@extends('layout.main')



            @section('main-section')


                <div class="content">

                    <!-- Start Content-->
                    <div class="container-fluid">

                        <!-- start page title -->
                        <div class="row">
                            <div class="col-12">
                                <div class="page-title-box">
                                    <div class="page-title-right">
                                        <ol class="breadcrumb m-0">
                                            <li class="breadcrumb-item"><a href="javascript: void(0);">EFU</a></li>

                                            <li class="breadcrumb-item active">Property Form</li>
                                        </ol>
                                    </div>
                                    <h4 class="page-title">EFU Property Management Portal</h4>
                                </div>
                            </div>
                        </div>
                        <!-- end page title -->




                        <div class="row">
                            <div class="col-12">
                                <div class="card">
                                    <div class="card-body">
                                        <h4 class="header-title">Start Property Application</h4>
                                        <p class="sub-header">
                                          abcd
                                        </p>
                                        <form action="{{url('/')}}" method="POST">
                                            @csrf
                                        <div class="row">

                                            <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Name Of Insured</label>
                                                  <select class="form-control" name="_NameOfInsured">
                                                      <option value="">Please Select</option>

                                                      <%for (insurlist of data) { %>

                                                      <option value="<%=insurlist._Name%>"><%=insurlist._Name%></option>

                                                      <% } %>

                                                    </select>

                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-12">
                                                <div class="mb-12">
                                                  <label>Situation Location</label>
                                                  <textarea
                                                    class="form-control"
                                                    id=""
                                                    name="_SituationLocation"
                                                    placeholder="Situation Location"
                                                    value=""
                                                  ></textarea>
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Type Of Cover</label>

                                                   <input
                                                    type="text"
                                                    class="form-control"
                                                    id=""
                                                    name="_TypeOfCover"
                                                    placeholder="Cover Type"
                                                    value=""
                                                  />



                                                </div>
                                            <p></p>
                                              </div>

                                               <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Limit of Liability</label>

                                                   <input
                                                    type="text"
                                                    class="form-control"
                                                    id=""
                                                    name="_LimitOfLiability"
                                                    placeholder="Limit of Liability"
                                                    value=""
                                                  />



                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-12">
                                                <div class="mb-12">
                                                  <label>Property Covered</label>
                                                  <textarea

                                                    class="form-control"
                                                    id=""
                                                    name="_PropertyCovered"
                                                    placeholder="Property Covered"
                                                    value=""
                                                  ></textarea>
                                                </div>
                                                <p></p>
                                              </div>



                                              <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Period From</label>
                                                  <input
                                                    type="date"
                                                    class="form-control"
                                                    id=""
                                                    name="txtperiodfrom"
                                                    placeholder="Period From"
                                                  />
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Period To</label>
                                                  <input
                                                    type="date"
                                                    class="form-control"
                                                    id=""
                                                    name="txtperiodto"
                                                    placeholder="Period To"
                                                  />
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-12">
                                                <div class="mb-12">
                                                  <label>Deductibles</label>
                                                  <textarea
                                                    class="form-control"
                                                    id=""
                                                    name="_Deductibles"
                                                    placeholder="Deductibles"
                                                    value=""
                                                  ></textarea>
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>PRCL Share</label>
                                                  <input
                                                    type="text"
                                                    class="form-control"
                                                    id=""
                                                    name="prclsharetxt"
                                                    placeholder="PRCL Share"
                                                    value=""
                                                  />
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-6">
                                                <div class="mb-6">
                                                  <label>Reinsurance Comission</label>
                                                  <input
                                                    type="text"
                                                    class="form-control"
                                                    id=""
                                                    name="ReinsurancetxtComission"
                                                    placeholder="Reinsurance Comission"
                                                    value=""
                                                  />
                                                </div>
                                                <p></p>
                                              </div>

                                              <div class="col-lg-12">
                                                <div class="mb-12">
                                                  <label>Term and Conditions</label>
                                                  <textarea
                                                    placeholder="Term and Conditions"
                                                    name="_TermAndConditions"
                                                    class="form-control"
                                                  ></textarea>
                                                </div>
                                                <p></p>
                                              </div>





                                              <div class="col-lg-12">
                                                <h3>Add List One</h3>
                                                <p></p>
                                                <button type="button" onclick="add1()" class="btn btn-danger">
                                                  Add
                                                </button>
                                              </div>
                                              <div class="col-lg-12" hidden>
                                                <input type="text" name="txtinc1" id="txtinc1" value="1" />
                                                <p></p>
                                              </div>
                                              <table class="table" id="table1">
                                                  <tr>
                                                      <th>Sum Insured </th>
                                                      <th>Sum Insured Amount</th>

                                                  </tr>
                                                <tr>
                                                  <td>
                                                      <select class="form-control" name="SumInsuredBMC">
                                                      <option value="">Please Select</option>
                                                      <option value="BMC">Sum Insured BMC</option>
                                                      <option value="Stocks G">Sum Insured Stocks G</option>
                                                      <option value="Stock O">Sum Insured Stock O</option>
                                                      <option value="LOP">Sum Insured LOP</option>
                                                      <option value="Without BreakUp">Sum Insured Without BreakUp</option>
                                                    </select>

                                                    </td>

                                                  <td>
                                                    <input
                                                      type="text"
                                                      class="form-control"
                                                      id=""
                                                      name="SumInsuredstockamount"
                                                      placeholder="Amount"
                                                    />
                                                  </td>


                                                </tr>
                                              </table>

                                              <div class="col-lg-12">
                                                <h3>Add List Two</h3>
                                                <p></p>
                                                <button type="button" onclick="add2()" class="btn btn-danger">
                                                  Add
                                                </button>
                                              </div>
                                              <div class="col-lg-12" hidden>
                                                <input type="text" name="txtinc2" id="txtinc2" value="1" />
                                                <p></p>
                                              </div>

                                              <div class="col-lg-12">
                                              <table class="table" id="table2">


                                                <tr>
                                                      <th>R I Gross Rates Heading</th>
                                                      <th>R I Gross Rates </th>
                                                      <th>Declaration Stock G</th>
                                                      <th>Declaration Stock O</th>

                                                  </tr>
                                                <tr>
                                                  <td>
                                                      <select class="form-control" name="RIGrossBMC" id="RIGrossBMC">
                                                      <option value="">Please Select</option>
                                                      <option value="BMC">R I Gross Rates BMC</option>
                                                      <option value="Stocks G">R I Gross Rates Stocks G</option>
                                                      <option value="Stock O">R I Gross Rates Stock O</option>
                                                      <option value="LOP">R I Gross Rates LOP</option>

                                                    </select>

                                                    </td>

                                                  <td>
                                                    <input
                                                      type="text"
                                                      class="form-control"
                                                      id=""
                                                      name="RIGrossstockamount"
                                                      placeholder="Rate"
                                                    />
                                                  </td>

                                                     <td>


                                                      <select class="form-control" name="RIGrossstockdeductable" id="RIGrossstockdeductable">
                                                      <option value="1">Please Select</option>
                                                      <option value="1">100%</option>
                                                      <option value="75">75%</option>
                                                      <option value="50">50%</option>


                                                    </select>
                                                  </td>

                                                   <td>

                                                    <select class="form-control" name="RIGrossstockdeductableo" id="RIGrossstockdeductable" onchange="">
                                                      <option value="1">Please Select</option>
                                                      <option value="1">100%</option>
                                                      <option value="75">75%</option>
                                                      <option value="50">50%</option>

                                                    </select>
                                                  </td>



                                                </tr>

                                              </table>
                                              </div>

                                        <div class="col-lg-12">


                                            <div class="mb-12">
                                                <button type="submit" class="btn btn-success" onclick="GoodJob()" id="sa-success">Submit</button>

                                            </div>
                                            <p></p>
                                    </div> <!-- end col -->



                        </div>
                        <!-- end row -->
                    </form>

                    </div> <!-- container -->

                </div> <!-- content -->



<script>
    var inc1 = 2;
    function add1() {
      $("#table1").append(
        "<tr>" +
          '<td><select class="form-control" name="SumInsuredBMC"><option value="">Please Select</option> <option value="BMC">Sum Insured BMC</option><option value="Stocks G">Sum Insured Stocks G</option><option value="Stock O">Sum Insured Stock O</option><option value="LOP">Sum Insured LOP</option><option value="Without BreakUp">Sum Insured Without BreakUp</option></select></td>' +

          '<td> <input type="text"class="form-control" id="" name="SumInsuredstockamount"placeholder="Amount" /></td>' +

          '<td><input type="button" onclick="SomeDeleteRowFunction1()" value="Delete"></td>' +
          "</tr>"
      );

      document.getElementById("txtinc1").value = inc1++;
    }

    function SomeDeleteRowFunction1() {
      document.getElementById("txtinc1").value = --inc1;
      // event.target will be the input element.
      var td = event.target.parentNode;
      var tr = td.parentNode; // the row to be removed
      tr.parentNode.removeChild(tr);
    }

    var inc2 = 2;
    function add2() {
      $("#table2").append(
        "<tr>" +
          '<td> <select class="form-control" name="RIGrossBMC"><option value="">Please Select</option><option value="BMC">R I Gross Rates BMC</option> <option value="Stocks G">R I Gross Rates Stocks G</option><option value="Stock O">R I Gross Rates Stock O</option><option value="LOP">R I Gross Rates LOP</option></select></td>' +

          '<td> <input type="text" class="form-control" id="" name="RIGrossstockamount" placeholder="Amount" /></td>' +

          '<td><input type="button" onclick="SomeDeleteRowFunction2()" value="Delete"></td>' +
          "</tr>"
      );

      document.getElementById("txtinc2").value = inc2++;
    }

    function SomeDeleteRowFunction2() {
      document.getElementById("txtinc2").value = --inc2;
      // event.target will be the input element.
      var td = event.target.parentNode;
      var tr = td.parentNode; // the row to be removed
      tr.parentNode.removeChild(tr);
    }

    var inc3 = 2;
    function add3() {
      $("#table3").append(
        "<tr>" +
          '<td><select class="form-control" name="RIGrossPremiumsBMC"><option value="">Please Select</option> <option value="R I Gross Premiums BMC">R I Gross Premiums BMC</option> <option value="R I Gross Premiums Stocks G">R I Gross Premiums Stocks G</option><option value="R I Gross Premiums Stocks O">R I Gross Premiums Stocks O</option> <option value="R I Gross Premiums LOP">R I Gross Premiums LOP</option> </select></td>' +

          '<td><input type="text" class="form-control" id="" name="RIGrossPremiumsstockamount" placeholder="Amount" /></td>' +

          '<td><input type="button" onclick="SomeDeleteRowFunction3()" value="Delete"></td>' +
          "</tr>"
      );

      document.getElementById("txtinc3").value = inc3++;
    }

    function SomeDeleteRowFunction3() {
      document.getElementById("txtinc3").value = --inc3;
      // event.target will be the input element.
      var td = event.target.parentNode;
      var tr = td.parentNode; // the row to be removed
      tr.parentNode.removeChild(tr);
    }


    var inc5 = 2;
    function add5() {
      $("#table5").append(
        "<tr>" +
          '<td> <select class="form-control" name="PRCLShareGrossPremium"><option value="">Please Select</option> <option value="PRCL Share Gross Premium BMC">PRCL Share Gross Premium BMC</option><option value="PRCL Share Gross Premium Stocks G">PRCL Share Gross Premium Stocks G</option> <option value="PRCL Share Gross Premium Stocks O">PRCL Share Gross Premium Stocks O</option><option value="PRCL Share Gross Premium LOP">PRCL Share Gross Premium LOP</option></select></td>' +

          '<td><input type="text" class="form-control" id="" name="PRCLShareGrossPremiumstockamount" placeholder="Amount" /></td>' +

          '<td><input type="button" onclick="SomeDeleteRowFunction5()" value="Delete"></td>' +
          "</tr>"
      );

      document.getElementById("txtinc5").value = inc5++;
    }

    function SomeDeleteRowFunction5() {
      document.getElementById("txtinc5").value = --inc5;
      // event.target will be the input element.
      var td = event.target.parentNode;
      var tr = td.parentNode; // the row to be removed
      tr.parentNode.removeChild(tr);
    }


    var inc7 = 2;
    function add7() {
      $("#table7").append(
        "<tr>" +
          '<td><select class="form-control" name="PRCLShareNetPremiumBMC"><option value="">Please Select</option><option value="PRCL Share Net Premium BMC">PRCL Share Net Premium BMC</option> <option value="PRCL Share Net Premium Stocks G">PRCL Share Net Premium Stocks G</option><option value="PRCL Share Net Premium Stocks O">PRCL Share Net Premium Stocks O</option> <option value="PRCL Share Net Premium LOP">PRCL Share Net Premium LOP</option> </select></td>' +

          '<td><input type="text" class="form-control" id="" name="PRCLShareNetPremiumstockamount" placeholder="Amount"  /></td>' +

          '<td><input type="button" onclick="SomeDeleteRowFunction7()" value="Delete"></td>' +
          "</tr>"
      );

      document.getElementById("txtinc7").value = inc7++;
    }

    function SomeDeleteRowFunction7() {
      document.getElementById("txtinc3").value = --inc7;
      // event.target will be the input element.
      var td = event.target.parentNode;
      var tr = td.parentNode; // the row to be removed
      tr.parentNode.removeChild(tr);
    }
  </script>



@endsection('main-section')