form.foreaction.cloud
Open in
urlscan Pro
104.26.15.213
Public Scan
Submitted URL: http://www.georgianbluffs.ca/contactGB
Effective URL: https://form.foreaction.cloud/submit/georgian-bluffs?_mid_=10868&_mid_=33840
Submission: On September 25 via api from CA — Scanned from CA
Effective URL: https://form.foreaction.cloud/submit/georgian-bluffs?_mid_=10868&_mid_=33840
Submission: On September 25 via api from CA — Scanned from CA
Form analysis 1 forms found in the DOM
<form novalidate="" validateemailandphone="" ng-reflect-enable-validate-email-and-phone="true" class="ng-untouched ng-pristine ng-invalid"><input name="_csrf" type="hidden" ng-reflect-name="_csrf" ng-reflect-model="HX5GVPKN-56WarYwiS2iRxk46d4EOA"
class="ng-untouched ng-pristine ng-valid" value="HX5GVPKN-56WarYwiS2iRxk46d4EOAPlELUo">
<div fxlayout="column" fxlayoutgap="20px" ng-reflect-layout="column" ng-reflect-gap="20px" style="flex-direction: column; box-sizing: border-box; display: flex;">
<div class="section" fxlayout="column" fxlayout.gt-sm="row" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" style="margin-bottom: 20px; flex-direction: row; box-sizing: border-box; display: flex;">
<a aria-label="Skip to issue information" href="#issueSection" hreftabindex="-1"></a><a id="reporter_information" name="reporter_information" tabindex="-1"></a>
<div class="section-title section-title-primary" fxflex="100%" fxflex.gt-sm="30%" fxlayoutalign.gt-sm="end start" ng-reflect-align-gt-sm="end start" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="30%"
style="place-content: flex-start flex-end; align-items: flex-start; flex-direction: row; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 30%;"><span ngclass.gt-sm="right-align" class="right-align"
ng-reflect-ng-class-gt-sm="right-align" ng-reflect-ng-style-gt-sm="[object Object]" style="max-width: 100px;">Tell us about <span class="bold-section-title">yourself</span></span></div>
<div class="section-content" fxflex="100%" fxflex.gt-sm="70%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="70%" aria-label="Tell us about <span class="bold-section-title">yourself</span>"
style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 70%;">
<div fxlayout="column" fxlayout.gt-sm="row" fxlayoutgap.gt-sm="25px" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" ng-reflect-gap-gt-sm="25px" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxflex.gt-sm="50%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="50%"
style="margin-right: 25px; flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 50%;"><mat-form-field
class="mat-form-field ng-tns-c1-2 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float ng-untouched ng-pristine ng-invalid" floatlabel="always"
ng-reflect-float-label="always">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input autocomplete="given-name" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" matinput="" maxlength="60"
name="firstName" required="" ng-reflect-required="" ng-reflect-maxlength="60" ng-reflect-name="firstName" ng-reflect-is-disabled="false" ng-reflect-disabled="false" id="mat-input-0" aria-invalid="false"
aria-required="true"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-2 ng-star-inserted" ng-reflect-ng-switch="true" id="mat-form-field-label-3" for="mat-input-0" aria-owns="mat-input-0"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><mat-label class="ng-star-inserted">First Name</mat-label><!----><!--bindings={
"ng-reflect-ng-if": "true"
}--><span aria-hidden="true" class="mat-placeholder-required mat-form-field-required-marker ng-tns-c1-2 ng-star-inserted"> *</span></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-2 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-2 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
<div fxflex="100%" fxflex.gt-sm="50%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="50%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 50%;">
<mat-form-field class="mat-form-field ng-tns-c1-3 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float ng-untouched ng-pristine ng-invalid" floatlabel="always"
ng-reflect-float-label="always">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input autocomplete="family-name" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" matinput="" maxlength="60"
name="lastName" required="" ng-reflect-required="" ng-reflect-maxlength="60" ng-reflect-name="lastName" ng-reflect-is-disabled="false" ng-reflect-disabled="false" id="mat-input-1" aria-invalid="false" aria-required="true"><span
class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-3 ng-star-inserted" ng-reflect-ng-switch="true" id="mat-form-field-label-5" for="mat-input-1" aria-owns="mat-input-1"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><mat-label class="ng-star-inserted">Last Name</mat-label><!----><!--bindings={
"ng-reflect-ng-if": "true"
}--><span aria-hidden="true" class="mat-placeholder-required mat-form-field-required-marker ng-tns-c1-3 ng-star-inserted"> *</span></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-3 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-3 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
<div fxlayout="column" fxlayout.gt-sm="row" fxlayoutgap.gt-sm="25px" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" ng-reflect-gap-gt-sm="25px" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxflex.gt-sm="50%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="50%"
style="margin-right: 25px; flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 50%;"><mat-form-field
class="mat-form-field ng-tns-c1-4 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid"
floatlabel="always" ng-reflect-float-label="always">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input autocomplete="email" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" email="" matinput="" name="email"
ng-reflect-required="false" ng-reflect-email="" ng-reflect-name="email" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Email Address" id="mat-input-2" placeholder="Email Address"
aria-invalid="false" aria-required="false"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-4 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-7" for="mat-input-2" aria-owns="mat-input-2"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Email Address<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-4 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-4 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
<div fxflex="100%" fxflex.gt-sm="50%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="50%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 50%;">
<mat-form-field
class="mat-form-field ng-tns-c1-5 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid"
floatlabel="always" ng-reflect-float-label="always">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input autocomplete="tel" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" matinput="" name="phoneNumber"
pattern="^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$" phone="" ng-reflect-required="false" ng-reflect-pattern="^\(?([0-9]{3})\)?[-. ]?([0-9]{" ng-reflect-name="phoneNumber" ng-reflect-is-disabled="false"
ng-reflect-disabled="false" ng-reflect-placeholder="Phone Number" id="mat-input-3" placeholder="Phone Number" aria-invalid="false" aria-required="false"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-5 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-9" for="mat-input-3" aria-owns="mat-input-3"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Phone Number<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-5 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-5 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
<div fxlayout="column" fxlayout.gt-sm="row" fxlayoutgap.gt-sm="25px" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" ng-reflect-gap-gt-sm="25px" style="flex-direction: row; box-sizing: border-box; display: flex;"><mat-form-field
class="mat-form-field ng-tns-c1-6 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-valid"
floatlabel="always" fxflex="100%" fxflex.gt-sm="15%" ng-reflect-float-label="always" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="15%" style="margin-right: 25px; flex: 1 1 100%; box-sizing: border-box; max-width: 15%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-valid" matinput="" maxlength="12" name="unitNumber"
ng-reflect-maxlength="12" ng-reflect-name="unitNumber" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Apt. #" id="mat-input-4" placeholder="Apt. #" aria-invalid="false"
aria-required="false"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-6 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-11" for="mat-input-4" aria-owns="mat-input-4"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Apt. #<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-6 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-6 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field>
<div fxflex="100%" fxflex.gt-sm="85%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="85%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 85%;">
<mat-form-field
class="mat-form-field ng-tns-c1-7 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-valid"
floatlabel="always" fxflex="100%" ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix">
<div fxlayout="row" ng-reflect-layout="row" style="flex-direction: row; box-sizing: border-box; display: flex;"><input
class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-valid" matinput="" name="address" ng-reflect-required="false" ng-reflect-autocomplete="[object Object]"
ng-reflect-name="address" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Address" autocomplete="off" role="combobox" aria-autocomplete="list" aria-expanded="false"
aria-owns="mat-autocomplete-0" id="mat-input-5" placeholder="Address" aria-invalid="false" aria-required="false"><mat-icon class="clickable grey mat-icon material-icons" role="img" aria-hidden="true">close</mat-icon></div>
<mat-autocomplete class="mat-autocomplete" ng-reflect-display-with="function (address) {
i"><!----></mat-autocomplete><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-7 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-13" for="mat-input-5" aria-owns="mat-input-5"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Address<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span>
</div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-7 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-7 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
</div>
</div>
<div class="section" fxlayout="column" fxlayout.gt-sm="row" id="issueSection" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" style="margin-bottom: 20px; flex-direction: row; box-sizing: border-box; display: flex;">
<a aria-label="Skip to submit" href="#submitSection" hreftabindex="-1"></a>
<div class="section-title section-title-primary" fxflex="100%" fxflex.gt-sm="30%" fxlayoutalign.gt-sm="end start" ng-reflect-align-gt-sm="end start" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="30%"
style="place-content: flex-start flex-end; align-items: flex-start; flex-direction: row; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 30%;"><span ngclass.gt-sm="right-align" class="right-align"
ng-reflect-ng-class-gt-sm="right-align" ng-reflect-ng-style-gt-sm="[object Object]" style="max-width: 180px;">Please provide some <span class="bold-section-title">details</span></span></div>
<div class="section-content" fxflex="100%" fxflex.gt-sm="70%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="70%"
aria-label="Please provide some <span class="bold-section-title">details</span>" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 70%;">
<div fxlayout="row" ng-reflect-layout="row" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 100%;"><mat-form-field
class="reduced-bottom-padding reduced-top-margin no-underline mat-form-field ng-tns-c1-8 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid"
floatlabel="always" fxflex="100%" ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><span aria-hidden="true" hidden="true" id="dropdowntreeLabel"> Category * </span><ejs-dropdowntree aria-labelledby="dropdowntreeLabel" filtertype="Contains" floatlabeltype="Always" id="dropdowntree"
mode="Delimiter" ng-reflect-allow-filtering="true" ng-reflect-change-on-blur="false" ng-reflect-enabled="true" ng-reflect-filter-type="Contains" ng-reflect-float-label-type="Always" ng-reflect-mode="Delimiter"
ng-reflect-placeholder="Category *" ng-reflect-show-clear-button="true" class="e-control e-dropdowntree e-lib" ng-reflect-fields="[object Object]">
<div class="e-float-input e-control-wrapper e-input-group e-show-dd-icon e-ddt e-lib e-keyboard" tabindex="0" aria-disabled="false" aria-owns="dropdowntree_options" role="listbox" aria-haspopup="true" aria-expanded="false"
aria-activedescendant="null" aria-labelledby="dropdowntreeLabel" filtertype="Contains" floatlabeltype="Always" mode="Delimiter" ng-reflect-allow-filtering="true" ng-reflect-change-on-blur="false" ng-reflect-enabled="false"
ng-reflect-filter-type="Contains" ng-reflect-float-label-type="Always" ng-reflect-mode="Delimiter" ng-reflect-placeholder="selectIssue *" ng-reflect-show-clear-button="true" style="width: 100%;"><select aria-hidden="true"
tabindex="-1" class="e-ddt-hidden" name="null" id="dropdowntree_hidden" aria-label="hidden"></select><input role="textbox" type="text" readonly="" class="" aria-label="Selected category name" aria-disabled="false"><span
class="e-float-line"></span><label class="e-float-text e-label-top">Category *</label><span class="e-clear-icon e-icons e-icon-hide"></span><span class="e-input-group-icon e-ddt-icon e-icons"></span></div>
</ejs-dropdowntree><!--bindings={
"ng-reflect-ng-if": "false"
}--><input aria-hidden="true" aria-label="hidden category input" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" hidden="hidden" matinput="" name="categoryId"
ng-reflect-required="true" ng-reflect-name="categoryId" required="" id="mat-input-6" aria-invalid="false" aria-required="true"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "false"
}--></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-8 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-8 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field></div>
</div><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div fxlayout="row" ng-reflect-layout="row" class="ng-star-inserted" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 100%;"><mat-form-field
class="mat-form-field ng-tns-c1-14 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-invalid"
floatlabel="always" fxflex="100%" ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-invalid" matinput="" name="summary" required="" ng-reflect-required=""
ng-reflect-maxlength="240" ng-reflect-name="summary" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Summary" maxlength="240" id="mat-input-10" placeholder="Summary" aria-invalid="false"
aria-required="true"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-14 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-23" for="mat-input-10" aria-owns="mat-input-10"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Summary<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "true"
}--><span aria-hidden="true" class="mat-placeholder-required mat-form-field-required-marker ng-tns-c1-14 ng-star-inserted"> *</span></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-14 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-14 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
<div fxlayout="row" ng-reflect-layout="row" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 100%;"><mat-form-field
class="no-side-padding no-underline mat-form-field ng-tns-c1-9 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float mat-form-field-hide-placeholder ng-untouched ng-pristine ng-valid"
floatlabel="always" fxflex="100%" ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input aria-hidden="true" aria-label="hidden details input" class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-valid"
hidden="hidden" matinput="" name="description" ng-reflect-required="false" ng-reflect-name="description" ng-reflect-placeholder="Details" id="mat-input-7" placeholder="Details" aria-invalid="false" aria-required="false">
<div class="redactor-box redactor-blur redactor-styles-on" dir="ltr">
<div class="redactor-toolbar-wrapper-air">
<div class="redactor-air" domtargetshow="" style="display: none;">
<a class="re-button re-format re-button-icon" data-re-name="format" data-dropdown="true" href="#" alt="Format" rel="format" role="button" aria-label="Format" tabindex="-1" data-re-icon="true"><i class="re-icon-format"></i></a><a class="re-button re-bold re-button-icon" data-re-name="bold" href="#" alt="Bold" rel="bold" role="button" aria-label="Bold" tabindex="-1" data-re-icon="true"><i class="re-icon-bold"></i></a><a class="re-button re-italic re-button-icon" data-re-name="italic" href="#" alt="Italic" rel="italic" role="button" aria-label="Italic" tabindex="-1" data-re-icon="true"><i class="re-icon-italic"></i></a><a class="re-button re-lists re-button-icon" data-re-name="lists" data-dropdown="true" href="#" alt="Lists" rel="lists" role="button" aria-label="Lists" tabindex="-1" data-re-icon="true"><i class="re-icon-lists"></i></a><a class="re-button re-link re-button-icon" data-re-name="link" data-dropdown="true" href="#" alt="Link" rel="link" role="button" aria-label="Link" tabindex="-1" data-re-icon="true"><i class="re-icon-link"></i></a><a class="re-button re-fontcolor re-button-icon" data-re-name="fontcolor" href="#" alt="Text Color" rel="fontcolor" role="button" aria-label="Text Color" tabindex="-1" data-re-icon="true" data-dropdown="true"><i class="re-icon-fontcolor"></i></a><a class="re-button re-fontsize re-button-icon" data-re-name="fontsize" href="#" alt="Size" rel="fontsize" role="button" aria-label="Size" tabindex="-1" data-re-icon="true" data-dropdown="true"><i class="re-icon-fontsize"></i></a><a class="re-button re-fontfamily re-button-icon" data-re-name="fontfamily" href="#" alt="Font" rel="fontfamily" role="button" aria-label="Font" tabindex="-1" data-re-icon="true" data-dropdown="true"><i class="re-icon-fontfamily"></i></a>
</div>
</div><span class="redactor-voice-label" id="redactor-voice-0" aria-hidden="false">Case Details Textarea</span>
<div class="redactor-styles redactor-in redactor-in-0" dir="ltr" aria-labelledby="redactor-voice-0" role="presentation" contenteditable="true" style="min-height: 125px;">
<p></p>
</div><textarea aria-label="details editor" id="redactorTextarea" rows="4" name="content-0" data-redactor-uuid="0" domtargetshow="" class="redactor-source" style="display: none;"></textarea>
<ul dir="ltr" class="redactor-statusbar"></ul>
</div><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-9 ng-star-inserted" ng-reflect-ng-switch="false" id="mat-form-field-label-17" for="mat-input-7" aria-owns="mat-input-7"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!---->Details<!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span>
</div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-9 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-9 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
<div fxflex="100%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-height: 100%;"><span class="fake-material-label "> Location
</span><mat-accordion class="no-side-padding mat-accordion" style="width: 100%;"><mat-expansion-panel class="no-border-panel mat-expansion-panel ng-tns-c7-10" hidetoggle="" ng-reflect-hide-toggle=""><mat-expansion-panel-header
class="no-background-hover mat-expansion-panel-header ng-tns-c8-11 ng-trigger ng-trigger-expansionHeight ng-star-inserted" role="button" id="mat-expansion-panel-header-0" tabindex="0" aria-controls="cdk-accordion-child-0"
aria-expanded="false" aria-disabled="false" style="height:48px;0:height;height:48px;"><span class="mat-content"><!--bindings={}--><!--bindings={
"ng-reflect-ng-if": "true"
}--><span class="button-span ng-star-inserted" style=""><i class="foreActionIcon-map icon-padding"></i><span class="map-toggle">Click here to select a location on the map</span></span></span><!--bindings={
"ng-reflect-ng-if": "false"
}--></mat-expansion-panel-header>
<div class="mat-expansion-panel-content ng-trigger ng-trigger-bodyExpansion" role="region" aria-labelledby="mat-expansion-panel-header-0" id="cdk-accordion-child-0"
style="height:0px;visibility:hidden;0:height;1:visibility;height:0px;visibility:hidden;">
<div class="mat-expansion-panel-body">
<div class="map-container">
<div style="position: relative; width: 100%; height: 100%; overflow: hidden; -webkit-tap-highlight-color: transparent;">
<div style="z-index: 0; width: 100%; height: 100%; position: absolute; touch-action: none;">
<div style="position: absolute; height: 100%; width: 100%; z-index: 0;">
<div style="position: absolute; width: 728px; height: 400px; z-index: 1;"></div><canvas width="728" height="400" style="position: absolute; left: 0px; top: 0px; width: 728px; height: 400px; z-index: 0;"></canvas>
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<div style="position: absolute; bottom: 4.55em; left: 0.5em; z-index: 1; height: 0px; direction: ltr; color: rgb(51, 51, 51); font: 11px Arial, sans-serif;">
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<path id="triangle_22_" d="M14.1,28l-3.6,3.6L7,28L14.1,28z"></path>
<path id="here_21_"
d="M19.4,19.9c-0.7-0.9-0.7-1.4-0.2-1.8c0.6-0.6,1.1-0.3,1.8,0.3L19.4,19.9z M27,10.3c0.6-0.6,1.1-0.3,1.8,0.3l-1.5,1.5C26.5,11.2,26.6,10.7,27,10.3z M31.6,11.8c-0.7,1-1.9,2.7-3.2,1.4l3.2-3.2c-0.3-0.3-0.5-0.6-0.7-0.7c-1.7-1.7-3.7-1.7-5.2-0.2c-1,1-1.3,2.2-1,3.3l-1-1.1c-0.3,0.2-1.5,1.2-0.6,2.9l-1.1-1l-1.5,1.5l2.1,2.1C21,15.5,19.3,15.6,18,17c-1.5,1.5-1.4,3.2-0.3,4.7l-0.2-0.2c-1.5-1.5-3-0.9-3.8-0.2c-0.6,0.6-1,1.4-0.8,2l-3.1-3.1L8,21.8l6.2,6.2h3.3l-2.2-2.2c-1.2-1.2-1.2-1.8-0.6-2.4c0.5-0.5,1.2-0.2,2.3,0.9l2.2,2.2l1.7-1.7l-2.1-2.1c1.5,1.1,3.3,1.2,4.9-0.4c0,0,0,0,0,0l0,0c1-0.9,1.3-1.8,1.3-1.8l-1.3-0.8c-0.7,1-1.9,2.7-3.1,1.5l3.2-3.2l2,2l1.7-1.7l-2.5-2.5c-1.2-1.2-0.5-2.3,0-2.7c0.2,0.5,0.6,0.9,1,1.4c1.6,1.6,3.7,1.9,5.5,0.1c0,0,0,0,0,0l0,0c1-0.9,1.3-1.8,1.3-1.8L31.6,11.8z">
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<div style="user-select: none; position: relative; top: 2.73em; padding-left: 1px;"><span unselectable="on">© 1987–2024 HERE, Canada |
</span><a target="_blank" href="https://legal.here.com/en/terms/serviceterms/us" style="color: inherit;">Terms of use</a><span style="color: inherit; display: none;"> |
<a target="_blank" style="color: inherit;">Report image</a></span></div>
</div>
<div class="H_ui">
<div class="H_l_top H_l_left">
<div class="H_l_anchor H_l_horizontal"></div>
<div class="H_l_anchor H_l_vertical"></div>
</div>
<div class="H_l_top H_l_right">
<div class="H_l_anchor H_l_horizontal"></div>
<div class="H_l_anchor H_l_vertical"></div>
</div>
<div class="H_l_bottom H_l_left">
<div class="H_l_anchor H_l_vertical"></div>
<div class="H_l_anchor H_l_horizontal"></div>
</div>
<div class="H_l_bottom H_l_right">
<div class="H_l_anchor H_l_vertical"></div>
<div class="H_l_anchor H_l_horizontal">
<div class="H_ctl H_scalebar" title="Change to miles" style="direction: ltr;"><svg height="28" version="1.1" class="H_scalebar_svg" xmlns="http://www.w3.org/2000/svg" width="74">
<polyline style="fill:none;stroke:white;stroke-width:4;stroke-opacity:0.8" points="2 19 2 26 72 26 72 19"></polyline>
<polyline style="fill:none; stroke:black; stroke-width:2" points="2 20 2 26 72 26 72 20"></polyline><text
style="stroke:white;stroke-width:2;stroke-opacity:0.8;text-anchor:end;font: bold 10px 'Lucida Grande','Lucida Sans Unicode',Arial,Helvetica,sans-serif" x="66" y="22">500 m</text><text
style="text-anchor:end;font: bold 10px 'Lucida Grande','Lucida Sans Unicode',Arial,Helvetica,sans-serif;color:black;" x="66" y="22">500 m</text>
</svg></div>
<div class="H_ctl" style="display: none;">
<div class="H_btn" title="Choose view"><svg version="1.1" class="H_icon" viewBox="0 0 26 26">
<polygon points="19,14 17,14 19,16 13,19 6,16 9,14 7,14 3,16 13,21 23,16"></polygon>
<polygon points="13,15 3,10 13,5 23,10"></polygon>
</svg></div>
<div class="H_overlay">
<div class="H_rdo">
<div class="H_rdo_title">Choose view</div>
<div class="H_rdo_buttons">
<div class="H_btn">Map view</div>
<div class="H_btn">Satellite</div>
<div class="H_btn">Terrain</div>
</div>
</div>
<div class="H_btn">Traffic conditions</div>
<div class="H_btn">Public transport</div>
<div class="H_btn">Show traffic incidents</div>
</div>
</div>
</div>
</div>
<div class="H_l_anchor H_l_top H_l_center H_l_horizontal" style="margin-left: 0px;"></div>
<div class="H_l_anchor H_l_left H_l_middle H_l_vertical" style="margin-top: 0px;"></div>
<div class="H_l_anchor H_l_right H_l_middle H_l_vertical" style="margin-top: -48px;">
<div class="H_ctl H_zoom H_grp">
<div class="H_btn" title="Zoom in"><svg class="H_icon" viewBox="0 0 25 25">
<path
d="M 18.5,11 H 14 V 6.5 c 0,-.8 -.7,-1.5 -1.5,-1.5 -.8,0 -1.5,.7 -1.5,1.5 V 11 H 6.5 C 5.7,11 5,11.7 5,12.5 5,13.3 5.7,14 6.5,14 H 11 v 4.5 c 0,.8 .7,1.5 1.5,1.5 .8,0 1.5,-.7 1.5,-1.5 V 14 h 4.5 C 19.3,14 20,13.3 20,12.5 20,11.7 19.3,11 18.5,11 z">
</path>
</svg></div>
<div class="H_btn" title="Zoom out"><svg class="H_icon" viewBox="0 0 25 25">
<path d="m 6.5,11 h 12 c .8,0 1.5,.7 1.5,1.5 0,.8 -.7,1.5 -1.5,1.5 H 6.5 C 5.7,14 5,13.3 5,12.5 5,11.7 5.67,11 6.5,11 z"></path>
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</div>
<div class="H_l_anchor H_l_bottom H_l_center H_l_horizontal" style="margin-left: 0px;"></div>
</div>
</div>
</div><!--bindings={}-->
</div>
</div>
</mat-expansion-panel></mat-accordion><mat-form-field
class="map-negative-top-margin mat-form-field ng-tns-c1-12 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float ng-untouched ng-pristine ng-valid"
floatlabel="always" fxflex="100%" ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix">
<div fxlayout="row" style="padding-top: 0.5em; flex-direction: row; box-sizing: border-box; display: flex;" ng-reflect-layout="row"><input
class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-valid" matinput="" name="locationText" ng-reflect-autocomplete="[object Object]"
ng-reflect-name="locationText" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Location of the issue" autocomplete="off" role="combobox" aria-autocomplete="list" aria-expanded="false"
aria-owns="mat-autocomplete-1" id="mat-input-8" placeholder="Location of the issue" aria-invalid="false" aria-required="false"><mat-icon class="clickable grey mat-icon material-icons" role="img"
aria-hidden="true">close</mat-icon></div><mat-autocomplete class="mat-autocomplete" ng-reflect-display-with="function (address) {
i"><!----></mat-autocomplete><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-12 ng-star-inserted" ng-reflect-ng-switch="true" id="mat-form-field-label-19" for="mat-input-8" aria-owns="mat-input-8"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><mat-label aria-hidden="true" aria-label="hidden label" hidden="true" class="ng-star-inserted">Location </mat-label><!----><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span>
</div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-12 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-12 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
<div fxlayout="row" fxlayoutgap="25px" ng-reflect-layout="row" ng-reflect-gap="25px" style="flex-direction: row; box-sizing: border-box; display: flex;">
<div fxflex="100%" fxlayout="column" ng-reflect-layout="column" ng-reflect-flex="100%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 100%;"><mat-form-field
class="mat-form-field ng-tns-c1-13 mat-primary mat-form-field-type-mat-input mat-form-field-appearance-legacy mat-form-field-can-float mat-form-field-should-float ng-untouched ng-pristine ng-valid" floatlabel="always" fxflex="100%"
ng-reflect-float-label="always" ng-reflect-flex="100%" style="flex: 1 1 100%; box-sizing: border-box; max-height: 100%;">
<div class="mat-form-field-wrapper">
<div class="mat-form-field-flex"><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "0"
}-->
<div class="mat-form-field-infix"><input class="mat-input-element mat-form-field-autofill-control cdk-text-field-autofill-monitored ng-untouched ng-pristine ng-valid" matinput="" maxlength="100" name="locationDescription"
ng-reflect-required="false" ng-reflect-maxlength="100" ng-reflect-name="locationDescription" ng-reflect-is-disabled="false" ng-reflect-disabled="false" ng-reflect-placeholder="Extra information about locati" id="mat-input-9"
placeholder="Extra information about location" aria-invalid="false" aria-required="false"><span class="mat-form-field-label-wrapper"><!--bindings={
"ng-reflect-ng-if": "true"
}--><label class="mat-form-field-label ng-tns-c1-13 ng-star-inserted" ng-reflect-ng-switch="true" id="mat-form-field-label-21" for="mat-input-9" aria-owns="mat-input-9"><!--bindings={
"ng-reflect-ng-switch-case": "false"
}--><!--bindings={
"ng-reflect-ng-switch-case": "true"
}--><mat-label class="ng-star-inserted">Location Description</mat-label><!----><!--bindings={
"ng-reflect-ng-if": "false"
}--></label></span></div><!--bindings={
"ng-reflect-ng-if": "0"
}-->
</div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="mat-form-field-underline ng-tns-c1-13 ng-star-inserted"><span class="mat-form-field-ripple"></span></div>
<div class="mat-form-field-subscript-wrapper" ng-reflect-ng-switch="hint"><!--bindings={
"ng-reflect-ng-switch-case": "error"
}--><!--bindings={
"ng-reflect-ng-switch-case": "hint"
}-->
<div class="mat-form-field-hint-wrapper ng-tns-c1-13 ng-trigger ng-trigger-transitionMessages ng-star-inserted"
style="opacity:1;transform:translateY(0%);0:opacity;1:transform;opacity:1;transform:translateY(0%);webkit-opacity:1;webkit-transform:translateY(0%);"><!--bindings={
"ng-reflect-ng-if": ""
}-->
<div class="mat-form-field-hint-spacer"></div>
</div>
</div>
</div>
</mat-form-field><!--bindings={
"ng-reflect-ng-if": "false"
}--></div>
</div>
<div fxflex="100%" fxlayout="row wrap" fxlayoutalign="start center" ng-reflect-layout="row wrap" ng-reflect-align="start center" ng-reflect-flex="100%"
style="flex-flow: wrap; box-sizing: border-box; display: flex; max-height: 100%; place-content: center flex-start; align-items: center; flex: 1 1 100%;"><input aria-label="file upload input" multiple="multiple" style="display: none"
type="file">
<div class="file-chooser" fxflex="100%" fxlayoutalign="center center" ng-reflect-klass="file-chooser" ng-reflect-ng-class="[object Object]" ng-reflect-align="center center" ng-reflect-flex="100%"
style="place-content: center; align-items: center; flex-direction: row; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 100%;"><button class="main-color-hover clickable" fxlayoutalign="start center" type="button"
ng-reflect-align="start center" style="place-content: center flex-start; align-items: center; flex-direction: row; box-sizing: border-box; display: flex;"><mat-icon class="mat-icon material-icons" role="img"
aria-hidden="true">attach_file</mat-icon><span>Drag or click here to add documents and pictures</span></button></div><!--bindings={
"ng-reflect-ng-for-of": ""
}-->
</div>
</div>
</div>
<div class="section" fxlayout="column" fxlayout.gt-sm="row" id="submitSection" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" style="flex-direction: row; box-sizing: border-box; display: flex;"><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div class="section-title section-title-primary ng-star-inserted" fxflex="100%" fxflex.gt-sm="30%" fxlayoutalign.gt-sm="end start" ng-reflect-align-gt-sm="end start" ng-reflect-flex="100%" ng-reflect-flex-gt-sm="30%"
style="place-content: flex-start flex-end; align-items: flex-start; flex-direction: row; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 30%;"><span ngclass.gt-sm="right-align" class="right-align"
ng-reflect-ng-class-gt-sm="right-align" ng-reflect-ng-style-gt-sm="[object Object]" style="max-width: 180px;"><span class="bold-section-title">Submit Form</span></span></div><!--bindings={
"ng-reflect-ng-if": "false"
}--><!--bindings={
"ng-reflect-ng-if": "false"
}-->
<div class="section-content" fxflex="100%" fxflex.gt-sm="70%" fxlayout="column" fxlayoutgap="25px" ng-reflect-klass="section-content" ng-reflect-ng-class="[object Object]" ng-reflect-layout="column" ng-reflect-gap="25px" ng-reflect-flex="100%"
ng-reflect-flex-gt-sm="70%" style="flex-direction: column; box-sizing: border-box; display: flex; flex: 1 1 100%; max-width: 70%;">
<div class="info-box" fxlayout="row" fxlayoutalign="start center" fxlayoutgap="10px" ng-reflect-layout="row" ng-reflect-gap="10px" ng-reflect-align="start center"
style="margin-bottom: 25px; flex-direction: row; box-sizing: border-box; display: flex; max-height: 100%; place-content: center flex-start; align-items: center;"><mat-icon class="mat-36 mat-icon material-icons" role="img" aria-hidden="true"
style="margin-right: 10px;">info</mat-icon><span>For your protection, the IP address of this request will be logged.</span><!--bindings={
"ng-reflect-ng-if": "[object Object]"
}--><input name="ipAddress" required="" type="hidden" ng-reflect-required="" ng-reflect-name="ipAddress" ng-reflect-model="149.88.16.227" class="ng-untouched ng-pristine ng-valid ng-star-inserted" value="149.88.16.227"></div><!--bindings={
"ng-reflect-ng-if": "true"
}-->
<div fxlayout="column" fxlayout.gt-sm="row" fxlayoutalign.gt-sm="start center" fxlayoutgap="25px" ng-reflect-layout="column" ng-reflect-layout-gt-sm="row" ng-reflect-gap="25px" ng-reflect-align-gt-sm="start center" class="ng-star-inserted"
style="flex-direction: row; box-sizing: border-box; display: flex; max-height: 100%; place-content: center flex-start; align-items: center; margin-bottom: 25px;">
<div fxflex="" fxlayoutalign="start center" ng-reflect-align="start center" ng-reflect-flex=""
style="place-content: center flex-start; align-items: center; flex-direction: row; box-sizing: border-box; display: flex; flex: 1 1 0%; margin-right: 25px;"><button class="primary-color mat-raised-button" fxflex="" mat-raised-button=""
translate="" type="Submit" ng-reflect-flex="" ng-reflect-translate="" style="flex: 1 1 0%; box-sizing: border-box;"><span class="mat-button-wrapper"> Submit </span>
<div class="mat-button-ripple mat-ripple" matripple="" ng-reflect-centered="false" ng-reflect-disabled="false" ng-reflect-trigger="[object HTMLButtonElement]"></div>
<div class="mat-button-focus-overlay"></div>
</button></div><!--bindings={
"ng-reflect-ng-if": "6Lfzi7wUAAAAADWi_TUH90PiYRZR42"
}--><input aria-label="Captcha verfication response" name="captchaResponse" type="hidden" ng-reflect-name="captchaResponse" class="ng-untouched ng-pristine ng-valid ng-star-inserted" value=""><label for="g-recaptcha-response" hidden="hidden"
class="ng-star-inserted">do not use</label><re-captcha size="invisible" ng-reflect-site-key="6Lfzi7wUAAAAADWi_TUH90PiYRZR42" ng-reflect-size="invisible" id="ngrecaptcha-0" class="ng-star-inserted">
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-2fb40swj4kc2" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Lfzi7wUAAAAADWi_TUH90PiYRZR42P9yfey_Cnp&co=aHR0cHM6Ly9mb3JtLmZvcmVhY3Rpb24uY2xvdWQ6NDQz&hl=en&v=EGbODne6buzpTnWrrBprcfAY&size=invisible&cb=vxwllapex6zg"></iframe>
</div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</re-captcha>
</div><!--bindings={
"ng-reflect-ng-if": "false"
}-->
<div class="success" fxlayout="row" fxlayoutalign="start center" fxlayoutgap="25px" ng-reflect-layout="row" ng-reflect-gap="25px" ng-reflect-align="start center"
style="margin-bottom: 25px; flex-direction: row; box-sizing: border-box; display: none; max-height: 100%; place-content: center flex-start; align-items: center;"><img alt="Submission success" height="64" src="/assets/img/success.png"
width="64" style="margin-right: 25px;">
<div fxlayout="column" ng-reflect-layout="column" style="flex-direction: column; box-sizing: border-box; display: flex;"><span class="success-title">Thank You!</span><span>We have received your request. Please keep reference ID
<b>#{{caseId}}</b> for your personal records and future enquiries.</span></div>
</div>
<div class="attachment-failure" fxlayout="row" fxlayoutalign="start center" fxlayoutgap="25px" ng-reflect-layout="row" ng-reflect-gap="25px" ng-reflect-align="start center"
style="margin-bottom: 25px; flex-direction: row; box-sizing: border-box; display: none; max-height: 100%; place-content: center flex-start; align-items: center;"><img alt="Attatchment failure" height="64" src="/assets/img/error.png"
width="64" style="margin-right: 25px;">
<div fxlayout="column" ng-reflect-layout="column" style="flex-direction: column; box-sizing: border-box; display: flex;"><span class="attachment-failure-title">Attachment Failure</span><span>Case was created but at least one attachment
could not be added.</span></div>
</div>
<div class="error" fxlayout="row" fxlayoutalign="start center" fxlayoutgap="25px" ng-reflect-layout="row" ng-reflect-gap="25px" ng-reflect-align="start center"
style="flex-direction: row; box-sizing: border-box; display: none; max-height: 100%; place-content: center flex-start; align-items: center;"><img alt="Submission error" height="64" src="/assets/img/error.png" width="64"
style="margin-right: 25px;">
<div fxlayout="column" ng-reflect-layout="column" style="flex-direction: column; box-sizing: border-box; display: flex;"><span class="error-title">Something went wrong!</span><span>We apologize for the inconvenience. Come back again
soon.</span></div>
</div><!--bindings={
"ng-reflect-ng-if": "false"
}-->
</div>
</div>
</div>
</form>Text Content
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infoFor your protection, the IP address of this request will be logged.
Submit
do not use
Thank You!We have received your request. Please keep reference ID #{{caseId}}
for your personal records and future enquiries.
Attachment FailureCase was created but at least one attachment could not be
added.
Something went wrong!We apologize for the inconvenience. Come back again soon.
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