@extends('layouts.admin')
@section('pageTitle')
  <title>Best Insurance | Completed Leads</title>
@stop
@section('pageCss')
<link rel="stylesheet" href="{{ URL::asset('assets/plugins/datepicker/datepicker3.css') }}">
@stop
@section('content')
<section class="content">
  <div class="box get-quote">

           
            @if(isset($information->insurer))
              {{--*/ $insurer = $information->insurer /*--}}
            @else
              {{--*/ $insurer = '' /*--}}
            @endif

            <div class="box box-warning col-md-12">
              <div class="box-header with-border">
                <h3 class="box-title" >
                {{$information->fname.' - '.$information->policy_number}}
                       
                </h3>
              </div>
            </div>
            @if($information->status == 0)
            <div class="box-header with-border col-md-12">
                <h3 class="box-title text-red col-md-12"  > Rejected!</h3>
                <P class="col-md-12"><b>Comment: </b>{{$information->comments_for_rejection}} </P>
            </div>
            @endif
            <div class="box-body no-padding">
              {!! Form::open(array('url' => 'account/update-completed-lead')) !!}
                <!-- text input -->
                
                <div class="form-group col-md-6" style="border-right: 2px solid #ccc;">
                    <!-- Quote Id -->
                    {{ Form::hidden('id', $information->id)}}
                    <div class="col-md-6 lead-padding">{!! Form::label('Policy Number') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->policy_number}} </div>

                    <!-- <div class="clearfix"></div> -->
                    <div class="clearfix"></div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{!! Form::label('Insurer') !!} :</div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{{$information->insurer}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Date Of Birth ') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->dob}}</div>
    
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Occupation') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->occupation}} </div>
                    <div class="clearfix"></div>
                                        <div class="col-md-6 lead-padding">{!! Form::label('Address') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$address}} </div>
                    <div class="clearfix"></div>

                    <div class="col-md-6 lead-padding">{!! Form::label('Telephone') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->telephone}} </div>
                    <div class="clearfix"></div>
                     <div class="col-md-6 lead-padding">{!! Form::label('Type Of Cover') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->typeofcover}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Monthly Commitment') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->monthlycommitment}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Monthly Benefit') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->monthlybenefit}} </div>
                    <div class="clearfix"></div>
                     <div class="col-md-6 lead-padding">{!! Form::label('Monthly Cost') !!} :</div>
                    <div class="col-md-6 lead-padding">£{{ number_format((float)str_replace(',','',$information->monthlycost), 2, '.', '') }}</div>
                    <div class="clearfix"></div>
                     <div class="col-md-6 lead-padding">{!! Form::label('Excess period') !!} :</div>
                    @if($information->excessperiod == 1)
                                            @elseif(!empty($information->excessperiod) )
                                          @else
                                          @endif
                    <div class="col-md-6 lead-padding">{{$excessperiod}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Account Number') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->accountnumber}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('IBAN') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->iban}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Bank Bic') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->bankbic}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Branch Bic') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->branchbic}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Town') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->town}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Bank Phone') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->bank_phone}} </div>
                  

                    <div class="clearfix"></div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding">{!! Form::label('Increasing Benefit ') !!} :</div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding"></div>

                    <div class="clearfix"></div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding">{!! Form::label('Premise Name') !!} :</div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding">{{$information->premiseName}} </div>
                    
                    <div class="clearfix"></div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding">{!! Form::label('Salary') !!} :</div>
                    <div class="col-md-6 col-xs-6 col-sm-6  lead-padding">{{$information->salary}} </div>
                     <div class="clearfix"></div>
                </div>

                
                <div class="form-group col-md-6">
                    <div class="col-md-6 lead-padding">{!! Form::label('Name') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->title.' '.$information->fname.' '.$information->lname}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding ">{!! Form::label('Employee Status') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->emp_status}} </div>
                    <div class="clearfix"></div>
                   
                    <div class="col-md-6 lead-padding">{!! Form::label('Employer Name ') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->employer_name}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Postcode') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->postcode}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Email') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->email}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Insurance Startdate') !!} :</div>
                    <div class="col-md-6 lead-padding">{{date('d-m-Y', strtotime($information->insurance_startdate))}} </div>
                    <div class="clearfix"></div>

                     <div class="col-md-6  col-xs-6 col-sm-6  lead-padding">{!! Form::label('Insurance Enddate') !!} :</div>
                    <div class="col-md-6  col-xs-6 col-sm-6  lead-padding">
                    @if($information->insurance_enddate == '0000-00-00')
                        00-00-0000
                    @else
                        {{date('d-m-Y', strtotime($information->insurance_enddate))}} 
                    @endif
                    </div>
                    <div class="clearfix"></div>
                   
                    <div class="col-md-6 lead-padding">{!! Form::label('Type of Protection') !!} :</div>
                    <div class="col-md-6 lead-padding">{{title_case(str_replace('_',' ',$information->typeofprotection))}} </div>
                    <div class="clearfix"></div>
                    
                    <div class="col-md-6 lead-padding">{!! Form::label('Age') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->age}} </div>
                    <div class="clearfix"></div>
                    
                    <div class="col-md-6 lead-padding">{!! Form::label('Benefit Period') !!} :</div>
                    @if($information->benefit_period == 6)
                      <div class="col-md-6 lead-padding">6 Months</div>
                    @elseif($information->benefit_period == 12)
                      <div class="col-md-6 lead-padding">12 Months</div>
                    @elseif($information->benefit_period == 0 || $information->benefit_period == '')
                      <div class="col-md-6 lead-padding">12 Months</div>
                    @else
                      <div class="col-md-6 lead-padding"></div>
                    @endif
                    <div class="clearfix"></div>
                     <div class="col-md-6 lead-padding">{!! Form::label('Cover') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->cover}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding lead-padding">{!! Form::label('Account Name') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->accountname}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Sortcode') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->sortcode}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Bank') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->bank}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Branch') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->branch}} </div>
                    <div class="clearfix"></div>
                     <div class="col-md-6 lead-padding">{!! Form::label('Branch Address') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->branch_address}} </div>
                    <div class="clearfix"></div>
                    <div class="col-md-6 lead-padding">{!! Form::label('Bank Postcode') !!} :</div>
                    <div class="col-md-6 lead-padding">{{$information->bank_postcode}} </div>
              
                    <div class="clearfix"></div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{!! Form::label('Affiliate Id') !!} :</div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{{$information->affid}} </div>
                    
                    <div class="clearfix"></div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{!! Form::label('Smoker') !!} :</div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{{$information->smoker}} </div>

                    <div class="clearfix"></div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{!! Form::label('Lead Source Field') !!} :</div>
                    <div class="col-md-6  col-xs-6 col-sm-6 lead-padding">{{$information->lead_source_field}} </div>
                    <div class="clearfix"></div>

                </div>
                @if(isset($productQuestions))
			    <div class="qsn-ansr">

                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Do you permanently reside and work within the UK, Channel Islands or Isle of Man?  </label>
                       <div class="ansr"> {{$productQuestions->question1}}</div>
                    </div>
                                        @if($gf != '')
                        <div class="col-md-12"> 
                         <label> Do you permanently reside and work within the UK, Channel Islands or Isle of Man?  </label>
                           <div class="ansr"> {{$productQuestions->question1}}</div>
                        </div>
                    @endif
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Have you or do you suffer from any major or chronic medical conditions or are you currently taking any medication or awaiting referral for consultation or treatment? </label>
                       <div class="ansr"> {{$productQuestions->question2}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Are you now and have you been for the past six months in continuous permanent employment, contract employment or self employment for more than 16 hours per week? </label>
                       <div class="ansr"> {{$productQuestions->question3}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label>Are you subject to any ongoing enquiry or disciplinary action by your employer</label>
                       <div class="ansr"> {{$productQuestions->question4}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label>Are you aware of any impending unemployment or a risk you may become unemployed. If you are self-employed, you must not be aware of any reasons which would mean your business is likely to close; </label>
                       <div class="ansr"> {{$productQuestions->question5}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Do you know of any redundancies, restructure, reorganisation, financial or contractual threats within the department you work in, even if you do not believe these actions will result in you becoming unemployed?  </label>
                       <div class="ansr"> {{$productQuestions->question6}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Are you aware of any circumstances which may lead to you giving up work to become a full-time carer. </label>
                       <div class="ansr"> {{$productQuestions->question7}}</div>
                    </div>
                  </div>
                  <div class="form-group col-md-12">
                    <div class="col-md-12"> 
                     <label> Have you ever been convicted of and/or charged with any criminal offence (other than motoring convictions and/or spent convictions)?  </label>
                       <div class="ansr"> {{$productQuestions->question8}}</div>
                    </div>
                  </div>
                
                </div>
                @endif


              </form>
            </div>
    </div>
    <!-- </div> -->
</section>

@stop
@section('pageBottomJs')
<style type="text/css">
    .lead-padding{
        margin-bottom: 15px;
    }
</style>

<link rel="stylesheet" href="{{ URL::asset('assets/plugins/iCheck/all.css') }}">
<!-- iCheck 1.0.1 -->
<script src="{{ URL::asset('assets/plugins/iCheck/icheck.min.js') }}"></script>
<script src="{{ URL::asset('assets/plugins/datepicker/bootstrap-datepicker.js') }}"></script>
<script>
    $(document).ready(function () {

        $('#datepicker').datepicker({
          autoclose: true
        });

        //date picker for insurer start date
        // $('#insurerStartdate').datepicker({
        //   autoclose: true,
        //   dateFormat:'YYYY-mm-dd'
        // });

        // $('input[type="checkbox"].minimal, input[type="radio"].minimal').iCheck({
        //   checkboxClass: 'icheckbox_minimal-blue',
        //   radioClass: 'iradio_minimal-blue'
        // });

    });
</script>
@stop