@section('content')
    <section id="quick-quote-wrapper">
        <div class="container fullwidth">
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2">

                <div class="home-section-title">
                    <h2>Insurance Calculator</h2>

                    {{-- <div class="description">
                        <p>Lorem ipsum dolor sit amet, consectetur adipisicing elit, sed do eiusmod tempor incididunt ut
                            labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco
                            laboris nisi ut aliquip ex ea commodo consequat.</p>
                    </div> --}}
                </div>

            </div>

            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            {{-- Pet Form --}}
                            <form class="ffq-form" id="ffq-frm" name="ffq-frm" action="{{route('submit-quote')}}"
                                  method="get">
                                {{ csrf_field() }}

                                <div class="form-field-wrapper">

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 form-element-gap">
                                            <div class="ff-label"><label>Pet Category</label></div>
                                            <div class="pet-type-wrapper">
                                                <div class="petcheckbox-field">
                                                    <input required="required" id="pet_type1" name="pet_category"
                                                           type="radio" value="dog" class="form-check-input">
                                                    <label for="pet_type1" class="form-check-label"> Dog </label>
                                                </div>
                                                <div class="petcheckbox-field">
                                                    <input required="required" id="pet_type2" name="pet_category"
                                                           type="radio" value="cat" class="form-check-input">
                                                    <label for="pet_type2" class="form-check-label"> Cat </label>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Name of your pet</label></div>
                                            <input name="pet_name" id="pet_name" value="" required="required" type="text"
                                                   class="input-lg numericInputAge" placeholder="Enter Pet Name"
                                                   aria-required="true">
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Breed of your pet</label></div>
                                            <input name="pet_breed" id="pet_breed" value="" required="required" type="text"
                                                   class="input-lg numericInputAge" placeholder="Enter Pet Breed"
                                                   aria-required="true">
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Gender of your pet</label></div>
                                            <select name="pet_gender" id="pet_gender" required="required"
                                                    class="input-lg numericInputAge">
                                                <option value="">Select</option>
                                                <option value="Male">Male</option>
                                                <option value="Female">Female</option>
                                            </select>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Date of birth of your pet</label></div>
                                            <div class="input-group date petdob">
                                                <input name="pet_dob" required="required" type="date"
                                                       class="input-lg numericInputAge" aria-required="true">
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="ff-label"><label>Subscription</label></div>
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="yearly"
                                                              checked>Yearly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="monthly">Monthly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="quarterly">Quarterly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="half-yearly">Half
                                                    Yearly</label>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="PT">
                                            <input type="hidden" name="policy_mode" id="policy_mode" value="annual">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="insured_value" id="insured_value" value="0">
                                            <input type="hidden" name="days" id="days" value="10">
                                            <input type="hidden" name="promo_code" value="">
                                            <input type="submit" id="btn_get_quote" value="Get Quote"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->
                                </div>
                            </form>
                            {{-- End OF Pet Form --}}


                        </div>
                        <!-- /quick-quote-form -->

                        <!-- quick-quote-details -->
                        <div class="quick-quote-details">
                            <div>
                                <h3> Pet insurance </h3>

                            </div>
                        </div>
                        <!-- /quick-quote-details -->

                    </div>
                </div>
                <!-- /quick-quote -->


            </div>

            {{-- for Experience Sri Lanka --}}
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2" style="margin-top:20px;">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            {{-- travel inbound Form --}}
                            <form class="ffq-form" id="ffq-frm" name="ffq-frm" action="{{route('submit-quote')}}"
                                  method="get">
                                {{ csrf_field() }}
                                <div class="form-field-wrapper">

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 form-element-gap">
                                            <div class="ff-label"><label>Type of Cover</label></div>
                                            <div class="travelinbound-type-wrapper">
                                                <div class="travelinboundcheckbox-field">
                                                    <input required="required" id="travelinbound_type1" name="cover_type"
                                                           type="radio" value="I">
                                                    <label for="travelinbound_type1" title="Individual"> Individual </label>
                                                </div>
                                                <div class="travelinboundcheckbox-field">
                                                    <input required="required" id="travelinbound_type2" name="cover_type"
                                                           type="radio" value="F">
                                                    <label for="travelinbound_type2" title="Family"> Family </label>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>When does your trip start?</label></div>
                                            <div class="input-group date travelinbounddepdate">
                                                <input name="departure_date" id="travelinbound_departure_date" value=""
                                                       required="required" type="date" class="input-lg"
                                                       placeholder="YYYY-MM-DD" title="">

                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>When does your trip end?</label></div>
                                            <div class="input-group date travelinboundreturndate">
                                                <input name="return_date" id="travelinbound_return_date" value=""
                                                       required="required" type="date" class="input-lg "
                                                       placeholder="YYYY-MM-DD" title="">

                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Your date of birth</label></div>
                                            <div class="input-group date travelinbounddob">
                                                <input name="policy_holder_dob" id="travelinbound_policy_holder_dob"
                                                       value="1984-06-27" required="required" type="date" class="input-lg ">

                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">

                                            <div class="ff-label">
                                                <label>Traveller Count</label>
                                            </div>

                                            <select name="traveller_count" required="required"
                                                    class="input-lg numericInputAge">
                                                <option value="1">1</option>
                                                <option value="2">2</option>
                                            </select>

                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">

                                        <div id="inboundtraveller_age_0_wrapper"
                                             class="col-lg-6 col-md-6 inboundtraveller_age_wrapper">
                                            <div class="ff-label"><label>Traveller 1 Date of Birth</label></div>
                                            <div class="input-group date travelinboundfamilydob">
                                                <input name="traveller_age_0" required="required" type="date"
                                                       value="1986-11-22">
                                            </div>
                                        </div>

                                        <div id="inboundtraveller_age_1_wrapper"
                                             class="col-lg-6 col-md-6 inboundtraveller_age_wrapper">
                                            <div class="ff-label"><label>Traveller 2 Date of Birth</label></div>
                                            <div class="input-group date travelinboundfamilydob">
                                                <input name="traveller_age_1" type="date" value="1996-10-02">
                                            </div>
                                        </div>

                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 form-element-gap">
                                            <div class="ff-label"><label>Type of Cover</label></div>

                                            <div class="travelinbound-policy-wrapper">

                                                <div class="travelinboundpolicycheckbox-field">
                                                    <input required="required" name="policy_type" type="radio" value="CUST"
                                                           checked>
                                                    <label for="travelinbound_policy_type1"> Build your own policy </label>
                                                </div>
                                                <div class="travelinboundpolicycheckbox-field">
                                                    <input required="required" name="policy_type" type="radio" value="COMP">
                                                    <label for="travelinbound_policy_type2">Comprehensive policy</label>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="IT">
                                            <input type="hidden" name="policy_mode" id="policy_mode" value="annual">
                                            <input type="hidden" name="days" id="days" value="10">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="promo_code" value="">
                                            <input type="submit" id="btn_get_quote" value="Get Quote"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                </div>

                            </form>


                        </div>

                        <div class="quick-quote-details">
                            <div>
                                <h3> Experience Sri Lanka insurance </h3>

                            </div>
                        </div>


                    </div>
                </div>

            </div>



            {{-- for Personal Accident Insurance --}}
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2" style="margin-top:20px;">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            <form class="ffq-form" id="ffq-frm" name="ffq-frm" action="{{route('submit-quote')}}">
                                {{ csrf_field() }}
                                <div class="form-field-wrapper">


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 form-element-gap">
                                            <div class="ff-label"><label>Lifestyle Category</label></div>

                                            <div class="lifestyle-type-wrapper">

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="45">
                                                        Camping Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="46">
                                                        Cycling Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="47">
                                                        Swimming Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="48">
                                                        Surfing Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="49">
                                                        Gym Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="50">
                                                        Sports Cover
                                                    </label>
                                                </div>

                                                <div class="checkbox">
                                                    <label>
                                                        <input name="pa_extensions[]" type="checkbox" value="51">
                                                        Hiking Cover
                                                    </label>
                                                </div>

                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Age</label></div>
                                            <input name="pa_age" required="required" type="text"
                                                   class="input-lg numericInputAge" placeholder="Enter Your Age">
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="ff-label"><label>Subscription</label></div>
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="yearly"
                                                              checked>Yearly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="monthly">Monthly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="quarterly">Quarterly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="half-yearly">Half
                                                    Yearly</label>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="LS">
                                            <input type="hidden" name="policy_mode" id="policy_mode" value="annual">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="promo_code" value="">
                                            <input type="hidden" name="insured_value" id="insured_value" value="0">
                                            <input type="hidden" name="pa_occupation" id="pa_occupation" value="">
                                            <input type="hidden" name="pa_name" id="pa_name" value="name">
                                            <input type="hidden" name="pa_phone" id="pa_phone" value="0000000000">
                                            <input type="submit" id="btn_get_quote" value="Get Quote"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                </div>

                            </form>


                        </div>

                        <div class="quick-quote-details">
                            <div>
                                <h3> Personal Accident Insurance </h3>

                            </div>
                        </div>

                    </div>
                </div>

            </div>


            {{-- for Mobile Insurance --}}
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2" style="margin-top:20px;">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            <form class="ffq-form" id="ffq-frm" name="ffq-frm" action="{{route('submit-quote')}}">
                                {{ csrf_field() }}
                                <div class="form-field-wrapper">

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Make</label></div>
                                            <select name="phone_make" id="mobile_make" required="required"
                                                    class="input-lg select2dropdown select2-hidden-accessible">
                                                <option value="1">Apple</option>
                                            </select>

                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Model</label></div>
                                            <select name="phone_model" id="mobile_model" required="required"
                                                    class="input-lg select2dropdown select2-hidden-accessible valid"
                                                    tabindex="-1" aria-hidden="true" aria-required="true" aria-invalid="false">
                                                <option value="1">iPhone XS</option>
                                                <option value="2">iPhone XS Max</option>
                                                <option value="3">iPhone XR</option>
                                                <option value="4">iPhone X</option>
                                                <option value="5">iPhone 8 Plus</option>
                                                <option value="6">iPhone 8</option>
                                                <option value="7">iPhone 7 Plus</option>
                                                <option value="8">iPhone 7</option>
                                                <option value="9">iPhone SE</option>
                                                <option value="10">iPhone 6s Plus</option>
                                                <option value="11">iPhone 6s</option>
                                                <option value="12">iPhone 6 Plus</option>
                                                <option value="13">iPhone 6</option>
                                                <option value="14">iPhone 5s</option>
                                            </select>

                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="ff-label"><label>Subscription</label></div>
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="yearly"
                                                              checked>Yearly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="monthly">Monthly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="quarterly">Quarterly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="half-yearly">Half
                                                    Yearly</label>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="MB">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="insured_value" id="insured_value" value="0">
                                            <input type="hidden" name="promo_code" value="">
                                            <input type="submit" id="btn_get_quote" value="Protect My Screen"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                </div>

                            </form>
                        </div>

                        <div class="quick-quote-details">
                            <div>
                                <h3> Mobile Insurance </h3>

                            </div>
                        </div>

                    </div>
                </div>

            </div>

            {{-- for Motor Insurance --}}
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2" style="margin-top:20px;">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            <form class="ffq-form" id="ffq-frm" name="ffq-frm" action="{{route('submit-quote')}}">
                                {{ csrf_field() }}

                                <div class="form-field-wrapper">
                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 form-element-gap">
                                            <div class="ff-label"><label>Vehicle Type</label></div>

                                            <div class="vehicle-type-wrapper">
                                                <div class="vehiclecheckbox-field">
                                                    <input required="required" id="vehicle_type1" name="vehicle_type"
                                                           type="radio" value="1" aria-required="true" checked>
                                                    <label for="vehicle_type1" title="Car"></label>
                                                </div>
                                                {{-- <div class="vehiclecheckbox-field">
                                                    <input required="required" id="vehicle_type3" name="vehicle_type"
                                                        type="radio" value="1" aria-required="true">
                                                    <label for="vehicle_type3" title="SUV"></label>
                                                </div> --}}
                                                <div class="vehiclecheckbox-field">
                                                    <input required="required" id="vehicle_type2" name="vehicle_type"
                                                        type="radio" value="2" aria-required="true">
                                                    <label for="vehicle_type2" title="Motor Bike"></label>
                                                </div>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->



                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-6 col-md-6 form-element-gap">
                                            <div class="ff-label"><label>Make</label></div>
                                            <select name="vehicle_make" id="vehicle_make"

                                                    required="required"
                                                    class="input-lg">

                                                <option value="138">Toyota</option>

                                            </select>

                                        </div>

                                        <div class="col-lg-6 col-md-6">
                                            <div class="ff-label"><label id="vehicle-reg-no-label">Model</label></div>
                                            <select name="vehicle_model" id="vehicle_model" required="required" class="input-lg" >

                                                <option value="12573"> Allion </option>
                                                <option value="12584"> Alphard </option>

                                            </select>

                                        </div>

                                    </div>
                                    <!-- form-group -->



                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-6 col-md-6 form-element-gap">
                                            <div class="ff-label"><label>Year of Manufacture</label></div>
                                            <select name="vehicle_yom" id="vehicle_yom" class="input-lg">

                                                <option value="2020"> 2020 </option>

                                            </select>

                                        </div>

                                        <div class="col-lg-6 col-md-6">
                                            <div class="ff-label"><label>Fuel Type</label></div>
                                            <select name="fuel_type" id="fuel_type" required="required" class="input-lg">

                                                <option value="MPCP">Petrol</option>

                                            </select>

                                            <input type="hidden" id="fuel_type_hidden" name="fuel_type_hidden"
                                                   value="Petrol">
                                        </div>

                                    </div>
                                    <!-- form-group -->



                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Sum Insured</label></div>
                                            <!--<input name="insured_value" id="insured_value" value="" required="required" type="text" class="input-lg numericInput" placeholder="Enter Sum Insured">-->
                                            <div class="input-group">
                                                <span class="input-group-addon"> LKR</span>
                                                <input name="insured_value" id="insured_value" value="" required="required"
                                                       type="text" class="input-lg numericInput"
                                                       placeholder="Enter Sum Insured" aria-required="true">
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Promo Code</label></div>
                                            <input type="text" name="promo_code" id="promo_code" class="input-lg"
                                                   placeholder="Enter Promo Code">

                                        </div>
                                    </div>
                                    <!-- form-group -->

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Customer Age</label></div>
                                            <input type="text" name="customer_age" id="customer_age" class="input-lg"
                                                   placeholder="Enter Customer Age">

                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="ff-label"><label>Subscription</label></div>
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="yearly"
                                                              checked>Yearly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="monthly">Monthly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription"
                                                              value="quarterly">Quarterly</label>
                                            </div>
                                        </div>
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <div class="radio-inline">
                                                <label><input type="radio" name="subscription" value="half-yearly">Half
                                                    Yearly</label>
                                            </div>
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="MT">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="policy_mode" id="policy_mode" value="annual">
                                            <input type="hidden" name="days" id="days" value="10">
                                            <input type="submit" id="btn_get_quote" value="Get Quote"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->

                                </div>

                            </form>

                        </div>

                        <div class="quick-quote-details">
                            <div>
                                <h3> Motor Insurance </h3>

                            </div>
                        </div>

                    </div>
                </div>

            </div>

            {{-- for cyber mobile --}}
            <div class="col-lg-8 col-lg-offset-2 col-md-8 col-md-offset-2" style="margin-top:20px;">

                <div id="quick-quote-motor">
                    <div class="quick-quote-inner">
                        <div class="quick-quote-form">

                            <form class="ffq-form" id="ffq-frm" name="ffq-frm1" action="{{route('check-single-quote')}}" method="post">
                                {{ csrf_field() }}
                                <div class="form-field-wrapper">

                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Make</label></div>
                                            <select name="phone_make" id="mobile_make" required="required"
                                                    class="input-lg select2dropdown select2-hidden-accessible">
                                                <option value="1">Apple</option>
                                            </select>

                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12">
                                            <div class="ff-label"><label>Model</label></div>
                                            <select name="phone_model" id="mobile_model" required="required"
                                                    class="input-lg select2dropdown select2-hidden-accessible valid"
                                                    tabindex="-1" aria-hidden="true" aria-required="true" aria-invalid="false">
                                                <option value="1">iPhone XS</option>
                                                <option value="2">iPhone XS Max</option>
                                                <option value="3">iPhone XR</option>
                                                <option value="4">iPhone X</option>
                                                <option value="5">iPhone 8 Plus</option>
                                                <option value="6">iPhone 8</option>
                                                <option value="7">iPhone 7 Plus</option>
                                                <option value="8">iPhone 7</option>
                                                <option value="9">iPhone SE</option>
                                                <option value="10">iPhone 6s Plus</option>
                                                <option value="11">iPhone 6s</option>
                                                <option value="12">iPhone 6 Plus</option>
                                                <option value="13">iPhone 6</option>
                                                <option value="14">iPhone 5s</option>
                                            </select>

                                        </div>
                                    </div>
                                    <!-- form-group -->


                                    <!-- form-group -->
                                    <div class="row form-group">
                                        <div class="col-lg-12 col-md-12 btn-holder">
                                            <input type="hidden" name="insurance_types" id="insurance_type" value="CP">
                                            <input type="hidden" name="device_type" id="device_type" value="MB">
                                            <input type="hidden" name="is_quick_quote" id="insurance_type" value="q">
                                            <input type="hidden" name="insured_value" id="insured_value" value="0">
                                            <input type="hidden" name="promo_code" value="">
                                            <input type="submit" id="btn_get_quote" value="Protect My Screen"
                                                   class="btn btn-get-quote">
                                        </div>
                                    </div>
                                    <!-- form-group -->


                                </div>

                            </form>
                        </div>

                        <div class="quick-quote-details">
                            <div>
                                <h3> Mobile Insurance </h3>

                            </div>
                        </div>

                    </div>
                </div>

            </div>

        </div>
        <!-- container -->
    </section>
@endsection