@extends('layouts.client')

@section('styles')
<style>
.ltl-table input {
	border: 1px solid 
	#f44336 !important;
	padding: 0px 5px !important;
}
</style>
@endsection

@section('content')
<div class="formswrap">
  <section class="forms-basic consearchbasic">
    <form class="form-floating form-validate @if($clientId == '3800') ltlform @endif" id="ratequotesearchform" name="ratequotesearchform">
	<div class="row m-b-40">
	  <div class="col-md-12">
		<div class="well white consearcheight">
			<fieldset>
				{{ csrf_field() }}
				<input type="hidden" name="search" id="search" value="true">
				<div class="col-md-6 padding-left">
					<legend>ORIGIN</legend>
					<div class="form-group">
						<label for="r_shipfrom_zip" class="control-label">ZIP</label>
						<input type="text" class="form-control" name="r_shipfrom_zip" id="r_shipfrom_zip" data-validation="required" data-validation-optional-if-answered="r_shipfrom_city">
					</div>
				</div>
				<div class="col-md-6 padding-right">
					<legend>DESTINATION</legend>
					<div class="form-group">
						<label for="r_shipto_zip" class="control-label">ZIP</label>
						<input type="text" class="form-control" name="r_shipto_zip" id="r_shipto_zip" data-validation="required" data-validation-depends-on="r_shipfrom_zip">
					</div>
				</div>
				<div class="col-md-12 ">
					<p class="orsep">OR</p>
				</div>	
				<div class="col-md-6 padding-left">		
					<div class="form-group">
						<label for="r_shipfrom_city" class="control-label">CITY</label>
						<input type="text" class="form-control cityField" name="r_shipfrom_city" id="r_shipfrom_city" data-validation="required" data-validation-optional-if-answered="r_shipfrom_zip">
					</div>
					<div class="form-group rate-state">
						<select name="r_shipfrom_state" id="r_shipfrom_state" class="select2 form-control" data-validation="required" data-validation-depends-on="r_shipfrom_city">
							{!! FormField::dropDownOptions('r_shipfrom_state', $states, false, 'STATE') !!}
						</select>
					</div>
				</div>
				<div class="col-md-6 padding-right">			
					<div class="form-group">
						<label for="r_shipto_city" class="control-label">CITY</label>
						<input type="text" class="form-control cityField" name="r_shipto_city" id="r_shipto_city" data-validation="required" data-validation-depends-on="r_shipfrom_city">
					</div>
					<div class="form-group rate-state">
						<select name="r_shipto_state" id="r_shipto_state" class="select2 form-control" data-validation="required" data-validation-depends-on="r_shipto_city">
							{!! FormField::dropDownOptions('r_shipto_state', $states, false, 'STATE') !!}
						</select>
					</div>
				</div>
				<div class="col-md-12 nopadding">
				<legend class="legend_in" style="margin-top: 30px;">EQUIPMENT</legend>
				<div class="form-group">
					<select class="form-control" id="r_equipment_id" name="r_equipment_id" data-validation="required">
						<option value="">Please Select</option>
						@foreach($equipments as $equipment)
						<option value="{{ $equipment->id }}" equipmenttype="{{ $equipment->type }}">
						{{ $equipment->name }}
						</option>
						@endforeach
					</select>
				</div>
				</div>
				
				<!------------------- sample tl selection box-------------------------->
				<div id="ltl-items-box" style="display:none;">		
				  <div class="col-md-12 no-padding">
					<div class="table-responsive">
						<table class="table table-full table-full-small ltl-table">
						  <thead>
							<tr>
							  <th>Description</th>
							  <th>Class</th>
							  <th>Unit</th>
							  <th>Length</th>
							  <th>Width</th>
							  <th>Height</th>
							  <th>Weight</th>
							  <th></th>
							</tr>
						  </thead>
						  <tbody id="ltl-items">
							<tr class="ltl-row">
							  <td>
								<input type="text" class="form-control ltl-field ltl-desc" name="ltlitems[description][]" data-validation="required" value="">
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-class" name="ltlitems[class][]" data-validation="required" value="">
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-unit" name="ltlitems[unit][]" data-validation="required, number" value="" >
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-length" name="ltlitems[length][]" data-validation="required, number" data-validation-allowing="float" value="" >
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-width" name="ltlitems[width][]" data-validation="required, number" data-validation-allowing="float" value="" >
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-height" name="ltlitems[height][]" data-validation="required, number" data-validation-allowing="float" value="" >
							  </td>
							  <td>
								<input type="text" class="form-control ltl-field ltl-weight" name="ltlitems[weight][]" data-validation="required, number" data-validation-allowing="float" value="" >
							  </td>
							  <td>
								<input class="btn btn-sm btn-danger add-ltl-row" type="button" name="+" value="+">
							  </td>
							</tr>
						  </tbody>
						</table>
					  </div>
				  </div>
				</div>
				<!----------------------------------------------------------> 
				
				
			</fieldset>
		</div>
	  </div>
	  <div class="clearfix"></div>
		<div class="newcontbtn">
			<input class="btn btn-sm btn-danger contbtnnew" type="submit" name="ratequote-search" id="ratequote-search" value="Search">
			<input type="hidden" name="search_clear" id="search_clear" value="">
			<input class="btn btn-sm btn-danger contbtnnew" type="button" name="ratequote-clear" id="ratequote-clear" value="Clear">
		</div>
	</div>
	</form>
	
	<div class="col-md-12 nopadding hide" id="sample-box">
	<div class="card no-margin">
		<div class="table-responsive white">
			<input class="btn btn-sm btn-danger contbtnnew pull-right m-r-10" type="button" name="new-quote" id="new-quote" value="NEW QUOTE">
			<div class="rate_quote_desc">
				<p><span class="quote_locate">ORIGIN:</span> <span id="s-org"></span></p>
				<p><span class="quote_locate">DESTINATION:</span> <span id="s-dest"></span></p>
				<p><span class="quote_locate">EQUIPMENT:</span> <span id="s-equp"></span></p>
			</div>
		</div>
		<div id="ltl-items-table">
		</div>
	</div>
	<div class="clearfix"></div><br/>
	<div id="sample-content">
	</div>
	</div>

	<div class="col-md-12 nopadding hide" id="rate-box">
    <div class="card no-margin">
		<div class="table-responsive white">
			<div class="rate_quote_desc">
				<p><span class="quote_locate">Origin:</span> <span id="r-org"></span></p>
				<p><span class="quote_locate">Destination:</span> <span id="r-dest"></span></p>
				<p><span class="quote_locate">Equipment:</span> <span id="r-equp"></span></p>
			</div>
          <table class="table table-bordered table-full table-full-small rate_quote_tb">
          	<colgroup>
            	<col class="auto-cell-size">
          	</colgroup>
            <thead>
              <tr>
                <th class="rate_cont_hd"></th>
                <th class="rate_cont_hd">RATE</th>
                <th class="rate_cont_hd">MOVE PROBABILITY(%)</th>
              </tr>
            </thead>
            <tbody>
              <tr id="row-95">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_95" value="95" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_95"></td>
                <td>40%</td>
              </tr>
              <tr id="row-100">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_100" value="100" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_100"></td>
                <td>60%</td>
              </tr>
              <tr id="row-105">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_105" value="105" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_105"></td>
                <td>70%</td>
              </tr>
              <tr id="row-110">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_110" value="110" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_110"></td>
                <td>80%</td>
              </tr>
              <tr id="row-120">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_120" value="120" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_120"></td>
                <td>90%</td>
              </tr>
              <tr id="row-130">
              	<td>
					<div class="form-group">
						<div class="radio">
						  <label class="filled">
							<input type="radio" name="rate_type" id="rate_type_130" value="130" > 
							</label>
						</div>
					</div>              		
              	</td>
                <td class="text-nowrap rv" id="rate_130"></td>
                <td>100%</td>
              </tr>
              <tr id="row-130">
              	<td>&nbsp;</td>
                <td>&nbsp;</td>
                <td class="">
                	<input class="btn btn-sm btn-danger contbtnnew pull-right" type="button" name="place-order" id="place-order" value="PLACE ORDER">
                	<input class="btn btn-sm btn-danger contbtnnew pull-right m-r-10" type="button" name="new-quote" id="new-quote" value="NEW QUOTE">
                </td>
              </tr>
            </tbody>
          </table>
        </div>
        </div>
<div class="clearfix"></div>
<div id="order-box" class="hide" style="margin-top:20px;">
<form action="{{ route('client.ratequote.store') }}" method="POST" id="orderform" class="form-floating" enctype="multipart/form-data">
{{ csrf_field() }}
<div id="address-details">
<div class="card">
	<a href="javascript:void(0);" class="btn-sm btn-danger btn-white add-stop-addr pull-right"><i class="md md-add"></i>Add Stop</a>
	<div class="clearfix"></div>
	<ul class="list-group list-addresses">
		<li class="list-group-item" id="shipfrom-list">
			<div class="list-main">
			<h4 class="list-group-item-heading">Ship From</h4>
			<p class="list-group-item-text addr-snap" id="shipfrom-snap">
			</p>
			</div>
			<div class="list-error">
				<input type="hidden" class="cust-addr-field" id="shipfrom_error" name="shipfrom_error" value="" data-validation="required" data-validation-error-msg="Please provide ship from details." data-validation-error-msg-container="#shipfrom_error_pos">
				<span id="shipfrom_error_pos"></span>
			</div>
			<div class="list-actions">
				<a href="javascript:void(0);" data-addr="shipfrom" data-for="shipfrom" data-title="Ship From" class="btn btn-link addr-edit"><i class="md md-edit"></i></a>
			</div>
			<span>
				<input type="hidden" class="cust-addr-field" id="shipfrom_customer_id" name="shipfrom_customer_id" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_name" name="shipfrom_name" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_address" name="shipfrom_address" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_city" name="shipfrom_city" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_state" name="shipfrom_state" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_zip" name="shipfrom_zip" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_contact" name="shipfrom_contact" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_phone" name="shipfrom_phone" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_email" name="shipfrom_email" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_shipping_from_hours" name="shipfrom_shipping_from_hours" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_shipping_to_hours" name="shipfrom_shipping_to_hours" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_apt_required" name="shipfrom_apt_required" value="">
				<input type="hidden" class="cust-addr-field" id="shipfrom_notes" name="shipfrom_notes" value="">
			</span>
		</li>
		<li class="list-group-item" id="shipto-list">
			<div class="list-main">
			<h4 class="list-group-item-heading">Ship To</h4>
			<p class="list-group-item-text addr-snap" id="shipto-snap">
			</p>
			</div>
			<div class="list-error">
				<input type="hidden" class="cust-addr-field" id="shipto_error" name="shipto_error" value="" data-validation="required" data-validation-error-msg="Please provide ship to details." data-validation-error-msg-container="#shipto_error_pos">
				<span id="shipto_error_pos"></span>
			</div>
			<div class="list-actions">
				<a href="javascript:void(0);" data-addr="shipto" data-for="shipto" data-title="Ship To" class="btn btn-link addr-edit"><i class="md md-edit"></i></a>
			</div>
			<span>
				<input type="hidden" class="cust-addr-field" id="shipto_customer_id" name="shipto_customer_id" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_name" name="shipto_name" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_address" name="shipto_address" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_city" name="shipto_city" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_state" name="shipto_state" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_zip" name="shipto_zip" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_contact" name="shipto_contact" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_phone" name="shipto_phone" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_email" name="shipto_email" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_receiving_from_hours" name="shipto_receiving_from_hours" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_receiving_to_hours" name="shipto_receiving_to_hours" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_apt_required" name="shipto_apt_required" value="">
				<input type="hidden" class="cust-addr-field" id="shipto_notes" name="shipto_notes" value="">
			</span>
		</li>
	</ul>
</div>
</div>
<div id="commodity-details">
<div class="well white odetails">
	<fieldset>
		<legend>Order Details</legend>
		<input type="hidden" id="miles" name="miles" value="">
		<div class="form-group filled col-md-12 padding-left hide" style="margin-top:50px;">
			<label class="control-label normal">Equipment Type</label>
			<select class="form-control" id="equipment_id" name="equipment_id" data-validation="required">
				<option value="">Please Select</option>
				@foreach($equipments as $equipment)
				<option value="{{ $equipment->id }}" equipmenttype="{{ $equipment->type }}">
				{{ $equipment->name }}
				</option>
				@endforeach
			</select>
		</div>
		<div id="tl-items-box" style="display:none;">
			<div class="form-group col-md-4 padding-left">
				<label for="freight_description" class="control-label">Freight Description</label>
				<input type="text" class="form-control tl-field" id="freight_description" name="freight_description" value="" data-validation="required">
			</div>
			<div class="form-group col-md-4 padding-left">
				<label for="total_weight" class="control-label">Total Weight</label>
				<input type="text" class="form-control tl-field" id="total_weight" name="total_weight" value="" data-validation="required">
			</div>
			<div class="form-group col-md-4 padding-left">
				<label for="total_weight" class="control-label">Class</label>
				<input type="text" class="form-control" id="class" name="class" value="50" data-validation="required" readonly>
			</div>
		</div>
		<div id="non-tl-items-box" style="display:none;">		
		  <div class="col-md-12 no-padding">
			<div class="table-responsive">
				<table class="table table-full table-full-small non-tl-table">
				  <thead>
					<tr>
					  <th>Description</th>
					  <th>Class</th>
					  <th>Unit</th>
					  <th>Length</th>
					  <th>Width</th>
					  <th>Height</th>
					  <th>Weight</th>
					  <th></th>
					</tr>
				  </thead>
				  <tbody id="non-tl-items">
					<tr>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[description][]" data-validation="required" value="">
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[class][]" data-validation="required" value="">
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[unit][]" data-validation="required, number" value="" >
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[length][]" data-validation="required, number" data-validation-allowing="float" value="" >
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[width][]" data-validation="required, number" data-validation-allowing="float" value="" >
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field" name="items[height][]" data-validation="required, number" data-validation-allowing="float" value="" >
					  </td>
					  <td>
						<input type="text" class="form-control non-tl-field non-tl-weight" name="items[weight][]" data-validation="required, number" data-validation-allowing="float" value="" >
					  </td>
					  <td>
						<input class="btn btn-sm btn-danger add-non-tl-row" type="button" name="+" value="+">
					  </td>
					</tr>
				  </tbody>
				</table>
			  </div>
		  </div>
		</div>
		<div class="form-group col-md-12 padding-left">
			<label for="requirements" class="control-label">Requirements</label>
			<input type="text" class="form-control" id="requirements" name="requirements" value="" data-validation="required">
		</div>
		<div class="form-group col-md-12 padding-left">
			<label for="total_weight" class="control-label">Notes</label>
			<textarea class="form-control" id="notes" name="notes"></textarea>
		</div>
	</fieldset>
</div>
</div>
<div class="col-md-4" id="requirement-details" style="padding-left:0px;">
<div class="well white">
	<fieldset>
		<legend>Order Requirement Details</legend>
		<div class="form-group" style="margin-top: 35px;">
			<label for="client_state" class="control-label normal">Billing</label>
			<select name="bill_type" id="bill_type" class="select2 form-control" data-validation="required" style="width:270px;">
				{!! FormField::dropDownOptions('bill_type', $billTypes, null) !!}
			</select>
		</div>
		<div class="form-group">
			<label for="requested_pickup_date" class="control-label">Requested P/U Date</label>
			<input type="text" class="form-control datepicker" id="requested_pickup_date" name="requested_pickup_date" value="" >
		</div>
		<div class="form-group">
			<label for="requested_pickup_time" class="control-label">Pickup Appointment Time</label>
			<input type="text" class="form-control timepicker" id="requested_pickup_time" name="requested_pickup_time" value="" >
		</div>
		<div class="form-group">
			<label for="requested_delivery_date" class="control-label">Requested Delivery Date</label>
			<input type="text" class="form-control datepicker" id="requested_delivery_date" name="requested_delivery_date" value="" >
		</div>
		<div class="form-group">
			<label for="requested_delivery_time" class="control-label">Delivery Appointment Time</label>
			<input type="text" class="form-control timepicker" id="requested_delivery_time" name="requested_delivery_time" value="" >
		</div>
	</fieldset>
</div>
</div>
<div class="col-md-4">
<div class="well white">
	<fieldset>
		<legend>Order Cost Details</legend>
		<div class="form-group">
			<label for="line_haul_charge" class="control-label">Line Haul Rate</label>
			<input type="text" class="form-control order-charge-part" id="line_haul_charge" name="line_haul_charge" value="" data-validation-optional="true" data-validation="number" data-validation-allowing="float" readonly>
		</div>
		<div class="form-group">
			<label for="fuel_charge" class="control-label">Fuel Surcharge</label>
			<input type="text" class="form-control order-charge-part" id="fuel_charge" name="fuel_charge" value="" data-validation-optional="true" data-validation="number" data-validation-allowing="float" >
		</div>
		<div class="form-group filled col-md-8 padding-left" style="margin-top: 21px;">
			<label class="control-label">Accessorial</label>
			<select name="accessorial_type" id="accessorial_type" class="select2 form-control" style="width:150px;">
				{!! FormField::dropDownOptions('accessorial_type', $accessorialTypes, null) !!}
			</select>			
		</div>
		<div class="form-group col-md-3 padding-left" style="margin-top: 12px;">
			<input type="text" placeholder="Rate" id="accessorial_rate" name="accessorial_rate" class="form-control">
		</div>
		 <div class="form-group col-md-1 padding-left" style="margin-top: 21px;">
			<input class="btn btn-sm btn-danger add-accessorial" type="button" name="+" value="+">
		 </div>
		<div class="clearfix"></div>
		<div class="col-md-12 no-padding">
			<div class="table-responsive">
				<table id="accessorials-table" class="table table-full table-full-small" >
				  <thead>
					<tr>
					  <th>Accessorial</th>
					  <th>Rate</th>
					  <th></th>
					</tr>
				  </thead>
				  <tbody id="accessorial-items">					  
				  </tbody>
				</table>
			</div>
		</div>
		<div class="clearfix"></div>
		<div class="form-group" style="margin-top: 10px;">
			<label for="accessorial_charge" class="control-label">Accessorial Charge</label>
			<input type="text" class="form-control order-charge-part" id="accessorial_charge" name="accessorial_charge" value="" data-validation-optional="true" data-validation="number" data-validation-allowing="float" readonly>
		</div>
		<div class="form-group">
			<label for="total_charge" class="control-label">Total Gross</label>
			<input type="text" class="form-control" id="total_charge" name="total_charge" value="" data-validation-optional="true" data-validation="number" data-validation-allowing="float" readonly>
		</div>
	</fieldset>
</div>
</div>
  <div class="col-md-4">
	<div class="well white ">
		<fieldset>
			<legend>Reference Number</legend>
			<div class="form-group filled col-md-10 padding-left">
				<label class="control-label">Reference #</label>
				<select name="reference_code" id="reference_code" class="select2 form-control" style="width:200px;">
					{!! FormField::dropDownOptions('reference_code', $referenceCodes, null) !!}
				</select>
			</div>
			<div class="form-group col-md-2">
				<input class="btn btn-sm btn-danger add-reference-code" type="button" name="+" value="+">
			</div>
			<div class="clearfix"></div>
			<div id="reference-codes">
			</div>
			<legend>Documents</legend>
			<div class="clearfix"></div>
			<div class="form-group filled col-md-12 padding-left">
				<label class="control-label">Document Type</label>
				<select name="document_type" id="document_type" class="select2 form-control" style="width:250px;">
					{!! FormField::dropDownOptions('document_type', $documentTypes, null) !!}
				</select>
			</div>
			<input class="btn btn-info btn-sm" type="button" name="uploadBtn" id="uploadBtn" value="Browse">
			<p class="fileselect" id="filename"></p>
			<input class="btn btn-sm btn-danger" type="button" name="attach" id="attach" value="Attach">
			<p style="margin-top: 10px;">List of Documents Attached</p>
			<table class="table table-bordered table-full table-full-small vendordoc">
			  <thead>
				<tr>
				  <th>Document Type</th>
				  <th>Document</th>
				  <th></th>
				</tr>
			  </thead>
			  <tbody id="filesContainer">
			  </tbody>
			</table>
		</fieldset>
	</div>
  </div>
  <div class="clearfix"></div>
	<div class="newcontbtn">
	  <input class="btn btn-sm btn-danger" type="submit" name="submit" value="ADD ORDER">
	</div>  	
</form>


<!-- Address Modal -->
<div class="modal fade" id="addressModal" role="dialog">
	<div class="modal-dialog">
	  <div class="modal-content">
		<div class="modal-header">
		  <button type="button" class="close" data-dismiss="modal">&times;</button>
		  <h4 class="modal-title firstTime addr-title-modal"></h4>
		</div>
		<form class="form-floating form-validate form-ajax" id="addressform" name="addressform">
		<div class="modal-body" style="overflow:hidden;">
			  <div class="col-md-12">
				<fieldset>
					<input type="hidden" class="hidden-field" id="_customer_id" name="_customer_id">
					<input type="hidden" class="hidden-field" id="_addr_index" name="_addr_index">
					<input type="hidden" class="hidden-field" id="_addr_for" name="_addr_for">
					<div class="form-group">
						<label for="_name" class="control-label">Name</label>
						<input type="text" data-func-cancel="clearAddressModalBox" class="form-control addr-box-field" id="_name" name="_name" data-validation="required">
					</div>
					<div class="form-group">
						<label for="_address" class="control-label">Address</label>
						<input type="text" class="form-control addr-box-field" id="_address" name="_address" data-validation="required">
					</div>
					<div class="form-group">
						<label for="_city" class="control-label">City</label>
						<input type="text" class="form-control addr-box-field cityField" id="_city" name="_city" data-validation="required">
					</div>
					<div class="form-group" id="addr-state" style="width:538px;margin-top: 35px;">
						<label for="_state" class="control-label normal">State</label>
						{!! FormField::select('_state', $states, null, true, 'Please Select') !!}
					</div>
					<div class="form-group">
						<label for="_zip" class="control-label">Zip</label>
						<input type="text" class="form-control addr-box-field" id="_zip" name="_zip" maxlength="5" data-validation="required, number">
					</div>
					<div class="form-group">
						<label for="_contact" class="control-label">Contact</label>
						<input type="text" class="form-control addr-box-field" id="_contact" name="_contact" data-validation="required">
					</div>
					<div class="form-group">
						<label for="_phone" class="control-label">Phone</label>
						<input type="text" class="form-control addr-box-field" id="_phone" name="_phone" data-validation="required">
					</div>
					<div class="form-group">
						<label for="_email" class="control-label">Email</label>
						<input type="text" class="form-control addr-box-field" id="_email" name="_email" value="">
					</div>
					<div class="clearfix"></div>
					<div class="form-group hours-box" id="shipfrom-hours">
						<label class="control-label">Shipping Hours</label>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_shipping_from_hours" name="_shipping_from_hours" data-validation="required">
						</div>
						<span class="form-group col-md-2">--</span>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_shipping_to_hours" name="_shipping_to_hours" data-validation="required">
						</div>
					</div>
					<div class="clearfix"></div>
					<div class="form-group hours-box" id="shipto-hours">
						<label class="control-label">Receiving Hours</label>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_receiving_from_hours" name="_receiving_from_hours" data-validation="required">
						</div>
						<span class="form-group col-md-2">--</span>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_receiving_to_hours" name="_receiving_to_hours" data-validation="required">
						</div>
					</div>
					<div class="clearfix"></div>
					<div class="form-group extra-stop-fields">
						<label class="control-label">Pickup Appointment</label>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control datepicker" id="_pickup_date" name="_pickup_date">
						</div>
						<span class="form-group col-md-2">--</span>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_pickup_time" name="_pickup_time">
						</div>
					</div>
					<div class="clearfix"></div>
					<div class="form-group extra-stop-fields">
						<label class="control-label">Delivery Appointment</label>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control datepicker" id="_delivery_date" name="_delivery_date">
						</div>
						<span class="form-group col-md-2">--</span>
						<div class="form-group col-md-5 padding-left">
							<input type="text" class="form-control timepicker" id="_delivery_time" name="_delivery_time">
						</div>
					</div>
					<div class="clearfix"></div>
					<div class="form-group">
						<div class="checkbox">
						  <label class="filled">
							<input type="checkbox" id="_apt_required" name="_apt_required" value="1"> Appointment Required </label>
						</div>
					</div>
					<div class="form-group">
						<label for="_notes" class="control-label">Notes</label>
						<textarea class="form-control addr-box-field" id="_notes" name="_notes"></textarea>
					</div>
				</fieldset>
			  </div>
			  <div class="clearfix"></div>
		</div>
		<div class="modal-footer firstTime_footer">
		  <input class="btn btn-sm btn-danger" type="submit" name="Submit" value="Submit" id="rate-save"></input>
		</div>
		</form>
	  </div>  
	</div>
</div>
<!-------------------->
</div>

</div>
<div class="clearfix"></div>
  </section>
</div>

<!-- Re Quote Modal -->
<div class="modal fade" id="reQuoteModal" role="dialog">
	<div class="modal-dialog">
	  <div class="modal-content">
		<div class="modal-header">
		  <button type="button" class="close" data-dismiss="modal">&times;</button>
		  <h4 class="modal-title firstTime">Rate Requote</h4>
		</div>
		<div class="modal-body" style="overflow:hidden;">
			  <div class="col-md-12" id="requote-desc">
			  	<legend>Rate Quote For </legend>
			  	<ul class="requote_list">
			  		<li><span class="pop_rate_txt">Origin:</span> <span id="re_f_org"></span></li>
			  		<li><span class="pop_rate_txt">Destination:</span> <span id="re_f_dest"></span></li>
			  	</ul>
			  	<legend>Order Has</legend>
			  	<ul class="requote_list">
			  		<li><span class="pop_rate_txt">Origin:</span> <span id="re_s_org"></span></li>
			  		<li><span class="pop_rate_txt">Destination:</span> <span id="re_s_dest"></span></li>
			  	</ul>
			  </div>
			  <div class="col-md-12 hide" id="requote-selection">
			   <div class="table-responsive white">
		          <table class="table table-bordered table-full table-full-small rate_quote_tb">
		          	<colgroup>
		            	<col class="auto-cell-size">
		          	</colgroup>
		            <thead>
		              <tr>
		                <th class="rate_cont_hd"></th>
		                <th class="rate_cont_hd">RATE</th>
		                <th class="rate_cont_hd">MOVE PROBABILITY(%)</th>
		              </tr>
		            </thead>
		            <tbody>
		              <tr id="re-row-95">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_95" value="95" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_95"></td>
		                <td>40%</td>
		              </tr>
		              <tr id="re-row-100">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_100" value="100" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_100"></td>
		                <td>60%</td>
		              </tr>
		              <tr id="re-row-105">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_105" value="105" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_105"></td>
		                <td>70%</td>
		              </tr>
		              <tr id="re-row-110">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_110" value="110" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_110"></td>
		                <td>80%</td>
		              </tr>
		              <tr id="re-row-120">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_120" value="120" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_120"></td>
		                <td>90%</td>
		              </tr>
		              <tr id="re-row-130">
		              	<td>
							<div class="form-group">
								<div class="radio">
								  <label class="filled">
									<input type="radio" name="re_rate_type" id="re_rate_type_130" value="130" > 
									</label>
								</div>
							</div>              		
		              	</td>
		                <td class="text-nowrap re-rv" id="re_rate_130"></td>
		                <td>100%</td>
		              </tr>
		            </tbody>
		          </table>
		        </div>
			  </div>
			  <div class="clearfix"></div>
		</div>
		<div class="modal-footer firstTime_footer">
		  <input class="btn btn-sm btn-danger" type="button" name="re-quote" value="Re Quote" id="re-quote"></input>
		   <input class="btn btn-sm btn-danger hide" type="button" name="requote-proceed" value="Proceed" id="requote-proceed"></input>
		</div>
	  </div>  
	</div>
</div>
<!-------------------->

@endsection

@section('scripts')
<script>var documentTypes = {!! json_encode($documentTypes) !!};</script>
<script charset="utf-8" src="{{asset('backend/js/services/client/rateQuote.js?v=1.5')}}"></script>
<script charset="utf-8" src="{{asset('backend/js/services/client/orders.js?v=1.0')}}"></script>
@endsection