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

URL: https://www.securewithbrashear.com/
Submission: On July 10 via automatic, source certstream-suspicious — Scanned from US

Form analysis 4 forms found in the DOM

#

<form id="quote-start-ggn75m7" 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-ggn75m7"
      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-ggn75m7" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-ggn75m7" :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="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="hospital">Hospital Income</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="pet">Pet Insurance</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</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-ggn75m7">
      <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-ggn75m7" 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-ggn75m7"> 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-ggn75m7"
          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-ggn75m7" 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-ggn75m7">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-ggn75m7" 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-ggn75m7"> 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-ggn75m7"
        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-ggn75m7" 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="productKey !== 'business'">Start a Quote</span>
      <span x-show="productKey === 'business'" 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-r7cfze1" 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-r7cfze1"
      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-r7cfze1" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-r7cfze1" :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="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="hospital">Hospital Income</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="pet">Pet Insurance</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</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-r7cfze1">
      <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-r7cfze1" 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-r7cfze1"> 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-r7cfze1"
          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-r7cfze1" 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-r7cfze1">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-r7cfze1" 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-r7cfze1"> 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-r7cfze1"
        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-r7cfze1" 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="productKey !== 'business'">Start a Quote</span>
      <span x-show="productKey === 'business'" 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 (502) 512-0158" href="tel:5025120158" class="red-link">
                        (502) 512-0158
                    </a>
  </h2>
  <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:" :aria-invalid="hasError('message')"
                  :aria-describedby="`md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')" @keydown.debounce.750ms="validateMessage()"
                  :error="hasError('message')"></textarea>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$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:" :aria-invalid="hasError('message')"
              :aria-describedby="`message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')" @keydown.debounce.750ms="validateMessage()"
              :error="hasError('message')"></textarea>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$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 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 (502) 512-0158" href="tel:5025120158" class="red-link">
                        (502) 512-0158
                    </a>
  </h2>
  <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:" :aria-invalid="hasError('message')"
                  :aria-describedby="`md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')" @keydown.debounce.750ms="validateMessage()"
                  :error="hasError('message')"></textarea>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$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:" :aria-invalid="hasError('message')"
              :aria-describedby="`message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')" @keydown.debounce.750ms="validateMessage()"
              :error="hasError('message')"></textarea>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$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 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>
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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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State Farm® Insurance Agent


BRIAN BRASHEAR


4.8 out of 5 average rating on Google (37 reviews)
107 Settlers Center Road
Taylorsville, KY 40071-7732

Look for us across the street from Spencer County High School and the
Taylorsville Post Office.


Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


ABOUT ME

I have been a Central Kentucky resident my entire life, graduating from Bullitt
East High School in 2005. After graduating from Western Kentucky University in
2009 with degrees in Secondary Education and English & Allied Language Arts, I
took a position at my alma mater, Bullitt East High School. Teaching there for
over 5 years and leading BEHS to become a ranked top 10 school in the state of
Kentucky, I determined that education was a beloved career. Being introduced to
the insurance field by a life-insurance advising career, and extensive
travelling throughout the Midwest, I developed incomparable knowledge of
competitor products and experience with in-home, personal visits with Seniors
who were searching for top-notch protection and guidance from a representative
in the field. While growing an insatiable desire to genuinely help families
choose the appropriate life insurance plan for their family, I strove to find a
more community-focused career to teach and protect those people and their assets
so that they may prepare for the unexpected. It was an easy decision that State
Farm would be the reliable and financially-stable company to help me reach those
families to demonstrate about how to prepare for the unexpected, mitigate their
risks, and ultimately, realize their dreams.

As a valued and praised State Farm Agent for nearly three years in February
2024, I am beyond excited to continue as the premier State Farm Agent in Spencer
County and Taylorsville, where my wife, our Chocolate Lab & Office Dog, Layla,
and I will be ever-present. My team and I look forward to continuing to be fresh
and friendly faces in the community, and there will be plenty of opportunities
to meet us at events and gatherings around town. Our office prides ourselves in
serving the area just south of Shelbyville and north of Bardstown, also serving
the communities of Bloomfield, Elk Creek, Fisherville, Little Mount, Mt. Eden,
Normandy, Waterford, and Wilsonville. We are also a proud member of the Spencer
County Chamber of Commerce!

We offer free quotes to better serve our customers in the following areas:

Auto Insurance

Commercial Auto & Fleet Insurance

Small Business Insurance

Worker’s Comp Insurance

Rental Property Insurance

Homeowner’s Insurance

Renter’s Insurance

Condo Insurance

RV & Boat Insurance

Life Insurance

Health Insurance

In addition to 24/7 Customer Service, our highly-qualified team promises
attention to detail to ensure when the unexpected occurs, we are here to help!

…Read More
 * 
 * 
 * 
 * 
 * 
 * 


4.8 out of 5 average rating on Google (37 reviews)


OFFICE HOURS


Today

8:30am - 5:30pm (Eastern)
Mon-Fri
8:30am - 5:30pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!
 * 
 * 
 * 
 * 
 * 
 * 


INSURANCE PRODUCTS OFFERED

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


OTHER PRODUCTS

Banking

View Licenses
 * 
 * 
 * 
 * 
 * 
 * 


4.8 out of 5 average rating on Google (37 reviews)

Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?

Select an Insurance Product
Select Product AutoHomeownersCondo OwnersRentersLifeHospital IncomeMedicare
SupplementPet InsuranceSmall Business

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

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

Start a Quote Request a Quote




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


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Today

8:30am - 5:30pm (Eastern)
Mon-Fri
8:30am - 5:30pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!


ADDRESS

107 Settlers Center Road
Taylorsville, KY 40071-7732

Map & Directions
   


 * PHONE
   
   (502) 289-0981
   
   
   
   
   
   
   
   
   


LANGUAGES

English


About Me


I have been a Central Kentucky resident my entire life, graduating from Bullitt
East High School in 2005. After graduating from Western Kentucky University in
2009 with degrees in Secondary Education and English & Allied Language Arts, I
took a position at my alma mater, Bullitt East High School. Teaching there for
over 5 years and leading BEHS to become a ranked top 10 school in the state of
Kentucky, I determined that education was a beloved career. Being introduced to
the insurance field by a life-insurance advising career, and extensive
travelling throughout the Midwest, I developed incomparable knowledge of
competitor products and experience with in-home, personal visits with Seniors
who were searching for top-notch protection and guidance from a representative
in the field. While growing an insatiable desire to genuinely help families
choose the appropriate life insurance plan for their family, I strove to find a
more community-focused career to teach and protect those people and their assets
so that they may prepare for the unexpected. It was an easy decision that State
Farm would be the reliable and financially-stable company to help me reach those
families to demonstrate about how to prepare for the unexpected, mitigate their
risks, and ultimately, realize their dreams.

As a valued and praised State Farm Agent for nearly three years in February
2024, I am beyond excited to continue as the premier State Farm Agent in Spencer
County and Taylorsville, where my wife, our Chocolate Lab & Office Dog, Layla,
and I will be ever-present. My team and I look forward to continuing to be fresh
and friendly faces in the community, and there will be plenty of opportunities
to meet us at events and gatherings around town. Our office prides ourselves in
serving the area just south of Shelbyville and north of Bardstown, also serving
the communities of Bloomfield, Elk Creek, Fisherville, Little Mount, Mt. Eden,
Normandy, Waterford, and Wilsonville. We are also a proud member of the Spencer
County Chamber of Commerce!

We offer free quotes to better serve our customers in the following areas:

Auto Insurance

Commercial Auto & Fleet Insurance

Small Business Insurance

Worker’s Comp Insurance

Rental Property Insurance

Homeowner’s Insurance

Renter’s Insurance

Condo Insurance

RV & Boat Insurance

Life Insurance

Health Insurance

In addition to 24/7 Customer Service, our highly-qualified team promises
attention to detail to ensure when the unexpected occurs, we are here to help!


Products



INSURANCE PRODUCTS OFFERED

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


OTHER PRODUCTS

Banking

View Licenses


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Today

8:30am - 5:30pm (Eastern)
Mon-Fri
8:30am - 5:30pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!


ADDRESS

107 Settlers Center Road
Taylorsville, KY 40071-7732

Map & Directions
   


 * PHONE
   
   (502) 289-0981
   
   
   
   
   
   
   
   
   


LANGUAGES

English


Simple Insights®



SIMPLE INSIGHTS®


HOW TO REGISTER A CAR AT THE DMV


HOW TO REGISTER A CAR AT THE DMV

Car registration requirements at the DMV can vary depending on the state that
you live in.


FOUR KINDS OF SAVINGS AND OTHER IMPORTANT SAVINGS ACCOUNT INFORMATION


FOUR KINDS OF SAVINGS AND OTHER IMPORTANT SAVINGS ACCOUNT INFORMATION

It’s easy to find reasons to save money, but it’s not always easy to get
started. We share some information about savings accounts and savings types to
help you build a strong financial foundation.


CAR MAINTENANCE TASKS YOU CAN DO YOURSELF


CAR MAINTENANCE TASKS YOU CAN DO YOURSELF

To combat auto repair costs that keep climbing, some auto maintenance can be
done at home. Here are ones that are usually do-it-yourself.

View More Articles

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COFFEE BREAK (FEAT. CAITLIN CLARK, JENNY TAFT) :30


Contact Us Our Mission Our Team We're Hiring


YOU CAN ALSO CALL US AT (502) 512-0158


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.





The mission of Brian Brashear State Farm is to provide second-to-none
attentiveness and support for all of our customers when navigating the uncertain
pathways of the real world, by advising our community from all backgrounds and
experiences, to mitigating their risks from the unexpected and uncertain through
comprehension of product knowledge, while crafting a customizable life plan to
ensure our customers have confidence with the undeniable support of our
products. We are proud members of the Spencer County Chamber Commerce, and look
forward to serving a communal role in Taylorsville--Spencer County by
involvement in local community organizations and support of our
first-responders.

…Read More

MARY DAYTON

Account Manager

Meet Mary Dayton, she is one of your friendly insurance account managers here at
Brian Brashear State Farm. Mary has been part of the Spencer County community
for almost 15 years and looks forward being able to help her community. You can
often find her at Ray Jewel Park volunteering. She has been extremely active
with the Spencer County Youth Baseball Association for more than five years now.
She currently volunteers on the board as the treasurer.
…Read More
NC

NICHOLAS CECIL

Account Manager


CN

CHEYENNE NORTON

Customer Service Representative



ELIZABETH BANKS





OUR AGENCY

My team's mission is to help people manage the risks of everyday life, recover
from the unexpected and realize their dreams. We are located in Taylorsville, KY
and help customers with their insurance and financial services needs, including:

 * Auto insurance
 * Home insurance
 * Life insurance
 * Retirement planning


…Read More
Learn more about our agency and the career opportunities with us.
Available Positions
Insurance Account Position - State Farm Agent Team Member

Taylorsville, KY Full Time

Insurance Staff Position - State Farm Agent Team Member

Taylorsville, KY Full Time

Please Note: This opportunity is about potential employment with an independent
contractor agent who solicits applications for State Farm products and services,
and does NOT result in employment with any of the State Farm Insurance
Companies. The employment selection decision , terms and conditions of
employment (such as compensation and benefits) are all determined solely by the
independent contractor agent.


YOU CAN ALSO CALL US AT (502) 512-0158


CONTACT US

Your preferred method of contact
 * Your Email
 * Your Phone

Your Name*
Your Phone*
Your Email*
Your Message:*

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

Your preferred method of contact
 * Your Email
 * Your Phone

I'd like more info about: *


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

Your Message:*


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


PLEASE CORRECT THE FOLLOWING:

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



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






AGENT LICENSES FOR BRIAN BRASHEAR

KY-DOI-895915
NMLS #: 2405354

If you are using a screen reader and having difficulty with this website please
call (502) 289-0981.



DISCLOSURES

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

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

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

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

Rocket Mortgage, LLC; NMLS #3030; www.NMLSConsumerAccess.org . Equal Housing
Lender. Licensed in 50 states. AL License No. MC 20979, Control No. 100152352.
AR, TX: 1050 Woodward Ave., Detroit, MI 48226-1906, (888) 474-0404; AZ: 1 N.
Central Ave., Ste. 2000, Phoenix, AZ 85004, Mortgage Banker License #BK-0902939;
CA: Licensed by the Department of Financial Protection and Innovation under the
California Residential Mortgage Lending Act; CO: Regulated by the Division of
Real Estate; GA: Residential Mortgage Licensee #11704; IL: Residential Mortgage
Licensee #4127 – Dept. of Financial and Professional Regulation; KS: Licensed
Mortgage Company MC.0025309; MA: Mortgage Lender License #ML 3030; ME:
Supervised Lender License; MN: Not an offer for a rate lock agreement; MS:
Licensed by the MS Dept. of Banking and Consumer Finance; NH: Licensed by the NH
Banking Dept., #6743MB; NV: License #626; NJ: New Jersey – Rocket Mortgage, LLC,
1050 Woodward Ave., Detroit, MI 48226, (888) 474-0404, Licensed by the N.J.
Department of Banking and Insurance.; NY: Rocket Mortgage, LLC, 1050 Woodward
Ave., Detroit, MI 48226 Licensed Mortgage Banker-NYS Department of Financial
Services; OH: MB 850076; OR: License #ML-1387; PA: Licensed by the Dept. of
Banking – License #21430; RI: Licensed Lender; WA: Consumer Loan Company License
CL-3030. Conditions may apply.

State Farm VP Management Corp. is a separate entity from those State Farm
entities which provide banking and insurance products. Investing involves risk,
including potential for loss.

Neither State Farm nor its agents provide tax or legal advice. Please consult a
tax or legal advisor for advice regarding your personal circumstances.

Like a good neighbor, State Farm is there.®
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