@extends('modules.head') @section('contenido')

<form action="{{ url('/newaccountcreated') }}" id="newAccountCreatedForm" method="post">
    @csrf

    @if (\Session::has('error'))
    <div class="alert alert-danger" style="display:none">
        <ul>
            <li id="error_content">{!! \Session::get('error') !!}</li>
        </ul>
    </div>
    @endif
    <div class="pendingBtnsDiv">
        <h1>Create New Account</h1>
        <div>
            <a href="/pendingAccounts" class="btn btnAdd">Back</a>
        </div>
        <div>
            <input type="submit" class="submitDataButton btnSticky" name="action" value="Save & Continue Later" />
        </div>
    </div>
    <section class="sAccounts">
        <aside>
            <h3 class="h3 on"><b>General:</b></h3>
            <div class="dv on">
                <div>
                    <label for="companyName">Company name:</label>
                    <input type="text" class="form-control" id="companyName" name="companyName" value="" placeholder="Company Name" />
                    @error('companyName')<span style="color:red">{{ $message }}</span>@enderror
                    <span id="span_error_company" style="color:red"></span>
                </div>
                <div>
                    <label for="firstName">First name:</label>
                    <input type="text" class="form-control txtVal" id="firstName" name="firstName" value="" placeholder="First Name" />
                    @error('firstName')<span style="color:red">{{ $message }}</span>@enderror
                </div>
                <div>
                    <label for="lastName">Last name:</label>
                    <input type="text" class="form-control txtVal" id="lastName" name="lastName" value="" placeholder="Last Name" />
                    @error('lastName')<span style="color:red">{{ $message }}</span>@enderror
                </div>
                <div>
                    <label for="email">Email:</label>
                    <input type="text" class="form-control txtVal" id="email" name="email" value="" placeholder="email@email.com" />
                    @error('email')<span style="color:red">{{ $message }}</span>@enderror
                    <span id="span_error_email" style="color:red"></span>
                </div>
                <div>
                    <label for="cellPhone">Cell Phone:</label>
                    <input type="text" maxlength="14" class="form-control txtVal" id="cellPhone" name="cellPhone" value="" placeholder="xxx-xxx-xxxx" data-inputmask="'mask': '999-999-9999'"   />
                    {{-- @error('cellPhone')<span style="color:red">{{ $message }}</span>@enderror --}}
                </div>
                <div>
                    <label for="businessPhone">Business Phone:</label>
                    <input type="text" maxlength="14" class="form-control" id="businessPhone" name="businessPhone" value="" placeholder="xxx-xxx-xxxx" data-inputmask="'mask': '999-999-9999'"/>
                    {{-- @error('businessPhone')<span style="color:red">{{ $message }}</span>@enderror --}}
                </div>
                <div>
                    <label for="faxNumber">Fax #:</label>
                    <input type="text" class="form-control" id="faxNumber" name="faxNumber" value="" placeholder="Fax #" />
                </div>
                <div>
                    <label for="website">Website:</label>
                    <input type="text" class="form-control" id="website" name="website" value="" placeholder="Website" />
                </div>
                <div>
                    <label for="referralCode">Referral Code:</label>
                    <input type="text" class="form-control" id="referralCode" name="referralCode" value="" placeholder="Referral Code" />
                </div>
                <div>
                    <label>How did you hear about us?</label>
                    <select class="form-control" name="hearAbout">
                        <option selected disabled>Choose...</option>
                        @foreach ($hearAbouts as $hearAbout)
                        <option value="{{ $hearAbout['id'] }}">{{ $hearAbout['name'] }}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                    <label for="servicing">Servicing:</label>
                    <input type="text" class="form-control" id="servicing" name="servicing" value="" placeholder="Who are you servicing?" />
                </div>
                <div>
                    <label for="finNumber">FIN #:</label>
                    <input type="text" class="form-control" id="finNumber" name="finNumber" value="" placeholder="FIN #" />
                </div>
                <div>
                    <label>Send Invoice:</label>
                    <select class="form-control" name="sendInvoice">
                        <option type="radio" id="sendInvoice1" name="sendInvoice" value="1" selected>Yes</option>
                        <option type="radio" id="sendInvoice2" name="sendInvoice" value="0">No</option>
                    </select>
                </div>
                <div>
                    <label>PO Required:</label>
                    <select class="form-control" name="poRequired" id="poRequired">
                        <option disabled selected>Choose...</option>
                        <option type="radio" id="poRequired1" name="poRequired" value="1">Yes</option>
                        <option type="radio" id="poRequired2" name="poRequired" value="0">No</option>
                    </select>
                </div>
                <div>
                    <label>Business Type:</label>
                    <select class="form-control" id="businessType" name="businessType">
                        <option disabled selected>Choose...</option>
                        @foreach($businessTypes as $businessType)
                        <option value="{{ $businessType->id }}">{{$businessType->name}}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                    <label>Company Size:</label>
                    <select class="form-control" id="companySize" name="companySize">
                        <option disabled selected>Choose...</option>
                        @foreach($companysizes as $companysize)
                        <option value="{{ $companysize }}">{{ $companysize }}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                    <label>Branch:</label>
                    <select class="form-control" id="branch" name="branch">
                        <option disabled selected>Choose...</option>
                        @foreach($branches as $branch)
                        <option value="{{ $branch->id }}">{{ $branch->branch_code }}</option>
                        @endforeach
                    </select>
                </div>
                <div class="form-group pendingAcc_div" id="licenseNumber_div" style="display:none">
                    <label for="licenseNumber">License #:</label>
                    <input type="text" class="form-control" id="licenseNumber" name="licenseNumber" value="" placeholder="Lic #" />
                </div>
                <input type="hidden" name="source" value="3">
            </div>
            <h3 class="h3 on"><b>Contact:</b></h3>
            <div class="dv on">
                <div>
                    <label for="contact_name">First Name:</label>
                    <input type="text" class="form-control" id="contact_name" name="contact_name" value="" placeholder="First Name" />
                </div>
                <div>
                    <label for="contact_last_name">Last Name:</label>
                    <input type="text" class="form-control" id="contact_last_name" name="contact_last_name" value="" placeholder="Last Name" />
                </div>
                <div>
                    <input type="button" class="form-control" id="add_contact_button" value="Add Contact" />
                </div>
                <input type="hidden" id="contacts_hidden" name="contacts" value="" />
                <table class="table table-striped" id="contact_table" style="display:none">
                    <thead>
                        <tr>
                            <th>First Name</th>
                            <th>Last Name</th>
                            <th>Action</th>
                        </tr>
                    </thead>
                    <tbody>
                    </tbody>
                </table>
            </div>
            <h3 class="h3 on"><b>Addresses:</b></h3>
            <div class="dv on">
                <h4>Billing Address</h4>
                <input type="hidden" id="hdn_bill_county" value="" />
                <input type="hidden" id="bill_country" name="bill_country" value=""/>
                <div class="form-group pendingAcc_div">
                    <label for="sel_bill_country">Country:</label>
                    <select class="form-control" id="sel_bill_country" name="sel_bill_country">
                        <option selected disabled>Choose...</option>
                        @foreach ($countries as $country)
                            <option value="{{ $country->short_name }}">{{ $country->short_name }}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                </div>
                <div class="form-group pendingAcc_div" id="billing_address">
                    <label for="bill_address">Address:</label>
                    <input type="text" class="form-control autocomplete bill_address bill_address_field" id="autocomplete_billing" name="bill_address" value="" placeholder="Address" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="billing_address2">
                    <label for="bill_address2">Address 2:</label>
                    <input type="text" class="form-control bill_address_field" id="bill_address2" name="bill_address2" value="" placeholder="Address 2" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="billing_city">
                    <label for="bill_city">City:</label>
                    <input type="text" class="form-control bill_address_field" id="bill_city" name="bill_city" value="" placeholder="City" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="billing_state">
                    <label for="bill_state">State:</label>
                    <select class="form-control bill_address_field" id="bill_state" name="bill_state" disabled>
                        <option selected disabled>Choose...</option>
                        @foreach ($states as $state)
                        <option value="{{ $state->code }}">{{ $state->code }}</option>
                        @endforeach
                    </select>
                </div>
                <div class="form-group pendingAcc_div" id="billing_zipCode">
                    <label for="bill_zipCode">Zip Code:</label>
                    <input type="text" class="form-control bill_address_field" id="bill_zipCode" name="bill_zipCode" value="" placeholder="Zip Code" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="billing_taxCode" data-tax-codes="{{$taxcodes}}" style="visibility:hidden">
                    <label for="bill_taxCode">Tax Code:</label>
                    <input type="text" class="form-control" id="bill_taxCode" name="bill_taxCode" value="" placeholder="Tax Code" />
                </div>
                <div class="dvCheckBox">
                    <input class="form-check-input bill_address_field" type="checkbox" value="" id="flexCheckDefault" disabled>
                    <label for="flexCheckDefault">Ship to same billing address</label>
                </div>

                <h4>Shipping Address</h4>
                <input type="hidden" id="ship_country" name="ship_country" value="" />
                <div class="form-group pendingAcc_div" id="billing_address">
                    <label for="sel_ship_country">Country:</label>
                    <select class="form-control" id="sel_ship_country" name="sel_ship_country">
                        <option selected disabled>Choose...</option>
                        @foreach ($countries as $country)
                            <option value="{{ $country->short_name }}">{{ $country->short_name }}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_address">
                    <label for="ship_address">Address:</label>
                    <input type="text" class="form-control autocomplete ship_address_field" id="autocomplete_shipping" name="ship_address" value="" placeholder="Address" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_address2">
                    <label for="ship_address2">Address 2:</label>
                    <input type="text" class="form-control ship_address_field" id="ship_address2" name="ship_address2" value="" placeholder="Address 2" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_city">
                    <label for="ship_city">City:</label>
                    <input type="text" class="form-control ship_address_field" id="ship_city" name="ship_city" value="" placeholder="City" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_state">
                    <label for="ship_state">State:</label>
                    <select class="form-control ship_address_field" id="ship_state" name="ship_state" disabled>
                        <option selected disabled>Choose...</option>
                        @foreach ($states as $state)
                        <option value="{{ $state->code }}">{{ $state->code }}</option>
                        @endforeach
                    </select>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_zipCode">
                    <label for="ship_zipCode">Zip Code:</label>
                    <input type="text" class="form-control ship_address_field" id="ship_zipCode" name="ship_zipCode" value="" placeholder="Zip Code" disabled/>
                </div>
                <div class="form-group pendingAcc_div" id="shipping_taxCode" data-tax-codes="{{$taxcodes}}">
                    <label for="ship_taxCode">Tax Code:</label>
                    <input type="text" class="form-control" id="ship_taxCode" name="ship_taxCode" value="" placeholder="Tax Code" readonly />
                </div>
            </div>
            <h3 class="h3 on"><b>Accounting:</b></h3>
            <div class="dv on">
                <div>
                    <label>Payment Terms:</label>
                    <input type="text" class="form-control" value="COD" disabled>
                    <input type="hidden" class="form-control" id="paymentTerms" name="paymentTerms" value=7 />
                </div>
                <div>
                    <div>
                        <label>Tax Status:</label>
                        <select class="form-control" name="taxStatus">
                            <option disabled selected>Choose...</option>
                            @foreach ($tax_status as $item)
                            <option value={{ $item['id'] }}>{{ $item['name'] }}</option>
                            @endforeach
                        </select>
                    </div>
                </div>
                <div>
                    <label>Price List:</label>
                    <select class="form-control" name="priceList">
                        <option disabled selected>Choose...</option>
                        @foreach ($pricelists as $pricelist)
                        <option value={{ $pricelist['id'] }}>{{ $pricelist['list_name'] }}</option>
                        @endforeach
                    </select>
                </div>
                <div>
                    <label>Group:</label>
                    <select class="form-control" name="group">
                        <option disabled selected>Choose...</option>
                        @foreach ($groups as $group)
                        <option value="{{ $group->id }}">{{ $group->group_name }}</option>
                        @endforeach
                    </select>
                </div>
                <div class="form-group pendingAcc_div" id="exemptNumberDiv" style="display:none">
                    <label for="exemptNumber">Exempt #:</label>
                    <input type="text" class="form-control" id="exemptNumber" name="exemptNumber" value="" />
                </div>
            </div>
            <div style="display: none;">
                <h3 class="h3"><b>Remarks:</b></h3>
                <div class="dv">
                    <div>
                        <label>Remarks</label>
                        <textarea class="form-control rounded-0" cols="900" rows="15" name="remarks"></textarea>
                    </div>
                </div>
                <h3 class="h3"><b>Attachments:</b></h3>
                <div class="dv"></div>
            </div>
        </aside>
    </section>
</form>
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