www.mysfagentkristen.com Open in urlscan Pro
34.69.219.172  Public Scan

Submitted URL: http://www.mysfagentkristen.com/
Effective URL: https://www.mysfagentkristen.com/
Submission: On October 25 via api from US — Scanned from DE

Form analysis 4 forms found in the DOM

#

<form id="quote-start-1ra8wln" 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-1ra8wln"
      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-1ra8wln" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-1ra8wln" :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-1ra8wln">
      <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-1ra8wln" 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-1ra8wln"> 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-1ra8wln"
          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-1ra8wln" 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-1ra8wln">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-1ra8wln" 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-1ra8wln"> 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-1ra8wln"
        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-1ra8wln" 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-mw9bdlq" 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-mw9bdlq"
      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-mw9bdlq" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-mw9bdlq" :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-mw9bdlq">
      <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-mw9bdlq" 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-mw9bdlq"> 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-mw9bdlq"
          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-mw9bdlq" 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-mw9bdlq">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-mw9bdlq" 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-mw9bdlq"> 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-mw9bdlq"
        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-mw9bdlq" 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 (815) 265-4505" href="tel:8152654505" class="red-link">
                        (815) 265-4505
                    </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 (815) 265-4505" href="tel:8152654505" class="red-link">
                        (815) 265-4505
                    </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">
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        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
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(815) 265-4505


OFFICE HOURS


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9am - 5pm (Central)
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9am - 5pm
Sat-Sun
Closed
After Hours by Appointment
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INSURANCE PRODUCTS OFFERED

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


OTHER PRODUCTS

Banking, Mutual Funds, Annuities

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State Farm® Insurance Agent


KRISTEN VOGEL


VOGEL INS AND FIN SVCS INC


CPCU®


OFFICE HOURS


Today

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


ADDRESS

105 E Crescent Street
Gilman, IL 60938-1505




Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


ABOUT ME

🎃🍂 This October, as you carve pumpkins and decorate your home for fall,
remember to review your insurance coverage. We're here to ensure you're
protected against unexpected tricks or treats! #OctoberInsurance

This quarter in the office, we are collecting soup & crackers for God's Hands
Food Pantry in Gilman, IL. We'll match every item that's brought in.

When it comes to making decisions about your insurance and financial services, I
know it can seem overwhelming. At the Kristen Vogel State Farm Insurance agency,
we do things a bit different, and guarantee we’ll help make your life a bit
easier. We’ll give you the confidence that you’ve made the right decisions and
most importantly that you and your family are protected how you wish and within
your budget, should the unexpected happen. I'm here to protect your lifestyle.

Feel free to stop-by our office, conveniently located at the intersection of
highway 24 and downtown Gilman, IL and experience the difference. Don’t need one
more thing to do or coming in and chatting isn’t your thing? (We get it!) We’re
also available via call, text, email, and can even video chat. So, while you’re
waiting to pick your kids up from practice or want to meet us from the comfort
of your home, that works great! As a part of the Kristen Vogel State Farm
family, that’s exactly how you’ll be treated...like family!

My husband and I both grew up in Iroquois County and value our small-town roots.
My husband, two adorable daughters (Ashlynn and Reagan) and I enjoy playing
outside and s’mores by the campfire. You may run into us at the lake on the
weekends. We also have recently started collecting chickens (chicken math is a
real thing!) If you see us in the grocery store or at a sporting event, please
make sure to say, “hi!” I want to be an example of how important hard work is
for my two young daughters, so as they grow-up they know they can be and do
anything they want.

Professionally, I earned my undergraduate degree from Illinois State University
where I majored in Marketing. I have my MBA from Olivet College where I
specialized in Insurance. In addition, I hold my Chartered Property Casualty
Underwriter (CPCU), ChFC, and Chartered Life Underwriter (CLU) designations.

…Read More
 * 


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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


OFFICE INFO




OFFICE INFO


OFFICE HOURS


Today

9am - 5pm (Central)
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

105 E Crescent Street
Gilman, IL 60938-1505

Map & Directions
   


 * PHONE
   
   (815) 265-4505
   
   
   
   
   
   
   
   
   


LANGUAGES:

English, Spanish


About Me


🎃🍂 This October, as you carve pumpkins and decorate your home for fall,
remember to review your insurance coverage. We're here to ensure you're
protected against unexpected tricks or treats! #OctoberInsurance

This quarter in the office, we are collecting soup & crackers for God's Hands
Food Pantry in Gilman, IL. We'll match every item that's brought in.

When it comes to making decisions about your insurance and financial services, I
know it can seem overwhelming. At the Kristen Vogel State Farm Insurance agency,
we do things a bit different, and guarantee we’ll help make your life a bit
easier. We’ll give you the confidence that you’ve made the right decisions and
most importantly that you and your family are protected how you wish and within
your budget, should the unexpected happen. I'm here to protect your lifestyle.

Feel free to stop-by our office, conveniently located at the intersection of
highway 24 and downtown Gilman, IL and experience the difference. Don’t need one
more thing to do or coming in and chatting isn’t your thing? (We get it!) We’re
also available via call, text, email, and can even video chat. So, while you’re
waiting to pick your kids up from practice or want to meet us from the comfort
of your home, that works great! As a part of the Kristen Vogel State Farm
family, that’s exactly how you’ll be treated...like family!

My husband and I both grew up in Iroquois County and value our small-town roots.
My husband, two adorable daughters (Ashlynn and Reagan) and I enjoy playing
outside and s’mores by the campfire. You may run into us at the lake on the
weekends. We also have recently started collecting chickens (chicken math is a
real thing!) If you see us in the grocery store or at a sporting event, please
make sure to say, “hi!” I want to be an example of how important hard work is
for my two young daughters, so as they grow-up they know they can be and do
anything they want.

Professionally, I earned my undergraduate degree from Illinois State University
where I majored in Marketing. I have my MBA from Olivet College where I
specialized in Insurance. In addition, I hold my Chartered Property Casualty
Underwriter (CPCU), ChFC, and Chartered Life Underwriter (CLU) designations.


Products



INSURANCE PRODUCTS OFFERED

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


OTHER PRODUCTS

Banking, Mutual Funds, Annuities

FINRA’s BrokerCheck View Licenses


OFFICE INFO




OFFICE INFO


OFFICE HOURS


Today

9am - 5pm (Central)
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

105 E Crescent Street
Gilman, IL 60938-1505

Map & Directions
   


 * PHONE
   
   (815) 265-4505
   
   
   
   
   
   
   
   
   


LANGUAGES:

English, Spanish


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.


TEACHING KIDS TO SAVE MONEY


TEACHING KIDS TO SAVE MONEY

How to teach kids about money to help prepare them as financially responsible
adults.


DIVORCE AND FINANCES


DIVORCE AND FINANCES

When going through a divorce, focus on your finances. A little planning can go a
long way to help you move forward as you navigate your divorce and finances.

View More Articles
Contact Us Our Mission Our Team


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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.





My mission is to always make my customers feel confident they have made the
right choice when choosing the Kristen Vogel State Farm Agency team. Customers
will be treated like family, and they will know they can always rely on us to be
there and to provide the necessary information to make an informed decision for
their insurance and financial needs.

We will be their Good Neighbor by being active participants and giving back to
the communities we serve. My office will fulfill the State Farm mission. My
vision is to become the leader in insurance and financial services in the
communities we serve. Our community’s needs and demands will always be our
guide. Our pathway to excellence will be through our fun, focused, and healthy
working environment.

We will help all prospective customers prepare themselves, as well as their
family, with their present needs and concerns, as well as preparing them for the
longterm. Our success and continual growth will be based upon customer
relationships built on a mutual understanding, unmatched service, positive
attitudes, and professional advice.

…Read More

The Kristen Vogel State Farm Insurance team is top-notch and available to assist
you with your needs! My team is proficient in Spanish and proud to serve!

We provide auto insurance, home insurance, renters insurance, life insurance,
pet insurance, and more!

Natalie Munoz

Customer Service Representative

Read bio

Karla Rodriguez

Customer Relations Representative

License #21160020

Read bio

Viewing team member 1 of 2

Natalie Munoz

Customer Service Representative

Hi my name is Natalie Munoz I am 22 years old from Onarga, IL. I graduated from
Iroquois West High-School in 2020. I am a mother to a beautiful girl, Arely. I
am also bilingual. I love meeting new people & being able to help assist Spanish
speakers here at Kristen Vogel State Farm. It is always such a good feeling to
have customers feel confident doing business with us. Throughout my time at
State Farm, I have learned so much and am excited to see what the future holds
for me.

Viewing team member 2 of 2

Karla Rodriguez

Customer Relations Representative

License #21160020

It is my pleasure to introduce myself to you. My name is Karla Rodriguez. I am
bilingual (English/Spanish) and from Paxton, IL. I am a mom to a handsome boy
and have a cat and a new kitten. I am a graduate of Paxton-Buckley-Loda and
University of Spa and Cosmetology Arts of Springfield and am a licensed Nail
Technician. I love tapping into my creativity and meeting new people. I am new
to insurance but excited to help customers learn more with me.


Previous Next

Close



YOU CAN ALSO CALL US AT (815) 265-4505

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.






DESIGNATION FOR KRISTEN VOGEL

CPCU®


AGENT LICENSES FOR KRISTEN VOGEL

IL-3003087762
KY-DOI-1349591
MO-3003094558
IN-4029635

If you are using a screen reader and having difficulty with this website please
call (815) 265-4505.



DISCLOSURES

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

Securities are not FDIC insured, are not bank guaranteed and are subject to
investment risk, including possible loss of principal. Neither State Farm nor
its agents provide tax or legal advice. State Farm VP Management Corp. is a
separate entity from those State Farm and/or unaffiliated entities which provide
banking and insurance products. AP2024/07/0846

Securities distributed by State Farm VP Management Corp. State Farm VP
Management Corp. Customer Relationship Summary

Securities Supervisor address:1 State Farm Plaza , Bloomington, IL 61710-0001
Phone: 309-622-5001

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.

Pre-existing conditions: If you currently have a pet medical insurance policy,
switching carriers or purchasing a new policy may affect certain provisions such
as coverages for pre-existing conditions or deductibles already established
under your current policy. Let your State Farm® agent know if your existing
policy has provisions that might make it beneficial for you to keep.

Pet insurance products are underwritten in the United States by American Pet
Insurance Company and ZPIC Insurance Company, 6100-4th Ave. S, Seattle, WA
98108. Administered by Trupanion Managers USA, Inc. (CA license No. 0G22803, NPN
9588590). Terms and conditions apply, see full policy on Trupanion's website for
details. State Farm Mutual Automobile Insurance Company, its subsidiaries and
affiliates, neither offer nor are financially responsible for pet insurance
products. State Farm is a separate entity and is not affiliated with Trupanion
or American Pet Insurance.

State Farm (including State Farm Mutual Automobile Insurance Company and its
subsidiaries and affiliates) is not responsible for, and does not endorse or
approve, either implicitly or explicitly, the content of any third party sites
referenced in this material. Products and services are offered by third parties
and State Farm does not warrant the merchantability, fitness or quality of the
products and services of the third parties.

Like a good neighbor, State Farm is there.®
Legal Information
Ads & Tracking Security & Fraud Accessibility Terms of Use Notice of Privacy
Policy State Privacy Rights
Download the State Farm mobile app today

Give Agent Kristen a call

(815) 265-4505
© Copyright State Farm Mutual Automobile Insurance Company 2024.

Viewing team member 1 of 2

Natalie Munoz

Customer Service Representative

Hi my name is Natalie Munoz I am 22 years old from Onarga, IL. I graduated from
Iroquois West High-School in 2020. I am a mother to a beautiful girl, Arely. I
am also bilingual. I love meeting new people & being able to help assist Spanish
speakers here at Kristen Vogel State Farm. It is always such a good feeling to
have customers feel confident doing business with us. Throughout my time at
State Farm, I have learned so much and am excited to see what the future holds
for me.

Viewing team member 2 of 2

Karla Rodriguez

Customer Relations Representative

License #21160020

It is my pleasure to introduce myself to you. My name is Karla Rodriguez. I am
bilingual (English/Spanish) and from Paxton, IL. I am a mom to a handsome boy
and have a cat and a new kitten. I am a graduate of Paxton-Buckley-Loda and
University of Spa and Cosmetology Arts of Springfield and am a licensed Nail
Technician. I love tapping into my creativity and meeting new people. I am new
to insurance but excited to help customers learn more with me.


Previous Next

Close