sfinsu.com Open in urlscan Pro
34.69.219.172  Public Scan

URL: https://sfinsu.com/
Submission: On December 20 via api from US — Scanned from FR

Form analysis 4 forms found in the DOM

#

<form id="quote-start-jd9faa0" action="#" class="w-full mt-4 grid gap-6 @2xl:grid-cols-3 @2xl:items-center @2xl:bg-sf-charcoal-100 @2xl:p-6 @2xl:mt-0 @5xl:gap-6 @5xl:p-8 @lg:grid-cols-2 @lg:gap-4"
  :class="!['zip', 'loc'].includes(type()) ? '@lg:grid-cols-1 gap-x-0 @lg:gap-y-4 @2xl:gap-x-4' : '@lg:grid-cols-2 @lg:gap-4'">
  <div :class="!['zip', 'loc'].includes(type()) ? '@2xl:col-span-2' : ''" class="">
    <!-- start partial: shared/components/ui/select-input-label.hbs -->
    <label for="gaq-product-jd9faa0"
      class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
      :class="{}">
      <span class="absolute -top-4 left-0 text-xs font-semi">Select an Insurance Product</span>
      <div class="relative flex flex-row items-center w-full h-full">
        <select id="gaq-product-jd9faa0" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-jd9faa0" :aria-describedby="productSelected ? '' : describeErrorsID()" class="bg-white"
          aria-describedby="">
          <option value="" selected="" hidden="">Select Product</option>
          <template x-for="line in lineOptions">
            <option :value="line.key" x-text="line.label" :selected="line.key === productKey"></option>
          </template>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="auto">Auto</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="motorcycle">Motorcycle</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="homeowners">Homeowners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="condo">Condo Owners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="renters">Renters</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="life">Life</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="medicare">Medicare Supplement</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="hospital">Supplemental Health</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="pet">Pet Insurance</option>
        </select>
        <div class="absolute right-4 pointer-events-none">
          <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
              <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
            </svg></div>
        </div>
      </div>
    </label>
    <!-- end partial: shared/components/ui/select-input-label.hbs -->
  </div>
  <template x-if="['zip', 'loc'].includes(type())">
    <div id="specific-location-info-jd9faa0">
      <div x-show="type() === 'zip'" x-cloak="">
        <!-- start partial: shared/components/ui/text-input-label.hbs -->
        <div class="relative w-full " :class="{}">
          <input id="gaq-zip-jd9faa0" type="text" class="bg-white m2-form-input peer" x-model="zip" name="field-zip" autocomplete="postal-code" placeholder="ZIP Code" aria-required="true" :aria-invalid="!isZipValid()"
            :aria-describedby="isZipValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()">
          <label
            class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
            for="gaq-zip-jd9faa0"> ZIP Code </label>
        </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
      </div>
      <div x-show="type() === 'loc'" x-cloak="">
        <!-- start partial: shared/components/ui/select-input-label.hbs -->
        <label for="gaq-loc-jd9faa0"
          class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
          :class="{}">
          <span class="absolute -top-4 left-0 text-xs font-semi">State Selection</span>
          <div class="relative flex flex-row items-center w-full h-full">
            <select id="gaq-loc-jd9faa0" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()">
              <option value="" selected="" hidden="">Your State</option>
              <option value="AL" :selected="'AL' === state">Alabama</option>
              <option value="AK" :selected="'AK' === state">Alaska</option>
              <option value="AZ" :selected="'AZ' === state">Arizona</option>
              <option value="AR" :selected="'AR' === state">Arkansas</option>
              <option value="CA" :selected="'CA' === state">California</option>
              <option value="CO" :selected="'CO' === state">Colorado</option>
              <option value="CT" :selected="'CT' === state">Connecticut</option>
              <option value="DE" :selected="'DE' === state">Delaware</option>
              <option value="FL" :selected="'FL' === state">Florida</option>
              <option value="GA" :selected="'GA' === state">Georgia</option>
              <option value="HI" :selected="'HI' === state">Hawaii</option>
              <option value="ID" :selected="'ID' === state">Idaho</option>
              <option value="IL" :selected="'IL' === state">Illinois</option>
              <option value="IN" :selected="'IN' === state">Indiana</option>
              <option value="IA" :selected="'IA' === state">Iowa</option>
              <option value="KS" :selected="'KS' === state">Kansas</option>
              <option value="KY" :selected="'KY' === state">Kentucky</option>
              <option value="LA" :selected="'LA' === state">Louisiana</option>
              <option value="ME" :selected="'ME' === state">Maine</option>
              <option value="MD" :selected="'MD' === state">Maryland</option>
              <option value="MA" :selected="'MA' === state">Massachusetts</option>
              <option value="MI" :selected="'MI' === state">Michigan</option>
              <option value="MN" :selected="'MN' === state">Minnesota</option>
              <option value="MS" :selected="'MS' === state">Mississippi</option>
              <option value="MO" :selected="'MO' === state">Missouri</option>
              <option value="MT" :selected="'MT' === state">Montana</option>
              <option value="NE" :selected="'NE' === state">Nebraska</option>
              <option value="NV" :selected="'NV' === state">Nevada</option>
              <option value="NH" :selected="'NH' === state">New Hampshire</option>
              <option value="NJ" :selected="'NJ' === state">New Jersey</option>
              <option value="NM" :selected="'NM' === state">New Mexico</option>
              <option value="NY" :selected="'NY' === state">New York</option>
              <option value="NC" :selected="'NC' === state">North Carolina</option>
              <option value="ND" :selected="'ND' === state">North Dakota</option>
              <option value="OH" :selected="'OH' === state">Ohio</option>
              <option value="OK" :selected="'OK' === state">Oklahoma</option>
              <option value="OR" :selected="'OR' === state">Oregon</option>
              <option value="PA" :selected="'PA' === state">Pennsylvania</option>
              <option value="RI" :selected="'RI' === state">Rhode Island</option>
              <option value="SC" :selected="'SC' === state">South Carolina</option>
              <option value="SD" :selected="'SD' === state">South Dakota</option>
              <option value="TN" :selected="'TN' === state">Tennessee</option>
              <option value="TX" :selected="'TX' === state">Texas</option>
              <option value="UT" :selected="'UT' === state">Utah</option>
              <option value="VT" :selected="'VT' === state">Vermont</option>
              <option value="VA" :selected="'VA' === state">Virginia</option>
              <option value="WA" :selected="'WA' === state">Washington</option>
              <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
              <option value="WV" :selected="'WV' === state">West Virginia</option>
              <option value="WI" :selected="'WI' === state">Wisconsin</option>
              <option value="WY" :selected="'WY' === state">Wyoming</option>
            </select>
            <div class="absolute right-4 pointer-events-none">
              <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                  <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
                </svg></div>
            </div>
          </div>
        </label>
        <!-- end partial: shared/components/ui/select-input-label.hbs -->
      </div>
    </div>
  </template>
  <div id="specific-location-info-jd9faa0">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-jd9faa0" type="text" class="bg-white m2-form-input peer" x-model="zip" name="field-zip" autocomplete="postal-code" placeholder="ZIP Code" aria-required="true" :aria-invalid="!isZipValid()"
          :aria-describedby="isZipValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()" aria-describedby="">
        <label
          class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
          for="gaq-zip-jd9faa0"> ZIP Code </label>
      </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
    </div>
    <div x-show="type() === 'loc'" style="display: none;">
      <!-- start partial: shared/components/ui/select-input-label.hbs -->
      <label for="gaq-loc-jd9faa0"
        class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
        :class="{}">
        <span class="absolute -top-4 left-0 text-xs font-semi">State Selection</span>
        <div class="relative flex flex-row items-center w-full h-full">
          <select id="gaq-loc-jd9faa0" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()"
            aria-describedby="">
            <option value="" selected="" hidden="">Your State</option>
            <option value="AL" :selected="'AL' === state">Alabama</option>
            <option value="AK" :selected="'AK' === state">Alaska</option>
            <option value="AZ" :selected="'AZ' === state">Arizona</option>
            <option value="AR" :selected="'AR' === state">Arkansas</option>
            <option value="CA" :selected="'CA' === state">California</option>
            <option value="CO" :selected="'CO' === state">Colorado</option>
            <option value="CT" :selected="'CT' === state">Connecticut</option>
            <option value="DE" :selected="'DE' === state">Delaware</option>
            <option value="FL" :selected="'FL' === state">Florida</option>
            <option value="GA" :selected="'GA' === state">Georgia</option>
            <option value="HI" :selected="'HI' === state">Hawaii</option>
            <option value="ID" :selected="'ID' === state">Idaho</option>
            <option value="IL" :selected="'IL' === state">Illinois</option>
            <option value="IN" :selected="'IN' === state">Indiana</option>
            <option value="IA" :selected="'IA' === state">Iowa</option>
            <option value="KS" :selected="'KS' === state">Kansas</option>
            <option value="KY" :selected="'KY' === state">Kentucky</option>
            <option value="LA" :selected="'LA' === state">Louisiana</option>
            <option value="ME" :selected="'ME' === state">Maine</option>
            <option value="MD" :selected="'MD' === state">Maryland</option>
            <option value="MA" :selected="'MA' === state">Massachusetts</option>
            <option value="MI" :selected="'MI' === state">Michigan</option>
            <option value="MN" :selected="'MN' === state">Minnesota</option>
            <option value="MS" :selected="'MS' === state">Mississippi</option>
            <option value="MO" :selected="'MO' === state">Missouri</option>
            <option value="MT" :selected="'MT' === state">Montana</option>
            <option value="NE" :selected="'NE' === state">Nebraska</option>
            <option value="NV" :selected="'NV' === state">Nevada</option>
            <option value="NH" :selected="'NH' === state">New Hampshire</option>
            <option value="NJ" :selected="'NJ' === state">New Jersey</option>
            <option value="NM" :selected="'NM' === state">New Mexico</option>
            <option value="NY" :selected="'NY' === state">New York</option>
            <option value="NC" :selected="'NC' === state">North Carolina</option>
            <option value="ND" :selected="'ND' === state">North Dakota</option>
            <option value="OH" :selected="'OH' === state">Ohio</option>
            <option value="OK" :selected="'OK' === state">Oklahoma</option>
            <option value="OR" :selected="'OR' === state">Oregon</option>
            <option value="PA" :selected="'PA' === state">Pennsylvania</option>
            <option value="RI" :selected="'RI' === state">Rhode Island</option>
            <option value="SC" :selected="'SC' === state">South Carolina</option>
            <option value="SD" :selected="'SD' === state">South Dakota</option>
            <option value="TN" :selected="'TN' === state">Tennessee</option>
            <option value="TX" :selected="'TX' === state">Texas</option>
            <option value="UT" :selected="'UT' === state">Utah</option>
            <option value="VT" :selected="'VT' === state">Vermont</option>
            <option value="VA" :selected="'VA' === state">Virginia</option>
            <option value="WA" :selected="'WA' === state">Washington</option>
            <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
            <option value="WV" :selected="'WV' === state">West Virginia</option>
            <option value="WI" :selected="'WI' === state">Wisconsin</option>
            <option value="WY" :selected="'WY' === state">Wyoming</option>
          </select>
          <div class="absolute right-4 pointer-events-none">
            <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
              </svg></div>
          </div>
        </div>
      </label>
      <!-- end partial: shared/components/ui/select-input-label.hbs -->
    </div>
  </div>
  <div class="w-full @lg:col-span-2 @2xl:col-span-1">
    <button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="btn btn-primary">
      <span x-show="!['business', 'motorcycle'].includes(productKey)">Start a Quote</span>
      <span x-show="['business', 'motorcycle'].includes(productKey)" style="display: none;">Request a Quote</span>
    </button>
  </div>
  <template x-if="errors.length > 0">
    <div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID">
      <template x-for="error in errors">
        <h3 class="p-3 border-2 font-med text-sf-red-700 bg-sf-red-100 border-sf-red-700 rounded-2xl" x-html="error"></h3>
      </template>
    </div>
  </template>
</form>

#

<form id="quote-start-y0qi5r3" action="#" class="w-full mt-4 grid gap-6 @2xl:grid-cols-3 @2xl:items-center @2xl:bg-sf-charcoal-100 @2xl:p-6 @2xl:mt-0 @5xl:gap-6 @5xl:p-8 @lg:grid-cols-2 @lg:gap-4"
  :class="!['zip', 'loc'].includes(type()) ? '@lg:grid-cols-1 gap-x-0 @lg:gap-y-4 @2xl:gap-x-4' : '@lg:grid-cols-2 @lg:gap-4'">
  <div :class="!['zip', 'loc'].includes(type()) ? '@2xl:col-span-2' : ''" class="">
    <!-- start partial: shared/components/ui/select-input-label.hbs -->
    <label for="gaq-product-y0qi5r3"
      class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
      :class="{}">
      <span class="absolute -top-4 left-0 text-xs font-semi">Select an Insurance Product</span>
      <div class="relative flex flex-row items-center w-full h-full">
        <select id="gaq-product-y0qi5r3" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-y0qi5r3" :aria-describedby="productSelected ? '' : describeErrorsID()" class="bg-white"
          aria-describedby="">
          <option value="" selected="" hidden="">Select Product</option>
          <template x-for="line in lineOptions">
            <option :value="line.key" x-text="line.label" :selected="line.key === productKey"></option>
          </template>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="auto">Auto</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="motorcycle">Motorcycle</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="homeowners">Homeowners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="condo">Condo Owners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="renters">Renters</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="life">Life</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="medicare">Medicare Supplement</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="hospital">Supplemental Health</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="pet">Pet Insurance</option>
        </select>
        <div class="absolute right-4 pointer-events-none">
          <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
              <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
            </svg></div>
        </div>
      </div>
    </label>
    <!-- end partial: shared/components/ui/select-input-label.hbs -->
  </div>
  <template x-if="['zip', 'loc'].includes(type())">
    <div id="specific-location-info-y0qi5r3">
      <div x-show="type() === 'zip'" x-cloak="">
        <!-- start partial: shared/components/ui/text-input-label.hbs -->
        <div class="relative w-full " :class="{}">
          <input id="gaq-zip-y0qi5r3" type="text" class="bg-white m2-form-input peer" x-model="zip" name="field-zip" autocomplete="postal-code" placeholder="ZIP Code" aria-required="true" :aria-invalid="!isZipValid()"
            :aria-describedby="isZipValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()">
          <label
            class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
            for="gaq-zip-y0qi5r3"> ZIP Code </label>
        </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
      </div>
      <div x-show="type() === 'loc'" x-cloak="">
        <!-- start partial: shared/components/ui/select-input-label.hbs -->
        <label for="gaq-loc-y0qi5r3"
          class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
          :class="{}">
          <span class="absolute -top-4 left-0 text-xs font-semi">State Selection</span>
          <div class="relative flex flex-row items-center w-full h-full">
            <select id="gaq-loc-y0qi5r3" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()">
              <option value="" selected="" hidden="">Your State</option>
              <option value="AL" :selected="'AL' === state">Alabama</option>
              <option value="AK" :selected="'AK' === state">Alaska</option>
              <option value="AZ" :selected="'AZ' === state">Arizona</option>
              <option value="AR" :selected="'AR' === state">Arkansas</option>
              <option value="CA" :selected="'CA' === state">California</option>
              <option value="CO" :selected="'CO' === state">Colorado</option>
              <option value="CT" :selected="'CT' === state">Connecticut</option>
              <option value="DE" :selected="'DE' === state">Delaware</option>
              <option value="FL" :selected="'FL' === state">Florida</option>
              <option value="GA" :selected="'GA' === state">Georgia</option>
              <option value="HI" :selected="'HI' === state">Hawaii</option>
              <option value="ID" :selected="'ID' === state">Idaho</option>
              <option value="IL" :selected="'IL' === state">Illinois</option>
              <option value="IN" :selected="'IN' === state">Indiana</option>
              <option value="IA" :selected="'IA' === state">Iowa</option>
              <option value="KS" :selected="'KS' === state">Kansas</option>
              <option value="KY" :selected="'KY' === state">Kentucky</option>
              <option value="LA" :selected="'LA' === state">Louisiana</option>
              <option value="ME" :selected="'ME' === state">Maine</option>
              <option value="MD" :selected="'MD' === state">Maryland</option>
              <option value="MA" :selected="'MA' === state">Massachusetts</option>
              <option value="MI" :selected="'MI' === state">Michigan</option>
              <option value="MN" :selected="'MN' === state">Minnesota</option>
              <option value="MS" :selected="'MS' === state">Mississippi</option>
              <option value="MO" :selected="'MO' === state">Missouri</option>
              <option value="MT" :selected="'MT' === state">Montana</option>
              <option value="NE" :selected="'NE' === state">Nebraska</option>
              <option value="NV" :selected="'NV' === state">Nevada</option>
              <option value="NH" :selected="'NH' === state">New Hampshire</option>
              <option value="NJ" :selected="'NJ' === state">New Jersey</option>
              <option value="NM" :selected="'NM' === state">New Mexico</option>
              <option value="NY" :selected="'NY' === state">New York</option>
              <option value="NC" :selected="'NC' === state">North Carolina</option>
              <option value="ND" :selected="'ND' === state">North Dakota</option>
              <option value="OH" :selected="'OH' === state">Ohio</option>
              <option value="OK" :selected="'OK' === state">Oklahoma</option>
              <option value="OR" :selected="'OR' === state">Oregon</option>
              <option value="PA" :selected="'PA' === state">Pennsylvania</option>
              <option value="RI" :selected="'RI' === state">Rhode Island</option>
              <option value="SC" :selected="'SC' === state">South Carolina</option>
              <option value="SD" :selected="'SD' === state">South Dakota</option>
              <option value="TN" :selected="'TN' === state">Tennessee</option>
              <option value="TX" :selected="'TX' === state">Texas</option>
              <option value="UT" :selected="'UT' === state">Utah</option>
              <option value="VT" :selected="'VT' === state">Vermont</option>
              <option value="VA" :selected="'VA' === state">Virginia</option>
              <option value="WA" :selected="'WA' === state">Washington</option>
              <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
              <option value="WV" :selected="'WV' === state">West Virginia</option>
              <option value="WI" :selected="'WI' === state">Wisconsin</option>
              <option value="WY" :selected="'WY' === state">Wyoming</option>
            </select>
            <div class="absolute right-4 pointer-events-none">
              <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                  <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
                </svg></div>
            </div>
          </div>
        </label>
        <!-- end partial: shared/components/ui/select-input-label.hbs -->
      </div>
    </div>
  </template>
  <div id="specific-location-info-y0qi5r3">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-y0qi5r3" type="text" class="bg-white m2-form-input peer" x-model="zip" name="field-zip" autocomplete="postal-code" placeholder="ZIP Code" aria-required="true" :aria-invalid="!isZipValid()"
          :aria-describedby="isZipValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()" aria-describedby="">
        <label
          class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
          for="gaq-zip-y0qi5r3"> ZIP Code </label>
      </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
    </div>
    <div x-show="type() === 'loc'" style="display: none;">
      <!-- start partial: shared/components/ui/select-input-label.hbs -->
      <label for="gaq-loc-y0qi5r3"
        class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&amp;_select]:h-full [&amp;_select]:w-full [&amp;_select]:cursor-pointer [&amp;_select]:appearance-none [&amp;_select]:px-3 [&amp;_select]:transition-shadow [&amp;_select]:focus-within:outline-none [&amp;_select]:focus-within:ring [&amp;_select]:focus-within:ring-inset [&amp;_select]:focus-within:ring-sf-red-500 "
        :class="{}">
        <span class="absolute -top-4 left-0 text-xs font-semi">State Selection</span>
        <div class="relative flex flex-row items-center w-full h-full">
          <select id="gaq-loc-y0qi5r3" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()"
            aria-describedby="">
            <option value="" selected="" hidden="">Your State</option>
            <option value="AL" :selected="'AL' === state">Alabama</option>
            <option value="AK" :selected="'AK' === state">Alaska</option>
            <option value="AZ" :selected="'AZ' === state">Arizona</option>
            <option value="AR" :selected="'AR' === state">Arkansas</option>
            <option value="CA" :selected="'CA' === state">California</option>
            <option value="CO" :selected="'CO' === state">Colorado</option>
            <option value="CT" :selected="'CT' === state">Connecticut</option>
            <option value="DE" :selected="'DE' === state">Delaware</option>
            <option value="FL" :selected="'FL' === state">Florida</option>
            <option value="GA" :selected="'GA' === state">Georgia</option>
            <option value="HI" :selected="'HI' === state">Hawaii</option>
            <option value="ID" :selected="'ID' === state">Idaho</option>
            <option value="IL" :selected="'IL' === state">Illinois</option>
            <option value="IN" :selected="'IN' === state">Indiana</option>
            <option value="IA" :selected="'IA' === state">Iowa</option>
            <option value="KS" :selected="'KS' === state">Kansas</option>
            <option value="KY" :selected="'KY' === state">Kentucky</option>
            <option value="LA" :selected="'LA' === state">Louisiana</option>
            <option value="ME" :selected="'ME' === state">Maine</option>
            <option value="MD" :selected="'MD' === state">Maryland</option>
            <option value="MA" :selected="'MA' === state">Massachusetts</option>
            <option value="MI" :selected="'MI' === state">Michigan</option>
            <option value="MN" :selected="'MN' === state">Minnesota</option>
            <option value="MS" :selected="'MS' === state">Mississippi</option>
            <option value="MO" :selected="'MO' === state">Missouri</option>
            <option value="MT" :selected="'MT' === state">Montana</option>
            <option value="NE" :selected="'NE' === state">Nebraska</option>
            <option value="NV" :selected="'NV' === state">Nevada</option>
            <option value="NH" :selected="'NH' === state">New Hampshire</option>
            <option value="NJ" :selected="'NJ' === state">New Jersey</option>
            <option value="NM" :selected="'NM' === state">New Mexico</option>
            <option value="NY" :selected="'NY' === state">New York</option>
            <option value="NC" :selected="'NC' === state">North Carolina</option>
            <option value="ND" :selected="'ND' === state">North Dakota</option>
            <option value="OH" :selected="'OH' === state">Ohio</option>
            <option value="OK" :selected="'OK' === state">Oklahoma</option>
            <option value="OR" :selected="'OR' === state">Oregon</option>
            <option value="PA" :selected="'PA' === state">Pennsylvania</option>
            <option value="RI" :selected="'RI' === state">Rhode Island</option>
            <option value="SC" :selected="'SC' === state">South Carolina</option>
            <option value="SD" :selected="'SD' === state">South Dakota</option>
            <option value="TN" :selected="'TN' === state">Tennessee</option>
            <option value="TX" :selected="'TX' === state">Texas</option>
            <option value="UT" :selected="'UT' === state">Utah</option>
            <option value="VT" :selected="'VT' === state">Vermont</option>
            <option value="VA" :selected="'VA' === state">Virginia</option>
            <option value="WA" :selected="'WA' === state">Washington</option>
            <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
            <option value="WV" :selected="'WV' === state">West Virginia</option>
            <option value="WI" :selected="'WI' === state">Wisconsin</option>
            <option value="WY" :selected="'WY' === state">Wyoming</option>
          </select>
          <div class="absolute right-4 pointer-events-none">
            <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
              </svg></div>
          </div>
        </div>
      </label>
      <!-- end partial: shared/components/ui/select-input-label.hbs -->
    </div>
  </div>
  <div class="w-full @lg:col-span-2 @2xl:col-span-1">
    <button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="btn btn-primary">
      <span x-show="!['business', 'motorcycle'].includes(productKey)">Start a Quote</span>
      <span x-show="['business', 'motorcycle'].includes(productKey)" style="display: none;">Request a Quote</span>
    </button>
  </div>
  <template x-if="errors.length > 0">
    <div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID">
      <template x-for="error in errors">
        <h3 class="p-3 border-2 font-med text-sf-red-700 bg-sf-red-100 border-sf-red-700 rounded-2xl" x-html="error"></h3>
      </template>
    </div>
  </template>
</form>

POST

<form x-show="!sendResponse &amp;&amp; !sending" :action="`/contact${qs}`" method="post" aria-describedby="disclaimers">
  <h2 x-show="true" class="hidden text-2xl font-med md:block"> You can also call us at <a :id="$id('phone-link-contact-form')" aria-label="You can also call us at (818) 888-0228" href="tel:8188880228" class="red-link">
                        (818) 888-0228
                    </a>
  </h2>
  <!-- start partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <label x-id="['preferred__alpha']" :for="$id('preferred__alpha')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__alpha <input :id="$id('preferred__alpha')" type="url" name="preferred__alpha" tabindex="-1"
      x-model="form.preferred__alpha" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__beta']" :for="$id('preferred__beta')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__beta <input :id="$id('preferred__beta')" type="text" name="preferred__beta" tabindex="-1"
      x-model="form.preferred__beta" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__extra']" :for="$id('preferred__extra')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__extra <input :id="$id('preferred__extra')" type="checkbox" name="preferred__extra" tabindex="-1"
      x-model="form.preferred__extra" autocomplete="off" value="">
  </label>
  <!-- end partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <h2 class="text-2xl text-center mb-4 font-med md:hidden"> Contact Us </h2>
  <div class="flex flex-col min-w-0 md:mt-8 md:flex-row">
    <div class="w-full md:w-1/2 md:shrink-0 md:mr-8 lg:w-2/3 xl:m-0">
      <div class="flex flex-col w-full xl:flex-row">
        <div class="flex flex-col xl:h-full xl:justify-between xl:w-1/2 xl:pr-8">
          <div class="hidden mt-4 xl:block">
            <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
            <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
              <legend class="text-sm uppercase"> Your preferred method of contact </legend>
              <ul class="mt-2 flex flex-row">
                <li>
                  <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
                </li>
                <li>
                  <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
                </li>
              </ul>
            </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
          </div>
          <div class="xl:mt-6">
            <!-- start partial: shared/components/contact-forms/cf-contact-info.hbs -->
            <div class="flex flex-col w-full space-y-5" x-id="['contact-form-name', 'contact-form-phone', 'contact-form-email', 'contact-form-email-or-phone']">
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-name')" class="m2-form-input peer " name="contact-form-name" x-model="form.name" :aria-required="true" autocomplete="name" type="text" placeholder="Your Name" :aria-invalid="hasError('name')"
                  :aria-describedby="hasError('name') ? $id('error', 'name') : null" :error="hasError('name')" @keydown.debounce.750ms="validateName()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-name')"> Your Name<span aria-hidden="true" x-show="hasError('name')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-phone')" class="m2-form-input peer " name="contact-form-phone" x-model="form.phone" :aria-required="hasError('phone') &amp;&amp; form.pref == 'phone'" autocomplete="tel" type="text"
                  placeholder="Your Phone" :aria-invalid="hasError('phone')" :aria-describedby="hasError('phone') ? $id('error', 'phone') : null" :error="hasError('phone')" @keydown.debounce.750ms="validatePhone()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-phone')"> Your Phone<span aria-hidden="true" x-show="hasError('phone')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-email')" class="m2-form-input peer " name="contact-form-email" x-model="form.email" :aria-required="hasError('email') &amp;&amp; form.pref == 'email'" autocomplete="email" type="text"
                  placeholder="Your Email" :aria-invalid="hasError('email')" :aria-describedby="hasError('email') ? $id('error', 'email') : null" :error="hasError('email')" @keydown.debounce.750ms="validateEmail()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-email')"> Your Email<span aria-hidden="true" x-show="hasError('email')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-contact-info.hbs -->
          </div>
        </div>
        <div class="flex-col hidden xl:w-1/2 md:flex xl:flex-col-reverse xl:justify-end">
          <div class="h-full mt-5">
            <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
            <div class="relative h-full" x-id="[
        'md-contact-form-message'
    ]">
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full h-full" :class="{}">
                <textarea :id="$id('md-contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48 xl:h-full pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
                  :aria-describedby="`char-limit, md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
                  @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
                <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('md-contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
          </div>
          <div class="mt-4">
            <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
            <p class="text-xs" id="md-message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
            <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full md:w-1/2 lg:w-1/3 xl:justify-between xl:pl-8">
      <div class="mt-6 xl:hidden md:m-0">
        <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
        <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
          <legend class="text-sm uppercase"> Your preferred method of contact </legend>
          <ul class="mt-2 flex flex-row">
            <li>
              <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
            </li>
            <li>
              <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
            </li>
          </ul>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
      </div>
      <div class="flex w-full mt-4 xl:h-full">
        <!-- start partial: shared/components/contact-forms/cf-more-info.hbs -->
        <fieldset class="flex w-full flex-col" x-id="['contact-form-checkbox-input']">
          <legend class="mb-2 text-sm uppercase"> I'd like more info about: <span aria-hidden="true" x-show="hasError('message')"> * </span>
          </legend>
          <div class="grid sm:grid-flow-col sm:grid-cols-2 sm:grid-rows-3 md:grid-cols-1 md:grid-rows-6 xl:h-full">
            <template x-for="(i, k) in moreVals" :key="i.id">
              <div :id="$id(`contact-form-checkbox-${i.id}`)" class="m2-contact-form-checkbox">
                <input :id="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-input absolute h-0 w-0 overflow-hidden border-none p-0" x-model="form.more" type="checkbox"
                  :aria-describedby="hasError('message') ? $id('error', 'message') : null" :value="i.label" :aria-label="`${k + 1} of ${moreVals().length}, I'd like more info about ${i.label}`" :aria-invalid="hasError('more')"
                  @click="validateMessage()">
                <label :for="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-label flex cursor-pointer items-center rounded py-2 pl-8 transition-all hover:bg-sf-charcoal-100">
                  <svg viewBox="0 0 100 100" class="absolute left-1 h-4 w-4">
                    <path class="path" fill="none" stroke="#000" stroke-width="13" stroke-linecap="round" stroke-linejoin="round" stroke-miterlimit="10" d="M12.1 52.1l24.4 24.4 53-53"></path>
                  </svg>
                  <span class="text-sm" x-html="i.label"></span>
                </label>
              </div>
            </template>
          </div>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-more-info.hbs -->
      </div>
      <div class="mt-4 text-xs md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
        <p class="text-xs" id="message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
        <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
      </div>
      <div class="mt-5 md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
        <div class="relative h-full" x-id="[
        'contact-form-message'
    ]">
          <!-- start partial: shared/components/ui/text-input-label.hbs -->
          <div class="relative w-full h-full" :class="{}">
            <textarea :id="$id('contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48  pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
              :aria-describedby="`char-limit, message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
              @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
            <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$id('contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
            </label>
          </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
        </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
      </div>
    </div>
  </div>
  <div class="flex flex-col w-full mt-4 pt-3 md:flex-row xl:justify-end">
    <div class="md:w-1/2 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-file-input.hbs -->
      <div x-ref="contactFormAttachments" class="w-full" x-data="initFileInput()">
        <div x-show="$store.fileList.length" class="w-full mb-2 text-xl italic text-center border-b-2 border-gray-400 border-dashed" x-text="$store.fileList.length + ' attached file' + ($store.fileList.length > 1 ? 's:' : ':')">
        </div>
        <template x-for="(att, idx) in $store.fileList">
          <div :key="idx" class="relative my-2 grid w-full grid-cols-4 flex-nowrap bg-sf-charcoal-100 p-4">
            <div class="flex justify-center h-12 col-span-1 mr-4">
              <img x-show="checkType(att) === 'img'" :id="att.name" class="object-contain" :alt="att.name">
              <template x-if="checkType(att) != 'img'">
                <div x-html="svgIcon(checkType(att), &quot;h-full&quot;)" class="h-full">
                </div>
              </template>
            </div>
            <div class="flex flex-col justify-center col-span-3 mr-1">
              <div class="flex flex-row w-full mb-1">
                <span :aria-label="`This file is ${friendlySize(att.size)} in size`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 text-xs rounded-full w-max bg-sf-charcoal-200" x-html="friendlySize(att.size)"></span>
                <span :aria-label="`This file is a ${friendlyExtension(att.name)} file`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 ml-1 text-xs rounded-full w-max bg-sf-charcoal-200"
                  x-html="friendlyExtension(att.name)"></span>
              </div>
              <p class="text-sm truncate md:text-base" x-text="att.name">
              </p>
            </div>
            <a href="#" :title="`Cancel upload of ${att.name}`" @click.prevent="removeFile(idx)" class="absolute top-0 p-2 right-1">
                <span class="red-link whitespace-nowrap">
                    <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 12 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet"><path d="M8.57 8.43 7.429 9.571a.25.25 0 0 1-.359 0L6 8.501l-1.07 1.07a.25.25 0 0 1-.359 0L3.43 8.43a.25.25 0 0 1 0-.359l1.07-1.07-1.07-1.07a.25.25 0 0 1 0-.359l1.141-1.141a.25.25 0 0 1 .359 0L6 5.501l1.07-1.07a.25.25 0 0 1 .359 0L8.57 5.572a.25.25 0 0 1 0 .359L7.5 7.001l1.07 1.07a.25.25 0 0 1 0 .359M10.25 7c0-2.344-1.906-4.25-4.25-4.25S1.75 4.656 1.75 7 3.656 11.25 6 11.25 10.25 9.344 10.25 7M12 7A6 6 0 0 1 0 7a6 6 0 0 1 12 0"></path></svg></div>
                    Remove
                </span>
            </a>
          </div>
        </template>
        <div x-id="['m2-file-upload-input']">
          <label :for="$id(&quot;m2-file-upload-input&quot;)">
            <span role="button" class="text-lg btn btn-secondary" :aria-controls="$id(&quot;m2-file-upload-input&quot;)" tabindex="0" @keydown.enter="$refs['file-upload-input'].click()" @keydown.space="$refs['file-upload-input'].click()"
              x-text="`Add Attachments ${sizeRemainingMessage()}`">
            </span>
          </label>
          <input x-ref="file-upload-input" type="file" hidden="" :id="$id(&quot;m2-file-upload-input&quot;)" name="m2-cf-attachments" multiple="" :aria-disabled="tooManyBytes" :accept="acceptableFileTypes" @change="pickFiles($event.target.files)">
          <div class="mt-2 text-xs"> Please attach only <span x-text="readableExtensionList()"></span> file(s) — Unsupported file types will not be delivered to the agent. </div>
        </div>
      </div><!-- end partial: shared/components/contact-forms/cf-file-input.hbs -->
    </div>
    <div class="w-full mt-4 md:w-1/2 md:m-0 md:pl-8 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-submit.hbs -->
      <button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary"> Send Email </button><!-- end partial: shared/components/contact-forms/cf-submit.hbs -->
    </div>
  </div>
  <!-- start partial: shared/components/contact-forms/cf-errors.hbs -->
  <div x-show="hasErrors" role="alert" class="my-4 rounded-2xl bg-sf-red-100 p-4 text-sf-red-700">
    <!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
    <!-- "Please forgive this" -->
    <h3 class="font-semi mb-2 text-xl"> Please correct the following: </h3>
    <ul class="list-inside list-disc">
      <template x-for="(message, key) in errors" :key="$id('error', key)">
        <li class="mb-1" :id="$id('error', key)" x-html="message"></li>
      </template>
    </ul>
  </div><!-- end partial: shared/components/contact-forms/cf-errors.hbs -->
  <div id="disclaimers">
    <div class="mt-4">
      <!-- start partial: shared/components/contact-forms/cf-disclaimer.hbs -->
      <p :id="$id('cf-disclaimer')" class="text-xs leading-3"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email for marketing
        purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
        have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
        apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p><!-- end partial: shared/components/contact-forms/cf-disclaimer.hbs -->
    </div>
    <p class="mt-2" x-show="!false">
      <!-- start partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    </p>
    <p class="text-xs leading-3">
      <span class="font-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a licensed
      representative in the agent's office, or by contacting the State Farm toll-free customer service line at
      <span><a href="tel:8557337333" class="red-link" aria-label="Contact the State Farm toll-free customer service line at (855) 733-7333">(855) 733-7333</a>.</span>
    </p><!-- end partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    <p></p>
  </div>
</form>

POST

<form x-show="!sendResponse &amp;&amp; !sending" :action="`/contact${qs}`" method="post" aria-describedby="disclaimers">
  <h2 x-show="true" class="hidden text-2xl font-med md:block"> You can also call us at <a :id="$id('phone-link-contact-form')" aria-label="You can also call us at (818) 888-0228" href="tel:8188880228" class="red-link">
                        (818) 888-0228
                    </a>
  </h2>
  <!-- start partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <label x-id="['preferred__alpha']" :for="$id('preferred__alpha')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__alpha <input :id="$id('preferred__alpha')" type="url" name="preferred__alpha" tabindex="-1"
      x-model="form.preferred__alpha" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__beta']" :for="$id('preferred__beta')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__beta <input :id="$id('preferred__beta')" type="text" name="preferred__beta" tabindex="-1"
      x-model="form.preferred__beta" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__extra']" :for="$id('preferred__extra')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__extra <input :id="$id('preferred__extra')" type="checkbox" name="preferred__extra" tabindex="-1"
      x-model="form.preferred__extra" autocomplete="off" value="">
  </label>
  <!-- end partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <h2 class="text-2xl text-center mb-4 font-med md:hidden"> Contact Us </h2>
  <div class="flex flex-col min-w-0 md:mt-8 md:flex-row">
    <div class="w-full md:w-1/2 md:shrink-0 md:mr-8 lg:w-2/3 xl:m-0">
      <div class="flex flex-col w-full xl:flex-row">
        <div class="flex flex-col xl:h-full xl:justify-between xl:w-1/2 xl:pr-8">
          <div class="hidden mt-4 xl:block">
            <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
            <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
              <legend class="text-sm uppercase"> Your preferred method of contact </legend>
              <ul class="mt-2 flex flex-row">
                <li>
                  <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
                </li>
                <li>
                  <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
                </li>
              </ul>
            </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
          </div>
          <div class="xl:mt-6">
            <!-- start partial: shared/components/contact-forms/cf-contact-info.hbs -->
            <div class="flex flex-col w-full space-y-5" x-id="['contact-form-name', 'contact-form-phone', 'contact-form-email', 'contact-form-email-or-phone']">
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-name')" class="m2-form-input peer " name="contact-form-name" x-model="form.name" :aria-required="true" autocomplete="name" type="text" placeholder="Your Name" :aria-invalid="hasError('name')"
                  :aria-describedby="hasError('name') ? $id('error', 'name') : null" :error="hasError('name')" @keydown.debounce.750ms="validateName()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-name')"> Your Name<span aria-hidden="true" x-show="hasError('name')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-phone')" class="m2-form-input peer " name="contact-form-phone" x-model="form.phone" :aria-required="hasError('phone') &amp;&amp; form.pref == 'phone'" autocomplete="tel" type="text"
                  placeholder="Your Phone" :aria-invalid="hasError('phone')" :aria-describedby="hasError('phone') ? $id('error', 'phone') : null" :error="hasError('phone')" @keydown.debounce.750ms="validatePhone()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-phone')"> Your Phone<span aria-hidden="true" x-show="hasError('phone')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-email')" class="m2-form-input peer " name="contact-form-email" x-model="form.email" :aria-required="hasError('email') &amp;&amp; form.pref == 'email'" autocomplete="email" type="text"
                  placeholder="Your Email" :aria-invalid="hasError('email')" :aria-describedby="hasError('email') ? $id('error', 'email') : null" :error="hasError('email')" @keydown.debounce.750ms="validateEmail()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-email')"> Your Email<span aria-hidden="true" x-show="hasError('email')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-contact-info.hbs -->
          </div>
        </div>
        <div class="flex-col hidden xl:w-1/2 md:flex xl:flex-col-reverse xl:justify-end">
          <div class="h-full mt-5">
            <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
            <div class="relative h-full" x-id="[
        'md-contact-form-message'
    ]">
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full h-full" :class="{}">
                <textarea :id="$id('md-contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48 xl:h-full pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
                  :aria-describedby="`char-limit, md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
                  @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
                <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('md-contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
          </div>
          <div class="mt-4">
            <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
            <p class="text-xs" id="md-message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
            <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full md:w-1/2 lg:w-1/3 xl:justify-between xl:pl-8">
      <div class="mt-6 xl:hidden md:m-0">
        <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
        <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
          <legend class="text-sm uppercase"> Your preferred method of contact </legend>
          <ul class="mt-2 flex flex-row">
            <li>
              <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
            </li>
            <li>
              <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
            </li>
          </ul>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
      </div>
      <div class="flex w-full mt-4 xl:h-full">
        <!-- start partial: shared/components/contact-forms/cf-more-info.hbs -->
        <fieldset class="flex w-full flex-col" x-id="['contact-form-checkbox-input']">
          <legend class="mb-2 text-sm uppercase"> I'd like more info about: <span aria-hidden="true" x-show="hasError('message')"> * </span>
          </legend>
          <div class="grid sm:grid-flow-col sm:grid-cols-2 sm:grid-rows-3 md:grid-cols-1 md:grid-rows-6 xl:h-full">
            <template x-for="(i, k) in moreVals" :key="i.id">
              <div :id="$id(`contact-form-checkbox-${i.id}`)" class="m2-contact-form-checkbox">
                <input :id="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-input absolute h-0 w-0 overflow-hidden border-none p-0" x-model="form.more" type="checkbox"
                  :aria-describedby="hasError('message') ? $id('error', 'message') : null" :value="i.label" :aria-label="`${k + 1} of ${moreVals().length}, I'd like more info about ${i.label}`" :aria-invalid="hasError('more')"
                  @click="validateMessage()">
                <label :for="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-label flex cursor-pointer items-center rounded py-2 pl-8 transition-all hover:bg-sf-charcoal-100">
                  <svg viewBox="0 0 100 100" class="absolute left-1 h-4 w-4">
                    <path class="path" fill="none" stroke="#000" stroke-width="13" stroke-linecap="round" stroke-linejoin="round" stroke-miterlimit="10" d="M12.1 52.1l24.4 24.4 53-53"></path>
                  </svg>
                  <span class="text-sm" x-html="i.label"></span>
                </label>
              </div>
            </template>
          </div>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-more-info.hbs -->
      </div>
      <div class="mt-4 text-xs md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
        <p class="text-xs" id="message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
        <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
      </div>
      <div class="mt-5 md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
        <div class="relative h-full" x-id="[
        'contact-form-message'
    ]">
          <!-- start partial: shared/components/ui/text-input-label.hbs -->
          <div class="relative w-full h-full" :class="{}">
            <textarea :id="$id('contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48  pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
              :aria-describedby="`char-limit, message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
              @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
            <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$id('contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
            </label>
          </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
        </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
      </div>
    </div>
  </div>
  <div class="flex flex-col w-full mt-4 pt-3 md:flex-row xl:justify-end">
    <div class="md:w-1/2 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-file-input.hbs -->
      <div x-ref="contactFormAttachments" class="w-full" x-data="initFileInput()">
        <div x-show="$store.fileList.length" class="w-full mb-2 text-xl italic text-center border-b-2 border-gray-400 border-dashed" x-text="$store.fileList.length + ' attached file' + ($store.fileList.length > 1 ? 's:' : ':')">
        </div>
        <template x-for="(att, idx) in $store.fileList">
          <div :key="idx" class="relative my-2 grid w-full grid-cols-4 flex-nowrap bg-sf-charcoal-100 p-4">
            <div class="flex justify-center h-12 col-span-1 mr-4">
              <img x-show="checkType(att) === 'img'" :id="att.name" class="object-contain" :alt="att.name">
              <template x-if="checkType(att) != 'img'">
                <div x-html="svgIcon(checkType(att), &quot;h-full&quot;)" class="h-full">
                </div>
              </template>
            </div>
            <div class="flex flex-col justify-center col-span-3 mr-1">
              <div class="flex flex-row w-full mb-1">
                <span :aria-label="`This file is ${friendlySize(att.size)} in size`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 text-xs rounded-full w-max bg-sf-charcoal-200" x-html="friendlySize(att.size)"></span>
                <span :aria-label="`This file is a ${friendlyExtension(att.name)} file`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 ml-1 text-xs rounded-full w-max bg-sf-charcoal-200"
                  x-html="friendlyExtension(att.name)"></span>
              </div>
              <p class="text-sm truncate md:text-base" x-text="att.name">
              </p>
            </div>
            <a href="#" :title="`Cancel upload of ${att.name}`" @click.prevent="removeFile(idx)" class="absolute top-0 p-2 right-1">
                <span class="red-link whitespace-nowrap">
                    <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 12 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet"><path d="M8.57 8.43 7.429 9.571a.25.25 0 0 1-.359 0L6 8.501l-1.07 1.07a.25.25 0 0 1-.359 0L3.43 8.43a.25.25 0 0 1 0-.359l1.07-1.07-1.07-1.07a.25.25 0 0 1 0-.359l1.141-1.141a.25.25 0 0 1 .359 0L6 5.501l1.07-1.07a.25.25 0 0 1 .359 0L8.57 5.572a.25.25 0 0 1 0 .359L7.5 7.001l1.07 1.07a.25.25 0 0 1 0 .359M10.25 7c0-2.344-1.906-4.25-4.25-4.25S1.75 4.656 1.75 7 3.656 11.25 6 11.25 10.25 9.344 10.25 7M12 7A6 6 0 0 1 0 7a6 6 0 0 1 12 0"></path></svg></div>
                    Remove
                </span>
            </a>
          </div>
        </template>
        <div x-id="['m2-file-upload-input']">
          <label :for="$id(&quot;m2-file-upload-input&quot;)">
            <span role="button" class="text-lg btn btn-secondary" :aria-controls="$id(&quot;m2-file-upload-input&quot;)" tabindex="0" @keydown.enter="$refs['file-upload-input'].click()" @keydown.space="$refs['file-upload-input'].click()"
              x-text="`Add Attachments ${sizeRemainingMessage()}`">
            </span>
          </label>
          <input x-ref="file-upload-input" type="file" hidden="" :id="$id(&quot;m2-file-upload-input&quot;)" name="m2-cf-attachments" multiple="" :aria-disabled="tooManyBytes" :accept="acceptableFileTypes" @change="pickFiles($event.target.files)">
          <div class="mt-2 text-xs"> Please attach only <span x-text="readableExtensionList()"></span> file(s) — Unsupported file types will not be delivered to the agent. </div>
        </div>
      </div><!-- end partial: shared/components/contact-forms/cf-file-input.hbs -->
    </div>
    <div class="w-full mt-4 md:w-1/2 md:m-0 md:pl-8 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-submit.hbs -->
      <button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary"> Send Email </button><!-- end partial: shared/components/contact-forms/cf-submit.hbs -->
    </div>
  </div>
  <!-- start partial: shared/components/contact-forms/cf-errors.hbs -->
  <div x-show="hasErrors" role="alert" class="my-4 rounded-2xl bg-sf-red-100 p-4 text-sf-red-700">
    <!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
    <!-- "Please forgive this" -->
    <h3 class="font-semi mb-2 text-xl"> Please correct the following: </h3>
    <ul class="list-inside list-disc">
      <template x-for="(message, key) in errors" :key="$id('error', key)">
        <li class="mb-1" :id="$id('error', key)" x-html="message"></li>
      </template>
    </ul>
  </div><!-- end partial: shared/components/contact-forms/cf-errors.hbs -->
  <div id="disclaimers">
    <div class="mt-4">
      <!-- start partial: shared/components/contact-forms/cf-disclaimer.hbs -->
      <p :id="$id('cf-disclaimer')" class="text-xs leading-3"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email for marketing
        purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
        have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
        apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p><!-- end partial: shared/components/contact-forms/cf-disclaimer.hbs -->
    </div>
    <p class="mt-2" x-show="!false">
      <!-- start partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    </p>
    <p class="text-xs leading-3">
      <span class="font-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a licensed
      representative in the agent's office, or by contacting the State Farm toll-free customer service line at
      <span><a href="tel:8557337333" class="red-link" aria-label="Contact the State Farm toll-free customer service line at (855) 733-7333">(855) 733-7333</a>.</span>
    </p><!-- end partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    <p></p>
  </div>
</form>

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State Farm® Insurance Agent


MIKE RENKENBERGER


5/5 average rating on Google (3 reviews)


OFFICE HOURS


Today

9am - 5pm (Pacific)
Mon-Fri
9am - 5pm
Sat-Sun
Closed
After Hours by Appointment


ADDRESS

21243 Ventura Blvd Suite 226
Woodland Hls, CA 91364-2148

South/East of the Auto Gallery - Porsche Dealership


Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


ABOUT ME

A Southern California local with over 25+ years of experience in Financial
Services. I take pride in the customers we serve. It’s my goal to make sure our
customers receive the highest standard of service and products that are tailed
to their needs and expectations.

State Farm, a Fortune 500 Company, is a leader in the insurance industry
offering a variety of products. We offer 24 hours customer service and claims
service to help you.

As a Woodland Hills resident, I take pride in local events that support the
surrounding community. Look for a State Farm booth at the next event you attend!



We look forward to helping you with your insurance needs:

Auto Insurance, Motorcycle Insurance, Homeowner Insurance, Earthquake Insurance,
Life Insurance, Pet Insurance, Renters Insurance, Jewelry Insurance, Business
Insurance, Works Compensation and more...

Call my office for a FREE convenient quote. We can be reached via, phone, email,
text or walk in.



While my office is located in Woodland Hills, we serve many customers in
Northridge, West Hills, Tarzana, Sherman Oaks, Calabasas, Van Nuys, Porter
Ranch, Chatsworth, Reseda, and all over California.



Things I Enjoy Outside of Work:

I spend my extra time as active as possible with my spouse and dog Lucky (we
think he is a Morkie). I enjoy riding my motorcycle, snow skiing with friends
and improving my golf game.



…Read More

5/5 average rating on Google (3 reviews)
(818) 888-0228


OFFICE HOURS


Today

9am - 5pm (Pacific)
Mon-Fri
9am - 5pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!

Contact me to schedule a virtual meeting




INSURANCE PRODUCTS OFFERED

Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health


OTHER PRODUCTS

Banking

View Licenses


5/5 average rating on Google (3 reviews)

Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?

Select an Insurance Product
Select Product AutoMotorcycleHomeownersCondo OwnersRentersLifeMedicare
SupplementSupplemental HealthSmall BusinessPet Insurance

ZIP Code
State Selection
Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming

ZIP Code
State Selection
Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming

Start a Quote Request a Quote




Continue a saved quote | Items needed for a quote
File a Claim Send Payment
 * Auto Insurance
 * Motorcycle Insurance
 * Homeowners Insurance
 * Condo Insurance
 * Renters Insurance
 * Business Insurance
 * Life Insurance
 * Rec Vehicles Insurance
 * Boat Insurance
   
 * 
   See More
   


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Today

9am - 5pm (Pacific)
Mon-Fri
9am - 5pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!

Contact me to schedule a virtual meeting


ADDRESS

21243 Ventura Blvd Suite 226
Woodland Hls, CA 91364-2148

Map & Directions
   


 * PHONE
   
   (818) 888-0228
   
   
   
   
   
   


 * FAX
   
   (818) 337-2055
   
   
   


LANGUAGES

English


About Me


A Southern California local with over 25+ years of experience in Financial
Services. I take pride in the customers we serve. It’s my goal to make sure our
customers receive the highest standard of service and products that are tailed
to their needs and expectations.

State Farm, a Fortune 500 Company, is a leader in the insurance industry
offering a variety of products. We offer 24 hours customer service and claims
service to help you.

As a Woodland Hills resident, I take pride in local events that support the
surrounding community. Look for a State Farm booth at the next event you attend!



We look forward to helping you with your insurance needs:

Auto Insurance, Motorcycle Insurance, Homeowner Insurance, Earthquake Insurance,
Life Insurance, Pet Insurance, Renters Insurance, Jewelry Insurance, Business
Insurance, Works Compensation and more...

Call my office for a FREE convenient quote. We can be reached via, phone, email,
text or walk in.



While my office is located in Woodland Hills, we serve many customers in
Northridge, West Hills, Tarzana, Sherman Oaks, Calabasas, Van Nuys, Porter
Ranch, Chatsworth, Reseda, and all over California.



Things I Enjoy Outside of Work:

I spend my extra time as active as possible with my spouse and dog Lucky (we
think he is a Morkie). I enjoy riding my motorcycle, snow skiing with friends
and improving my golf game.




Products



INSURANCE PRODUCTS OFFERED

Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health


OTHER PRODUCTS

Banking

View Licenses


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Today

9am - 5pm (Pacific)
Mon-Fri
9am - 5pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!

Contact me to schedule a virtual meeting


ADDRESS

21243 Ventura Blvd Suite 226
Woodland Hls, CA 91364-2148

Map & Directions
   


 * PHONE
   
   (818) 888-0228
   
   
   
   
   
   


 * FAX
   
   (818) 337-2055
   
   
   


LANGUAGES

English


Simple Insights®



SIMPLE INSIGHTS®


THE REAL CONSEQUENCES OF DRUNK DRIVING


THE REAL CONSEQUENCES OF DRUNK DRIVING

What's at stake if you're caught drunk driving? A lot. These tips help you avoid
the dangers of drinking and driving.


TIPS TO SAFELY DEEP FRY A TURKEY


TIPS TO SAFELY DEEP FRY A TURKEY

Review these safe turkey frying tips and take precautions to help protect
yourself, your guests and your home this holiday season.


CASHING OUT YOUR 401K OR TAKING A 401K LOAN: WHAT YOU NEED TO KNOW


CASHING OUT YOUR 401K OR TAKING A 401K LOAN: WHAT YOU NEED TO KNOW

Whether you are considering cashing out your 401k or taking a loan from it,
consider this information to help you make an informed decision.

View More Articles

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Your Name*
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Your Message:*

For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.

Your preferred method of contact
 * Your Email
 * Your Phone

I'd like more info about: *


For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.



Your Message:*


Remove
Please attach only file(s) — Unsupported file types will not be delivered to the
agent.
Send Email


PLEASE CORRECT THE FOLLOWING:

By filling out the form, you are providing express consent by electronic
signature that you may be contacted by telephone (via call and/or text messages)
and/or email for marketing purposes by State Farm Mutual Automobile Insurance
Company, its subsidiaries and affiliates ("State Farm") or an independent
contractor State Farm agent regarding insurance products and services using the
phone number and/or email address you have provided to State Farm, even if your
phone number is listed on a Do Not Call Registry. You further agree that such
contact may be made using an automatic telephone dialing system and/or
prerecorded voice (message and data rates may apply). Your consent is not a
condition of purchase. By continuing, you agree to the terms of the disclosures
above.



Please note: Insurance coverage cannot be bound or changed via submission of
this online e-mail form or via voice mail. To make policy changes or request
additional coverage, please speak with a licensed representative in the agent's
office, or by contacting the State Farm toll-free customer service line at (855)
733-7333.





Our mission is to help people manage the risks of everyday life, recover from
the unexpected and realize their dreams.

…Read More

Marilyn Reeve

License #0690433

Montana Lampe

License #4179224

Viewing team member 1 of 2

Marilyn Reeve

License #0690433

Viewing team member 2 of 2

Montana Lampe

License #4179224


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YOU CAN ALSO CALL US AT (818) 888-0228

preferred__alpha preferred__beta preferred__extra


CONTACT US

Your preferred method of contact
 * Your Email
 * Your Phone

Your Name*
Your Phone*
Your Email*



Your Message:*

For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.

Your preferred method of contact
 * Your Email
 * Your Phone

I'd like more info about: *


For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.



Your Message:*


Remove
Please attach only file(s) — Unsupported file types will not be delivered to the
agent.
Send Email


PLEASE CORRECT THE FOLLOWING:

By filling out the form, you are providing express consent by electronic
signature that you may be contacted by telephone (via call and/or text messages)
and/or email for marketing purposes by State Farm Mutual Automobile Insurance
Company, its subsidiaries and affiliates ("State Farm") or an independent
contractor State Farm agent regarding insurance products and services using the
phone number and/or email address you have provided to State Farm, even if your
phone number is listed on a Do Not Call Registry. You further agree that such
contact may be made using an automatic telephone dialing system and/or
prerecorded voice (message and data rates may apply). Your consent is not a
condition of purchase. By continuing, you agree to the terms of the disclosures
above.



Please note: Insurance coverage cannot be bound or changed via submission of
this online e-mail form or via voice mail. To make policy changes or request
additional coverage, please speak with a licensed representative in the agent's
office, or by contacting the State Farm toll-free customer service line at (855)
733-7333.






AGENT LICENSE FOR MIKE RENKENBERGER

CA-0G17208

If you are using a screen reader and having difficulty with this website please
call (818) 888-0228.



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Prices vary by state. Options selected by customer; availability, amount of
discounts, savings and eligibility may vary.

Life Insurance and annuities are issued by State Farm Life Insurance Company.
(Not Licensed in MA, NY, and WI) State Farm Life and Accident Assurance Company
(Licensed in New York and Wisconsin) Home Office, Bloomington, Illinois.

Deposit products offered by U.S. Bank National Association. Member FDIC.

The creditor and issuer of this credit card is U.S. Bank National Association,
pursuant to a license from Visa U.S.A. Inc.

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© Copyright State Farm Mutual Automobile Insurance Company 2024.

Viewing team member 1 of 2

Marilyn Reeve

License #0690433

Viewing team member 2 of 2

Montana Lampe

License #4179224


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