete<\/label><label for=\"select-3-field-162-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-jaiba\" id=\"select-3-field-162-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Jaiba<\/label><label for=\"select-3-field-163-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-barril\" id=\"select-3-field-163-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo Barril<\/label><label for=\"select-3-field-164-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-limn\" id=\"select-3-field-164-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Lim\u00f3n<\/label><label for=\"select-3-field-165-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-galeras\" id=\"select-3-field-165-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Galeras<\/label><label for=\"select-3-field-166-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-damas\" id=\"select-3-field-166-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato Damas<\/label><label for=\"select-3-field-167-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-carril\" id=\"select-3-field-167-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Carril<\/label><label for=\"select-3-field-168-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cambita-el-pueblecito\" id=\"select-3-field-168-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cambita El Pueblecito<\/label><label for=\"select-3-field-169-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cuchilla\" id=\"select-3-field-169-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Cuchilla<\/label><label for=\"select-3-field-170-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"medina\" id=\"select-3-field-170-6a32cbf6f3341\" data-calculation=\"0\"  \/>Medina<\/label><label for=\"select-3-field-171-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-jos-del-puerto\" id=\"select-3-field-171-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Jos\u00e9 del Puerto<\/label><label for=\"select-3-field-172-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-naranjal\" id=\"select-3-field-172-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Naranjal<\/label><label for=\"select-3-field-173-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-pinar\" id=\"select-3-field-173-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Pinar<\/label><label for=\"select-3-field-174-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cinaga\" id=\"select-3-field-174-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Ci\u00e9naga<\/label><label for=\"select-3-field-175-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"nizaolas-auyamas\" id=\"select-3-field-175-6a32cbf6f3341\" data-calculation=\"0\"  \/>Nizao-Las Auyamas<\/label><label for=\"select-3-field-176-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-rosario\" id=\"select-3-field-176-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Rosario<\/label><label for=\"select-3-field-177-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guanito\" id=\"select-3-field-177-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guanito<\/label><label for=\"select-3-field-178-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-del-padre\" id=\"select-3-field-178-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato del Padre<\/label><label for=\"select-3-field-179-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-nuevo\" id=\"select-3-field-179-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato Nuevo<\/label><label for=\"select-3-field-180-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-jagua\" id=\"select-3-field-180-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Jagua<\/label><label for=\"select-3-field-181-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-charcas-de-mara-nova\" id=\"select-3-field-181-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Charcas de Mar\u00eda Nova<\/label><label for=\"select-3-field-182-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pedro-corto\" id=\"select-3-field-182-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pedro Corto<\/label><label for=\"select-3-field-183-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabana-alta\" id=\"select-3-field-183-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabana Alta<\/label><label for=\"select-3-field-184-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"sabaneta\" id=\"select-3-field-184-6a32cbf6f3341\" data-calculation=\"0\"  \/>Sabaneta<\/label><label for=\"select-3-field-185-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"arroyo-cano\" id=\"select-3-field-185-6a32cbf6f3341\" data-calculation=\"0\"  \/>Arroyo Cano<\/label><label for=\"select-3-field-186-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"yaque\" id=\"select-3-field-186-6a32cbf6f3341\" data-calculation=\"0\"  \/>Yaque<\/label><label for=\"select-3-field-187-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"batista\" id=\"select-3-field-187-6a32cbf6f3341\" data-calculation=\"0\"  \/>Batista<\/label><label for=\"select-3-field-188-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"derrumbadero\" id=\"select-3-field-188-6a32cbf6f3341\" data-calculation=\"0\"  \/>Derrumbadero<\/label><label for=\"select-3-field-189-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jnova\" id=\"select-3-field-189-6a32cbf6f3341\" data-calculation=\"0\"  \/>J\u00ednova<\/label><label for=\"select-3-field-190-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"carrera-de-yegua\" id=\"select-3-field-190-6a32cbf6f3341\" data-calculation=\"0\"  \/>Carrera de Yegua<\/label><label for=\"select-3-field-191-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"matayaya\" id=\"select-3-field-191-6a32cbf6f3341\" data-calculation=\"0\"  \/>Matayaya<\/label><label for=\"select-3-field-192-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jorjillo\" id=\"select-3-field-192-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jorjillo<\/label><label for=\"select-3-field-193-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-puerto\" id=\"select-3-field-193-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Puerto<\/label><label for=\"select-3-field-194-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"gautier\" id=\"select-3-field-194-6a32cbf6f3341\" data-calculation=\"0\"  \/>Gautier<\/label><label for=\"select-3-field-195-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"caballero\" id=\"select-3-field-195-6a32cbf6f3341\" data-calculation=\"0\"  \/>Caballero<\/label><label for=\"select-3-field-196-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"comedero-arriba\" id=\"select-3-field-196-6a32cbf6f3341\" data-calculation=\"0\"  \/>Comedero Arriba<\/label><label for=\"select-3-field-197-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"quita-sueo\" id=\"select-3-field-197-6a32cbf6f3341\" data-calculation=\"0\"  \/>Quita Sue\u00f1o<\/label><label for=\"select-3-field-198-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cueva\" id=\"select-3-field-198-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Cueva<\/label><label for=\"select-3-field-199-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"platanal\" id=\"select-3-field-199-6a32cbf6f3341\" data-calculation=\"0\"  \/>Platanal<\/label><label for=\"select-3-field-200-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"angelina\" id=\"select-3-field-200-6a32cbf6f3341\" data-calculation=\"0\"  \/>Angelina<\/label><label for=\"select-3-field-201-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-bija\" id=\"select-3-field-201-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Bija<\/label><label for=\"select-3-field-202-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hernando-alonzo\" id=\"select-3-field-202-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hernando Alonzo<\/label><label for=\"select-3-field-203-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"baitoa\" id=\"select-3-field-203-6a32cbf6f3341\" data-calculation=\"0\"  \/>Baitoa<\/label><label for=\"select-3-field-204-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-del-yaque\" id=\"select-3-field-204-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato del Yaque<\/label><label for=\"select-3-field-205-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-canela\" id=\"select-3-field-205-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Canela<\/label><label for=\"select-3-field-206-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pedro-garca\" id=\"select-3-field-206-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pedro Garc\u00eda<\/label><label for=\"select-3-field-207-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-francisco-de-jacagua\" id=\"select-3-field-207-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Francisco de Jacagua<\/label><label for=\"select-3-field-208-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-caimito\" id=\"select-3-field-208-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Caimito<\/label><label for=\"select-3-field-209-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"juncalito\" id=\"select-3-field-209-6a32cbf6f3341\" data-calculation=\"0\"  \/>Juncalito<\/label><label for=\"select-3-field-210-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-palomas\" id=\"select-3-field-210-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Palomas<\/label><label for=\"select-3-field-211-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"canabacoa\" id=\"select-3-field-211-6a32cbf6f3341\" data-calculation=\"0\"  \/>Canabacoa<\/label><label for=\"select-3-field-212-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guayabal\" id=\"select-3-field-212-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guayabal<\/label><label for=\"select-3-field-213-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-rubio\" id=\"select-3-field-213-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Rubio<\/label><label for=\"select-3-field-214-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cuesta\" id=\"select-3-field-214-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Cuesta<\/label><label for=\"select-3-field-215-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"las-placetas\" id=\"select-3-field-215-6a32cbf6f3341\" data-calculation=\"0\"  \/>Las Placetas<\/label><label for=\"select-3-field-216-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"canca-la-piedra\" id=\"select-3-field-216-6a32cbf6f3341\" data-calculation=\"0\"  \/>Canca La Piedra<\/label><label for=\"select-3-field-217-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"el-limn\" id=\"select-3-field-217-6a32cbf6f3341\" data-calculation=\"0\"  \/>El Lim\u00f3n<\/label><label for=\"select-3-field-218-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"san-luis\" id=\"select-3-field-218-6a32cbf6f3341\" data-calculation=\"0\"  \/>San Luis<\/label><label for=\"select-3-field-219-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-caleta\" id=\"select-3-field-219-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Caleta<\/label><label for=\"select-3-field-220-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"palmarejovilla-linda\" id=\"select-3-field-220-6a32cbf6f3341\" data-calculation=\"0\"  \/>Palmarejo-Villa Linda<\/label><label for=\"select-3-field-221-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"pantoja\" id=\"select-3-field-221-6a32cbf6f3341\" data-calculation=\"0\"  \/>Pantoja<\/label><label for=\"select-3-field-222-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-cuaba\" id=\"select-3-field-222-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Cuaba<\/label><label for=\"select-3-field-223-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-guyiga\" id=\"select-3-field-223-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Gu\u00e1yiga<\/label><label for=\"select-3-field-224-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"hato-viejo\" id=\"select-3-field-224-6a32cbf6f3341\" data-calculation=\"0\"  \/>Hato Viejo<\/label><label for=\"select-3-field-225-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-victoria\" id=\"select-3-field-225-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Victoria<\/label><label for=\"select-3-field-226-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"mina\" id=\"select-3-field-226-6a32cbf6f3341\" data-calculation=\"0\"  \/>\u00c1mina<\/label><label for=\"select-3-field-227-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"guatapanal\" id=\"select-3-field-227-6a32cbf6f3341\" data-calculation=\"0\"  \/>Guatapanal<\/label><label for=\"select-3-field-228-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jaibn-pueblo-nuevo\" id=\"select-3-field-228-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jaib\u00f3n (Pueblo Nuevo)<\/label><label for=\"select-3-field-229-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"boca-de-mao\" id=\"select-3-field-229-6a32cbf6f3341\" data-calculation=\"0\"  \/>Boca de Mao<\/label><label for=\"select-3-field-230-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jicom\" id=\"select-3-field-230-6a32cbf6f3341\" data-calculation=\"0\"  \/>Jicom\u00e9<\/label><label for=\"select-3-field-231-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"maizal\" id=\"select-3-field-231-6a32cbf6f3341\" data-calculation=\"0\"  \/>Maizal<\/label><label for=\"select-3-field-232-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"paradero\" id=\"select-3-field-232-6a32cbf6f3341\" data-calculation=\"0\"  \/>Paradero<\/label><label for=\"select-3-field-233-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"cruce-de-guayacanes\" id=\"select-3-field-233-6a32cbf6f3341\" data-calculation=\"0\"  \/>Cruce de Guayacanes<\/label><label for=\"select-3-field-234-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"jaibn\" id=\"select-3-field-234-6a32cbf6f3341\" data-calculation=\"0\"  \/> Jaib\u00f3n<\/label><label for=\"select-3-field-235-6a32cbf6f3341\" class=\"forminator-option\"><input type=\"checkbox\" name=\"select-3[]\" value=\"la-caya\" id=\"select-3-field-235-6a32cbf6f3341\" data-calculation=\"0\"  \/>La Caya<\/label><input type='hidden' name='select-3-multiselect-default-values' class='multiselect-default-values' value='{\"0\":\"san-luis\"}' \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"address-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-row\" data-multiple=\"true\"><div class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"forminator-field-zip-address-2\" class=\"forminator-label\">C\u00f3digo Postal<\/label><input type=\"text\" name=\"address-2-zip\" placeholder=\"\" id=\"forminator-field-zip-address-2\" class=\"forminator-input\" value=\"\" \/><\/div><\/div><div class=\"forminator-col forminator-col-6\"><div class=\"forminator-field\"><label for=\"address-2-country\" class=\"forminator-label\">Pa\u00eds <\/label><select name=\"address-2-country\" id=\"address-2-country\" class=\"forminator-select\" data-default-value=\"Dominican Republic\"><option value=\"\" data-country-code=\"\" selected=\"selected\">Select country<\/option><option value=\"Afghanistan\" data-country-code=\"AF\" >Afghanistan<\/option><option value=\"Albania\" data-country-code=\"AL\" >Albania<\/option><option value=\"Algeria\" data-country-code=\"DZ\" >Algeria<\/option><option value=\"American Samoa\" data-country-code=\"AS\" >American Samoa<\/option><option value=\"Andorra\" data-country-code=\"AD\" >Andorra<\/option><option value=\"Angola\" data-country-code=\"AO\" >Angola<\/option><option value=\"Anguilla\" data-country-code=\"AI\" >Anguilla<\/option><option value=\"Antarctica\" data-country-code=\"AQ\" >Antarctica<\/option><option value=\"Antigua and Barbuda\" data-country-code=\"AG\" >Antigua and Barbuda<\/option><option value=\"Argentina\" data-country-code=\"AR\" >Argentina<\/option><option value=\"Armenia\" data-country-code=\"AM\" >Armenia<\/option><option value=\"Aruba\" data-country-code=\"AW\" >Aruba<\/option><option value=\"Australia\" data-country-code=\"AU\" >Australia<\/option><option value=\"Austria\" data-country-code=\"AT\" >Austria<\/option><option value=\"Azerbaijan\" data-country-code=\"AZ\" >Azerbaijan<\/option><option value=\"Bahamas\" data-country-code=\"BS\" >Bahamas<\/option><option value=\"Bahrain\" data-country-code=\"BH\" >Bahrain<\/option><option value=\"Bangladesh\" data-country-code=\"BD\" >Bangladesh<\/option><option value=\"Barbados\" data-country-code=\"BB\" >Barbados<\/option><option value=\"Belarus\" data-country-code=\"BY\" >Belarus<\/option><option value=\"Belgium\" data-country-code=\"BE\" >Belgium<\/option><option value=\"Belize\" data-country-code=\"BZ\" >Belize<\/option><option value=\"Benin\" data-country-code=\"BJ\" >Benin<\/option><option value=\"Bermuda\" data-country-code=\"BM\" >Bermuda<\/option><option value=\"Bhutan\" data-country-code=\"BT\" >Bhutan<\/option><option value=\"Bolivia\" data-country-code=\"BO\" >Bolivia<\/option><option value=\"Bosnia and Herzegovina\" data-country-code=\"BA\" >Bosnia and Herzegovina<\/option><option value=\"Botswana\" data-country-code=\"BW\" >Botswana<\/option><option value=\"Bouvet Island\" data-country-code=\"BV\" >Bouvet Island<\/option><option value=\"Brazil\" data-country-code=\"BR\" >Brazil<\/option><option value=\"British Indian Ocean Territory\" data-country-code=\"IO\" >British Indian Ocean Territory<\/option><option value=\"Brunei\" data-country-code=\"BN\" >Brunei<\/option><option value=\"Bulgaria\" data-country-code=\"BG\" >Bulgaria<\/option><option value=\"Burkina Faso\" data-country-code=\"BF\" >Burkina Faso<\/option><option value=\"Burundi\" data-country-code=\"BI\" >Burundi<\/option><option value=\"Cambodia\" data-country-code=\"KH\" >Cambodia<\/option><option value=\"Cameroon\" data-country-code=\"CM\" >Cameroon<\/option><option value=\"Canada\" data-country-code=\"CA\" >Canada<\/option><option value=\"Cape Verde\" data-country-code=\"CV\" >Cape Verde<\/option><option value=\"Cayman Islands\" data-country-code=\"KY\" >Cayman Islands<\/option><option value=\"Central African Republic\" data-country-code=\"CF\" >Central African Republic<\/option><option value=\"Chad\" data-country-code=\"TD\" >Chad<\/option><option value=\"Chile\" data-country-code=\"CL\" >Chile<\/option><option value=\"China, People&#039;s Republic of\" data-country-code=\"CN\" >China, People&#039;s Republic of<\/option><option value=\"Christmas Island\" data-country-code=\"CX\" >Christmas Island<\/option><option value=\"Cocos Islands\" data-country-code=\"CC\" >Cocos Islands<\/option><option value=\"Colombia\" data-country-code=\"CO\" >Colombia<\/option><option value=\"Comoros\" data-country-code=\"KM\" >Comoros<\/option><option value=\"Congo, Democratic Republic of the\" data-country-code=\"CD\" >Congo, Democratic Republic of the<\/option><option value=\"Congo, Republic of the\" data-country-code=\"CG\" >Congo, Republic of the<\/option><option value=\"Cook Islands\" data-country-code=\"CK\" >Cook Islands<\/option><option value=\"Costa Rica\" data-country-code=\"CR\" >Costa Rica<\/option><option value=\"Croatia\" data-country-code=\"HR\" >Croatia<\/option><option value=\"Cuba\" data-country-code=\"CU\" >Cuba<\/option><option value=\"Cura\u00e7ao\" data-country-code=\"CW\" >Cura\u00e7ao<\/option><option value=\"Cyprus\" data-country-code=\"CY\" >Cyprus<\/option><option value=\"Czech Republic\" data-country-code=\"CZ\" >Czech Republic<\/option><option value=\"C\u00f4te d&#039;Ivoire\" data-country-code=\"CI\" >C\u00f4te d&#039;Ivoire<\/option><option value=\"Denmark\" data-country-code=\"DK\" >Denmark<\/option><option value=\"Djibouti\" data-country-code=\"DJ\" >Djibouti<\/option><option value=\"Dominica\" data-country-code=\"DM\" >Dominica<\/option><option value=\"Dominican Republic\" data-country-code=\"DO\" selected=\"selected\">Dominican Republic<\/option><option value=\"East Timor\" data-country-code=\"TL\" >East Timor<\/option><option value=\"Ecuador\" data-country-code=\"EC\" >Ecuador<\/option><option value=\"Egypt\" data-country-code=\"EG\" >Egypt<\/option><option value=\"El Salvador\" data-country-code=\"SV\" >El Salvador<\/option><option value=\"Equatorial Guinea\" data-country-code=\"GQ\" >Equatorial Guinea<\/option><option value=\"Eritrea\" data-country-code=\"ER\" >Eritrea<\/option><option value=\"Estonia\" data-country-code=\"EE\" >Estonia<\/option><option value=\"Ethiopia\" data-country-code=\"ET\" >Ethiopia<\/option><option value=\"Falkland Islands\" data-country-code=\"FK\" >Falkland Islands<\/option><option value=\"Faroe Islands\" data-country-code=\"FO\" >Faroe Islands<\/option><option value=\"Fiji\" data-country-code=\"FJ\" >Fiji<\/option><option value=\"Finland\" data-country-code=\"FI\" >Finland<\/option><option value=\"France\" data-country-code=\"FR\" >France<\/option><option value=\"France, Metropolitan\" data-country-code=\"FX\" >France, Metropolitan<\/option><option value=\"French Guiana\" data-country-code=\"GF\" >French Guiana<\/option><option value=\"French Polynesia\" data-country-code=\"PF\" >French Polynesia<\/option><option value=\"French South Territories\" data-country-code=\"TF\" >French South Territories<\/option><option value=\"Gabon\" data-country-code=\"GA\" >Gabon<\/option><option value=\"Gambia\" data-country-code=\"GM\" >Gambia<\/option><option value=\"Georgia\" data-country-code=\"GE\" >Georgia<\/option><option value=\"Germany\" data-country-code=\"DE\" >Germany<\/option><option value=\"Ghana\" data-country-code=\"GH\" >Ghana<\/option><option value=\"Gibraltar\" data-country-code=\"GI\" >Gibraltar<\/option><option value=\"Greece\" data-country-code=\"GR\" >Greece<\/option><option value=\"Greenland\" data-country-code=\"GL\" >Greenland<\/option><option value=\"Grenada\" data-country-code=\"GD\" >Grenada<\/option><option value=\"Guadeloupe\" data-country-code=\"GP\" >Guadeloupe<\/option><option value=\"Guam\" data-country-code=\"GU\" >Guam<\/option><option value=\"Guatemala\" data-country-code=\"GT\" >Guatemala<\/option><option value=\"Guinea\" data-country-code=\"GN\" >Guinea<\/option><option value=\"Guinea-Bissau\" data-country-code=\"GW\" >Guinea-Bissau<\/option><option value=\"Guyana\" data-country-code=\"GY\" >Guyana<\/option><option value=\"Haiti\" data-country-code=\"HT\" >Haiti<\/option><option value=\"Heard Island And Mcdonald Island\" data-country-code=\"HM\" >Heard Island And Mcdonald Island<\/option><option value=\"Honduras\" data-country-code=\"HN\" >Honduras<\/option><option value=\"Hong Kong\" data-country-code=\"HK\" >Hong Kong<\/option><option value=\"Hungary\" data-country-code=\"HU\" >Hungary<\/option><option value=\"Iceland\" data-country-code=\"IS\" >Iceland<\/option><option value=\"India\" data-country-code=\"IN\" >India<\/option><option value=\"Indonesia\" data-country-code=\"ID\" >Indonesia<\/option><option value=\"Iran\" data-country-code=\"IR\" >Iran<\/option><option value=\"Iraq\" data-country-code=\"IQ\" >Iraq<\/option><option value=\"Ireland\" data-country-code=\"IE\" >Ireland<\/option><option value=\"Israel\" data-country-code=\"IL\" >Israel<\/option><option value=\"Italy\" data-country-code=\"IT\" >Italy<\/option><option value=\"Jamaica\" data-country-code=\"JM\" >Jamaica<\/option><option value=\"Japan\" data-country-code=\"JP\" >Japan<\/option><option value=\"Johnston Island\" data-country-code=\"JT\" >Johnston Island<\/option><option value=\"Jordan\" data-country-code=\"JO\" >Jordan<\/option><option value=\"Kazakhstan\" data-country-code=\"KZ\" >Kazakhstan<\/option><option value=\"Kenya\" data-country-code=\"KE\" >Kenya<\/option><option value=\"Kiribati\" data-country-code=\"KI\" >Kiribati<\/option><option value=\"Korea, Democratic People&#039;s Republic of\" data-country-code=\"KP\" >Korea, Democratic People&#039;s Republic of<\/option><option value=\"Korea, Republic of\" data-country-code=\"KR\" >Korea, Republic of<\/option><option value=\"Kosovo\" data-country-code=\"XK\" >Kosovo<\/option><option value=\"Kuwait\" data-country-code=\"KW\" >Kuwait<\/option><option value=\"Kyrgyzstan\" data-country-code=\"KG\" >Kyrgyzstan<\/option><option value=\"Lao People&#039;s Democratic Republic\" data-country-code=\"LA\" >Lao People&#039;s Democratic Republic<\/option><option value=\"Latvia\" data-country-code=\"LV\" >Latvia<\/option><option value=\"Lebanon\" data-country-code=\"LB\" >Lebanon<\/option><option value=\"Lesotho\" data-country-code=\"LS\" >Lesotho<\/option><option value=\"Liberia\" data-country-code=\"LR\" >Liberia<\/option><option value=\"Libya\" data-country-code=\"LY\" >Libya<\/option><option value=\"Liechtenstein\" data-country-code=\"LI\" >Liechtenstein<\/option><option value=\"Lithuania\" data-country-code=\"LT\" >Lithuania<\/option><option value=\"Luxembourg\" data-country-code=\"LU\" >Luxembourg<\/option><option value=\"Macau\" data-country-code=\"MO\" >Macau<\/option><option value=\"Madagascar\" data-country-code=\"MG\" >Madagascar<\/option><option value=\"Malawi\" data-country-code=\"MW\" >Malawi<\/option><option value=\"Malaysia\" data-country-code=\"MY\" >Malaysia<\/option><option value=\"Maldives\" data-country-code=\"MV\" >Maldives<\/option><option value=\"Mali\" data-country-code=\"ML\" >Mali<\/option><option value=\"Malta\" data-country-code=\"MT\" >Malta<\/option><option value=\"Marshall Islands\" data-country-code=\"MH\" >Marshall Islands<\/option><option value=\"Martinique\" data-country-code=\"MQ\" >Martinique<\/option><option value=\"Mauritania\" data-country-code=\"MR\" >Mauritania<\/option><option value=\"Mauritius\" data-country-code=\"MU\" >Mauritius<\/option><option value=\"Mayotte\" data-country-code=\"YT\" >Mayotte<\/option><option value=\"Mexico\" data-country-code=\"MX\" >Mexico<\/option><option value=\"Micronesia\" data-country-code=\"FM\" >Micronesia<\/option><option value=\"Moldova\" data-country-code=\"MD\" >Moldova<\/option><option value=\"Monaco\" data-country-code=\"MC\" >Monaco<\/option><option value=\"Mongolia\" data-country-code=\"MN\" >Mongolia<\/option><option value=\"Montenegro\" data-country-code=\"ME\" >Montenegro<\/option><option value=\"Montserrat\" data-country-code=\"MS\" >Montserrat<\/option><option value=\"Morocco\" data-country-code=\"MA\" >Morocco<\/option><option value=\"Mozambique\" data-country-code=\"MZ\" >Mozambique<\/option><option value=\"Myanmar\" data-country-code=\"MM\" >Myanmar<\/option><option value=\"Namibia\" data-country-code=\"NA\" >Namibia<\/option><option value=\"Nauru\" data-country-code=\"NR\" >Nauru<\/option><option value=\"Nepal\" data-country-code=\"NP\" >Nepal<\/option><option value=\"Netherlands\" data-country-code=\"NL\" >Netherlands<\/option><option value=\"Netherlands Antilles\" data-country-code=\"AN\" >Netherlands Antilles<\/option><option value=\"New Caledonia\" data-country-code=\"NC\" >New Caledonia<\/option><option value=\"New Zealand\" data-country-code=\"NZ\" >New Zealand<\/option><option value=\"Nicaragua\" data-country-code=\"NI\" >Nicaragua<\/option><option value=\"Niger\" data-country-code=\"NE\" >Niger<\/option><option value=\"Nigeria\" data-country-code=\"NG\" >Nigeria<\/option><option value=\"Niue\" data-country-code=\"NU\" >Niue<\/option><option value=\"Norfolk Island\" data-country-code=\"NF\" >Norfolk Island<\/option><option value=\"North Macedonia\" data-country-code=\"MK\" >North Macedonia<\/option><option value=\"Northern Mariana Islands\" data-country-code=\"MP\" >Northern Mariana Islands<\/option><option value=\"Norway\" data-country-code=\"NO\" >Norway<\/option><option value=\"Oman\" data-country-code=\"OM\" >Oman<\/option><option value=\"Pakistan\" data-country-code=\"PK\" >Pakistan<\/option><option value=\"Palau\" data-country-code=\"PW\" >Palau<\/option><option value=\"Palestine, State of\" data-country-code=\"PS\" >Palestine, State of<\/option><option value=\"Panama\" data-country-code=\"PA\" >Panama<\/option><option value=\"Papua New Guinea\" data-country-code=\"PG\" >Papua New Guinea<\/option><option value=\"Paraguay\" data-country-code=\"PY\" >Paraguay<\/option><option value=\"Peru\" data-country-code=\"PE\" >Peru<\/option><option value=\"Philippines\" data-country-code=\"PH\" >Philippines<\/option><option value=\"Pitcairn Islands\" data-country-code=\"PN\" >Pitcairn Islands<\/option><option value=\"Poland\" data-country-code=\"PL\" >Poland<\/option><option value=\"Portugal\" data-country-code=\"PT\" >Portugal<\/option><option value=\"Puerto Rico\" data-country-code=\"PR\" >Puerto Rico<\/option><option value=\"Qatar\" data-country-code=\"QA\" >Qatar<\/option><option value=\"Reunion Island\" data-country-code=\"RE\" >Reunion Island<\/option><option value=\"Romania\" data-country-code=\"RO\" >Romania<\/option><option value=\"Russia\" data-country-code=\"RU\" >Russia<\/option><option value=\"Rwanda\" data-country-code=\"RW\" >Rwanda<\/option><option value=\"Saint Helena\" data-country-code=\"SH\" >Saint Helena<\/option><option value=\"Saint Kitts and Nevis\" data-country-code=\"KN\" >Saint Kitts and Nevis<\/option><option value=\"Saint Lucia\" data-country-code=\"LC\" >Saint Lucia<\/option><option value=\"Saint Pierre &amp; Miquelon\" data-country-code=\"PM\" >Saint Pierre &amp; Miquelon<\/option><option value=\"Saint Vincent and the Grenadines\" data-country-code=\"VC\" >Saint Vincent and the Grenadines<\/option><option value=\"Samoa\" data-country-code=\"WS\" >Samoa<\/option><option value=\"San Marino\" data-country-code=\"SM\" >San Marino<\/option><option value=\"Sao Tome and Principe\" data-country-code=\"ST\" >Sao Tome and Principe<\/option><option value=\"Saudi Arabia\" data-country-code=\"SA\" >Saudi Arabia<\/option><option value=\"Senegal\" data-country-code=\"SN\" >Senegal<\/option><option value=\"Serbia\" data-country-code=\"RS\" >Serbia<\/option><option value=\"Seychelles\" data-country-code=\"SC\" >Seychelles<\/option><option value=\"Sierra Leone\" data-country-code=\"SL\" >Sierra Leone<\/option><option value=\"Singapore\" data-country-code=\"SG\" >Singapore<\/option><option value=\"Sint Maarten\" data-country-code=\"MF\" >Sint Maarten<\/option><option value=\"Slovakia\" data-country-code=\"SK\" >Slovakia<\/option><option value=\"Slovenia\" data-country-code=\"SI\" >Slovenia<\/option><option value=\"Solomon Islands\" data-country-code=\"SB\" >Solomon Islands<\/option><option value=\"Somalia\" data-country-code=\"SO\" >Somalia<\/option><option value=\"South Africa\" data-country-code=\"ZA\" >South Africa<\/option><option value=\"South Georgia and South Sandwich\" data-country-code=\"GS\" >South Georgia and South Sandwich<\/option><option value=\"Spain\" data-country-code=\"ES\" >Spain<\/option><option value=\"Sri Lanka\" data-country-code=\"LK\" >Sri Lanka<\/option><option value=\"Stateless Persons\" data-country-code=\"XX\" >Stateless Persons<\/option><option value=\"Sudan\" data-country-code=\"SD\" >Sudan<\/option><option value=\"Sudan, South\" data-country-code=\"SS\" >Sudan, South<\/option><option value=\"Suriname\" data-country-code=\"SR\" >Suriname<\/option><option value=\"Svalbard and Jan Mayen\" data-country-code=\"SJ\" >Svalbard and Jan Mayen<\/option><option value=\"Swaziland\" data-country-code=\"SZ\" >Swaziland<\/option><option value=\"Sweden\" data-country-code=\"SE\" >Sweden<\/option><option value=\"Switzerland\" data-country-code=\"CH\" >Switzerland<\/option><option value=\"Syria\" data-country-code=\"SY\" >Syria<\/option><option value=\"Taiwan, Republic of China\" data-country-code=\"TW\" >Taiwan, Republic of China<\/option><option value=\"Tajikistan\" data-country-code=\"TJ\" >Tajikistan<\/option><option value=\"Tanzania\" data-country-code=\"TZ\" >Tanzania<\/option><option value=\"Thailand\" data-country-code=\"TH\" >Thailand<\/option><option value=\"Togo\" data-country-code=\"TG\" >Togo<\/option><option value=\"Tokelau\" data-country-code=\"TK\" >Tokelau<\/option><option value=\"Tonga\" data-country-code=\"TO\" >Tonga<\/option><option value=\"Trinidad and Tobago\" data-country-code=\"TT\" >Trinidad and Tobago<\/option><option value=\"Tunisia\" data-country-code=\"TN\" >Tunisia<\/option><option value=\"Turkey\" data-country-code=\"TR\" >Turkey<\/option><option value=\"Turkmenistan\" data-country-code=\"TM\" >Turkmenistan<\/option><option value=\"Turks And Caicos Islands\" data-country-code=\"TC\" >Turks And Caicos Islands<\/option><option value=\"Tuvalu\" data-country-code=\"TV\" >Tuvalu<\/option><option value=\"US Minor Outlying Islands\" data-country-code=\"UM\" >US Minor Outlying Islands<\/option><option value=\"Uganda\" data-country-code=\"UG\" >Uganda<\/option><option value=\"Ukraine\" data-country-code=\"UA\" >Ukraine<\/option><option value=\"United Arab Emirates\" data-country-code=\"AE\" >United Arab Emirates<\/option><option value=\"United Kingdom\" data-country-code=\"GB\" >United Kingdom<\/option><option value=\"United States of America (USA)\" data-country-code=\"US\" >United States of America (USA)<\/option><option value=\"Uruguay\" data-country-code=\"UY\" >Uruguay<\/option><option value=\"Uzbekistan\" data-country-code=\"UZ\" >Uzbekistan<\/option><option value=\"Vanuatu\" data-country-code=\"VU\" >Vanuatu<\/option><option value=\"Vatican City\" data-country-code=\"VA\" >Vatican City<\/option><option value=\"Venezuela\" data-country-code=\"VE\" >Venezuela<\/option><option value=\"Vietnam\" data-country-code=\"VN\" >Vietnam<\/option><option value=\"Virgin Islands, British\" data-country-code=\"VG\" >Virgin Islands, British<\/option><option value=\"Virgin Islands, U.S.\" data-country-code=\"VI\" >Virgin Islands, U.S.<\/option><option value=\"Wallis And Futuna Islands\" data-country-code=\"WF\" >Wallis And Futuna Islands<\/option><option value=\"Western Sahara\" data-country-code=\"EH\" >Western Sahara<\/option><option value=\"Yemen Arab Rep.\" data-country-code=\"YE\" >Yemen Arab Rep.<\/option><option value=\"Yemen Democratic\" data-country-code=\"YD\" >Yemen Democratic<\/option><option value=\"Zambia\" data-country-code=\"ZM\" >Zambia<\/option><option value=\"Zimbabwe\" data-country-code=\"ZW\" >Zimbabwe<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"email-1\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1\" class=\"forminator-label\">Correo Electr\u00f3nico <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-3\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Experiencia Comercial<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10\" class=\"forminator-label\">Experiencia Comercial <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"number-1\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1\" class=\"forminator-label\">Tiempo<\/label><input type=\"number\" name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1\" class=\"forminator-input forminator-number--field\" pattern=\"^\\-?\\d*([\\.\\,]\\d+)?\" inputmode=\"decimal\" data-required=\"\" aria-required=\"false\" min=\"1\" max=\"150\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-12\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12\" class=\"forminator-label\">Actividad Econ\u00f3mica Principal <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-13\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-13\" class=\"forminator-label\">Actividad Econ\u00f3mica Secundaria<\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-2\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Ventas y\/o instalaciones de A\/C por a\u00f1o <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-2-1-6a32cbf6f3662\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"120\" id=\"forminator-field-checkbox-2-1-6a32cbf6f3662\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>1-20<\/span><\/label><label for=\"forminator-field-checkbox-2-2-6a32cbf6f3662\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"2050\" id=\"forminator-field-checkbox-2-2-6a32cbf6f3662\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>20-50<\/span><\/label><label for=\"forminator-field-checkbox-2-3-6a32cbf6f3662\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"1001000\" id=\"forminator-field-checkbox-2-3-6a32cbf6f3662\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>100-1000<\/span><\/label><label for=\"forminator-field-checkbox-2-4-6a32cbf6f3662\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-2[]\" value=\"1000ms\" id=\"forminator-field-checkbox-2-4-6a32cbf6f3662\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>1000-M\u00e1s<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-3\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Experiencia con productos Air-Con <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-3-1-6a32cbf6f367a\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"si\" id=\"forminator-field-checkbox-3-1-6a32cbf6f367a\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Si<\/span><\/label><label for=\"forminator-field-checkbox-3-2-6a32cbf6f367a\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"no\" id=\"forminator-field-checkbox-3-2-6a32cbf6f367a\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>No<\/span><\/label><\/div><\/div><div id=\"text-14\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-14\" class=\"forminator-label\">Tiempo <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-4\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Experiencia con productos MHI <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-4-1-6a32cbf6f3696\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"si\" id=\"forminator-field-checkbox-4-1-6a32cbf6f3696\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Si<\/span><\/label><label for=\"forminator-field-checkbox-4-2-6a32cbf6f3696\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-4[]\" value=\"no\" id=\"forminator-field-checkbox-4-2-6a32cbf6f3696\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>No<\/span><\/label><\/div><\/div><div id=\"text-15\" class=\"forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-15\" class=\"forminator-label\">Tiempo <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-5\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label class=\"forminator-label\">\u00bfHa recibido entrenamiento con Air-Con? <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-5-1-6a32cbf6f36bb\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"si\" id=\"forminator-field-checkbox-5-1-6a32cbf6f36bb\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Si<\/span><\/label><label for=\"forminator-field-checkbox-5-2-6a32cbf6f36bb\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-5[]\" value=\"no\" id=\"forminator-field-checkbox-5-2-6a32cbf6f36bb\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-6\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Si la respuesta es SI, especifique:<\/label><label for=\"forminator-field-checkbox-6-1-6a32cbf6f36cb\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"instalacin\" id=\"forminator-field-checkbox-6-1-6a32cbf6f36cb\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Instalaci\u00f3n<\/span><\/label><label for=\"forminator-field-checkbox-6-2-6a32cbf6f36cb\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"servicio\" id=\"forminator-field-checkbox-6-2-6a32cbf6f36cb\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Servicio<\/span><\/label><label for=\"forminator-field-checkbox-6-3-6a32cbf6f36cb\" class=\"forminator-checkbox forminator-checkbox-inline\"><input type=\"checkbox\" name=\"checkbox-6[]\" value=\"solucin-de-problemas\" id=\"forminator-field-checkbox-6-3-6a32cbf6f36cb\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Soluci\u00f3n de Problemas<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"section-4\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><h3 class=\"forminator-subtitle\">Referencias Comerciales<\/h3><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-2\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2\" class=\"forminator-label\">Compa\u00f1\u00eda<\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"\" id=\"forminator-field-name-2\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"name-3\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-3\" class=\"forminator-label\">Referencia y Posici\u00f3n<\/label><input type=\"text\" name=\"name-3\" value=\"\" placeholder=\"\" id=\"forminator-field-name-3\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"phone-1\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1\" class=\"forminator-label\">Tel\u00e9fono<\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-2\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-2\" class=\"forminator-label\">Correo Electr\u00f3nico<\/label><input type=\"email\" name=\"email-2\" value=\"\" placeholder=\"\" id=\"forminator-field-email-2\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-4\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-4\" class=\"forminator-label\">Compa\u00f1\u00eda<\/label><input type=\"text\" name=\"name-4\" value=\"\" placeholder=\"\" id=\"forminator-field-name-4\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"name-5\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-5\" class=\"forminator-label\">Referencia y Posici\u00f3n<\/label><input type=\"text\" name=\"name-5\" value=\"\" placeholder=\"\" id=\"forminator-field-name-5\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"phone-2\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2\" class=\"forminator-label\">Tel\u00e9fono<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-2\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-3\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-3\" class=\"forminator-label\">Correo Electr\u00f3nico<\/label><input type=\"email\" name=\"email-3\" value=\"\" placeholder=\"\" id=\"forminator-field-email-3\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-6\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-6\" class=\"forminator-label\">Compa\u00f1\u00eda<\/label><input type=\"text\" name=\"name-6\" value=\"\" placeholder=\"\" id=\"forminator-field-name-6\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"name-7\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-7\" class=\"forminator-label\">Referencia y Posici\u00f3n<\/label><input type=\"text\" name=\"name-7\" value=\"\" placeholder=\"\" id=\"forminator-field-name-7\" class=\"forminator-input forminator-name--field\" aria-required=\"false\" \/><\/div><\/div><div id=\"phone-3\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-3\" class=\"forminator-label\">Tel\u00e9fono<\/label><input type=\"text\" name=\"phone-3\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-3\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-4\" class=\"forminator-col forminator-col-3 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-4\" class=\"forminator-label\">Correo Electr\u00f3nico<\/label><input type=\"email\" name=\"email-4\" value=\"\" placeholder=\"\" id=\"forminator-field-email-4\" class=\"forminator-input forminator-email--field\" data-required=\"\" aria-required=\"false\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-7\" class=\"forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label class=\"forminator-label\">Certifico y doy fe que toda la informaci\u00f3n declarada en este formulario es ver\u00eddica y autorizo a Air-Con a confirmar cualquier informaci\u00f3n comercial y bancaria de considerarlo necesario. <span class=\"forminator-required\">*<\/span><\/label><label for=\"forminator-field-checkbox-7-1-6a32cbf6f375a\" class=\"forminator-checkbox\"><input type=\"checkbox\" name=\"checkbox-7[]\" value=\"si\" id=\"forminator-field-checkbox-7-1-6a32cbf6f375a\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>Si<\/span><\/label><label for=\"forminator-field-checkbox-7-2-6a32cbf6f375a\" class=\"forminator-checkbox\"><input type=\"checkbox\" name=\"checkbox-7[]\" value=\"no\" id=\"forminator-field-checkbox-7-2-6a32cbf6f375a\" data-calculation=\"0\"  \/><span aria-hidden=\"true\"><\/span><span>No<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"date-1\" class=\"forminator-col forminator-col-12 \"><label for=\"forminator-field-date-1\" class=\"forminator-label\">Fecha <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-date-select\"><div class=\"forminator-row\" data-multiple=\"true\"><div id=\"date-1-month\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-month\" class=\"forminator-label\">Mes<\/label><select name=\"date-1-month\" id=\"forminator-field-date-1-month\" class=\"forminator-select\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" data-default-value=\"6\"><option value=\"\" >Select month<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" selected=\"selected\">6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><\/select><\/div><\/div><div id=\"date-1-day\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-day\" class=\"forminator-label\">Dia<\/label><select name=\"date-1-day\" id=\"forminator-field-date-1-day\" class=\"forminator-select\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" data-default-value=\"17\"><option value=\"\" >Select day<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><option value=\"12\" >12<\/option><option value=\"13\" >13<\/option><option value=\"14\" >14<\/option><option value=\"15\" >15<\/option><option value=\"16\" >16<\/option><option value=\"17\" selected=\"selected\">17<\/option><option value=\"18\" >18<\/option><option value=\"19\" >19<\/option><option value=\"20\" >20<\/option><option value=\"21\" >21<\/option><option value=\"22\" >22<\/option><option value=\"23\" >23<\/option><option value=\"24\" >24<\/option><option value=\"25\" >25<\/option><option value=\"26\" >26<\/option><option value=\"27\" >27<\/option><option value=\"28\" >28<\/option><option value=\"29\" >29<\/option><option value=\"30\" >30<\/option><option value=\"31\" >31<\/option><\/select><\/div><\/div><div id=\"date-1-year\" class=\"forminator-col\"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-year\" class=\"forminator-label\">A\u00f1o<\/label><select name=\"date-1-year\" id=\"forminator-field-date-1-year\" class=\"forminator-select\" data-format=\"mm\/dd\/yy\" data-parent=\"date-1\" data-default-value=\"2026\"><option value=\"\" >Select Year<\/option><option value=\"2120\" >2120<\/option><option value=\"2119\" >2119<\/option><option value=\"2118\" >2118<\/option><option value=\"2117\" >2117<\/option><option value=\"2116\" >2116<\/option><option value=\"2115\" >2115<\/option><option value=\"2114\" >2114<\/option><option value=\"2113\" >2113<\/option><option value=\"2112\" >2112<\/option><option value=\"2111\" >2111<\/option><option value=\"2110\" >2110<\/option><option value=\"2109\" >2109<\/option><option value=\"2108\" >2108<\/option><option value=\"2107\" >2107<\/option><option value=\"2106\" >2106<\/option><option value=\"2105\" >2105<\/option><option value=\"2104\" >2104<\/option><option value=\"2103\" >2103<\/option><option value=\"2102\" >2102<\/option><option value=\"2101\" >2101<\/option><option value=\"2100\" >2100<\/option><option value=\"2099\" >2099<\/option><option value=\"2098\" >2098<\/option><option value=\"2097\" >2097<\/option><option value=\"2096\" >2096<\/option><option value=\"2095\" >2095<\/option><option value=\"2094\" >2094<\/option><option value=\"2093\" >2093<\/option><option value=\"2092\" >2092<\/option><option value=\"2091\" >2091<\/option><option value=\"2090\" >2090<\/option><option value=\"2089\" >2089<\/option><option value=\"2088\" >2088<\/option><option value=\"2087\" >2087<\/option><option value=\"2086\" >2086<\/option><option value=\"2085\" >2085<\/option><option value=\"2084\" >2084<\/option><option value=\"2083\" >2083<\/option><option value=\"2082\" >2082<\/option><option value=\"2081\" >2081<\/option><option value=\"2080\" >2080<\/option><option value=\"2079\" >2079<\/option><option value=\"2078\" >2078<\/option><option value=\"2077\" >2077<\/option><option value=\"2076\" >2076<\/option><option value=\"2075\" >2075<\/option><option value=\"2074\" >2074<\/option><option value=\"2073\" >2073<\/option><option value=\"2072\" >2072<\/option><option value=\"2071\" >2071<\/option><option value=\"2070\" >2070<\/option><option value=\"2069\" >2069<\/option><option value=\"2068\" >2068<\/option><option value=\"2067\" >2067<\/option><option value=\"2066\" >2066<\/option><option value=\"2065\" >2065<\/option><option value=\"2064\" >2064<\/option><option value=\"2063\" >2063<\/option><option value=\"2062\" >2062<\/option><option value=\"2061\" >2061<\/option><option value=\"2060\" >2060<\/option><option value=\"2059\" >2059<\/option><option value=\"2058\" >2058<\/option><option value=\"2057\" >2057<\/option><option value=\"2056\" >2056<\/option><option value=\"2055\" >2055<\/option><option value=\"2054\" >2054<\/option><option value=\"2053\" >2053<\/option><option value=\"2052\" >2052<\/option><option value=\"2051\" >2051<\/option><option value=\"2050\" >2050<\/option><option value=\"2049\" >2049<\/option><option value=\"2048\" >2048<\/option><option value=\"2047\" >2047<\/option><option value=\"2046\" >2046<\/option><option value=\"2045\" >2045<\/option><option value=\"2044\" >2044<\/option><option value=\"2043\" >2043<\/option><option value=\"2042\" >2042<\/option><option value=\"2041\" >2041<\/option><option value=\"2040\" >2040<\/option><option value=\"2039\" >2039<\/option><option value=\"2038\" >2038<\/option><option value=\"2037\" >2037<\/option><option value=\"2036\" >2036<\/option><option value=\"2035\" >2035<\/option><option value=\"2034\" >2034<\/option><option value=\"2033\" >2033<\/option><option value=\"2032\" >2032<\/option><option value=\"2031\" >2031<\/option><option value=\"2030\" >2030<\/option><option value=\"2029\" >2029<\/option><option value=\"2028\" >2028<\/option><option value=\"2027\" >2027<\/option><option value=\"2026\" selected=\"selected\">2026<\/option><option value=\"2025\" >2025<\/option><option value=\"2024\" >2024<\/option><option value=\"2023\" >2023<\/option><option value=\"2022\" >2022<\/option><option value=\"2021\" >2021<\/option><option value=\"2020\" >2020<\/option><option value=\"2019\" >2019<\/option><option value=\"2018\" >2018<\/option><option value=\"2017\" >2017<\/option><option value=\"2016\" >2016<\/option><option value=\"2015\" >2015<\/option><option value=\"2014\" >2014<\/option><option value=\"2013\" >2013<\/option><option value=\"2012\" >2012<\/option><option value=\"2011\" >2011<\/option><option value=\"2010\" >2010<\/option><option value=\"2009\" >2009<\/option><option value=\"2008\" >2008<\/option><option value=\"2007\" >2007<\/option><option value=\"2006\" >2006<\/option><option value=\"2005\" >2005<\/option><option value=\"2004\" >2004<\/option><option value=\"2003\" >2003<\/option><option value=\"2002\" >2002<\/option><option value=\"2001\" >2001<\/option><option value=\"2000\" >2000<\/option><option value=\"1999\" >1999<\/option><option value=\"1998\" >1998<\/option><option value=\"1997\" >1997<\/option><option value=\"1996\" >1996<\/option><option value=\"1995\" >1995<\/option><option value=\"1994\" >1994<\/option><option value=\"1993\" >1993<\/option><option value=\"1992\" >1992<\/option><option value=\"1991\" >1991<\/option><option value=\"1990\" >1990<\/option><option value=\"1989\" >1989<\/option><option value=\"1988\" >1988<\/option><option value=\"1987\" >1987<\/option><option value=\"1986\" >1986<\/option><option value=\"1985\" >1985<\/option><option value=\"1984\" >1984<\/option><option value=\"1983\" >1983<\/option><option value=\"1982\" >1982<\/option><option value=\"1981\" >1981<\/option><option value=\"1980\" >1980<\/option><option value=\"1979\" >1979<\/option><option value=\"1978\" >1978<\/option><option value=\"1977\" >1977<\/option><option value=\"1976\" >1976<\/option><option value=\"1975\" >1975<\/option><option value=\"1974\" >1974<\/option><option value=\"1973\" >1973<\/option><option value=\"1972\" >1972<\/option><option value=\"1971\" >1971<\/option><option value=\"1970\" >1970<\/option><option value=\"1969\" >1969<\/option><option value=\"1968\" >1968<\/option><option value=\"1967\" >1967<\/option><option value=\"1966\" >1966<\/option><option value=\"1965\" >1965<\/option><option value=\"1964\" >1964<\/option><option value=\"1963\" >1963<\/option><option value=\"1962\" >1962<\/option><option value=\"1961\" >1961<\/option><option value=\"1960\" >1960<\/option><option value=\"1959\" >1959<\/option><option value=\"1958\" >1958<\/option><option value=\"1957\" >1957<\/option><option value=\"1956\" >1956<\/option><option value=\"1955\" >1955<\/option><option value=\"1954\" >1954<\/option><option value=\"1953\" >1953<\/option><option value=\"1952\" >1952<\/option><option value=\"1951\" >1951<\/option><option value=\"1950\" >1950<\/option><option value=\"1949\" >1949<\/option><option value=\"1948\" >1948<\/option><option value=\"1947\" >1947<\/option><option value=\"1946\" >1946<\/option><option value=\"1945\" >1945<\/option><option value=\"1944\" >1944<\/option><option value=\"1943\" >1943<\/option><option value=\"1942\" >1942<\/option><option value=\"1941\" >1941<\/option><option value=\"1940\" >1940<\/option><option value=\"1939\" >1939<\/option><option value=\"1938\" >1938<\/option><option value=\"1937\" >1937<\/option><option value=\"1936\" >1936<\/option><option value=\"1935\" >1935<\/option><option value=\"1934\" >1934<\/option><option value=\"1933\" >1933<\/option><option value=\"1932\" >1932<\/option><option value=\"1931\" >1931<\/option><option value=\"1930\" >1930<\/option><option value=\"1929\" >1929<\/option><option value=\"1928\" >1928<\/option><option value=\"1927\" >1927<\/option><option value=\"1926\" >1926<\/option><option value=\"1925\" >1925<\/option><option value=\"1924\" >1924<\/option><option value=\"1923\" >1923<\/option><option value=\"1922\" >1922<\/option><option value=\"1921\" >1921<\/option><option value=\"1920\" >1920<\/option><\/select><\/div><\/div><\/div><\/div><\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div id=\"submit\" class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Aplicar<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"b6010e2a81\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/main\/wp-json\/wp\/v2\/pages\/1128\" \/><input type=\"hidden\" name=\"form_id\" value=\"1119\"><input type=\"hidden\" name=\"page_id\" value=\"1128\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/pages\/1128\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row][vc_column][vc_column_text][\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/pages\/1128"}],"collection":[{"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/comments?post=1128"}],"version-history":[{"count":2,"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/pages\/1128\/revisions"}],"predecessor-version":[{"id":1130,"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/pages\/1128\/revisions\/1130"}],"wp:attachment":[{"href":"https:\/\/airconrd.com\/main\/wp-json\/wp\/v2\/media?parent=1128"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}