myagentbeto.com Open in urlscan Pro
34.69.219.172  Public Scan

Submitted URL: http://insurance-quotes-dallas.com/
Effective URL: https://myagentbeto.com/
Submission: On November 24 via api from NL — Scanned from NL

Form analysis 4 forms found in the DOM

#

<form id="quote-start-efff6b7" 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-efff6b7"
      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-efff6b7" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-efff6b7" :aria-describedby="productSelected ? '' : describeErrorsID()" class="bg-white"
          aria-describedby="">
          <option value="" selected="" hidden="">Select Product</option>
          <template x-for="line in lineOptions">
            <option :value="line.key" x-text="line.label" :selected="line.key === productKey"></option>
          </template>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="auto">Auto</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="motorcycle">Motorcycle</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="homeowners">Homeowners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="condo">Condo Owners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="renters">Renters</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="life">Life</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="medicare">Medicare Supplement</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="hospital">Supplemental Health</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="pet">Pet Insurance</option>
        </select>
        <div class="absolute right-4 pointer-events-none">
          <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
              <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
            </svg></div>
        </div>
      </div>
    </label>
    <!-- end partial: shared/components/ui/select-input-label.hbs -->
  </div>
  <template x-if="['zip', 'loc'].includes(type())">
    <div id="specific-location-info-efff6b7">
      <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-efff6b7" 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-efff6b7"> 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-efff6b7"
          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-efff6b7" 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-efff6b7">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-efff6b7" 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-efff6b7"> 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-efff6b7"
        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-efff6b7" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()"
            aria-describedby="">
            <option value="" selected="" hidden="">Your State</option>
            <option value="AL" :selected="'AL' === state">Alabama</option>
            <option value="AK" :selected="'AK' === state">Alaska</option>
            <option value="AZ" :selected="'AZ' === state">Arizona</option>
            <option value="AR" :selected="'AR' === state">Arkansas</option>
            <option value="CA" :selected="'CA' === state">California</option>
            <option value="CO" :selected="'CO' === state">Colorado</option>
            <option value="CT" :selected="'CT' === state">Connecticut</option>
            <option value="DE" :selected="'DE' === state">Delaware</option>
            <option value="FL" :selected="'FL' === state">Florida</option>
            <option value="GA" :selected="'GA' === state">Georgia</option>
            <option value="HI" :selected="'HI' === state">Hawaii</option>
            <option value="ID" :selected="'ID' === state">Idaho</option>
            <option value="IL" :selected="'IL' === state">Illinois</option>
            <option value="IN" :selected="'IN' === state">Indiana</option>
            <option value="IA" :selected="'IA' === state">Iowa</option>
            <option value="KS" :selected="'KS' === state">Kansas</option>
            <option value="KY" :selected="'KY' === state">Kentucky</option>
            <option value="LA" :selected="'LA' === state">Louisiana</option>
            <option value="ME" :selected="'ME' === state">Maine</option>
            <option value="MD" :selected="'MD' === state">Maryland</option>
            <option value="MA" :selected="'MA' === state">Massachusetts</option>
            <option value="MI" :selected="'MI' === state">Michigan</option>
            <option value="MN" :selected="'MN' === state">Minnesota</option>
            <option value="MS" :selected="'MS' === state">Mississippi</option>
            <option value="MO" :selected="'MO' === state">Missouri</option>
            <option value="MT" :selected="'MT' === state">Montana</option>
            <option value="NE" :selected="'NE' === state">Nebraska</option>
            <option value="NV" :selected="'NV' === state">Nevada</option>
            <option value="NH" :selected="'NH' === state">New Hampshire</option>
            <option value="NJ" :selected="'NJ' === state">New Jersey</option>
            <option value="NM" :selected="'NM' === state">New Mexico</option>
            <option value="NY" :selected="'NY' === state">New York</option>
            <option value="NC" :selected="'NC' === state">North Carolina</option>
            <option value="ND" :selected="'ND' === state">North Dakota</option>
            <option value="OH" :selected="'OH' === state">Ohio</option>
            <option value="OK" :selected="'OK' === state">Oklahoma</option>
            <option value="OR" :selected="'OR' === state">Oregon</option>
            <option value="PA" :selected="'PA' === state">Pennsylvania</option>
            <option value="RI" :selected="'RI' === state">Rhode Island</option>
            <option value="SC" :selected="'SC' === state">South Carolina</option>
            <option value="SD" :selected="'SD' === state">South Dakota</option>
            <option value="TN" :selected="'TN' === state">Tennessee</option>
            <option value="TX" :selected="'TX' === state">Texas</option>
            <option value="UT" :selected="'UT' === state">Utah</option>
            <option value="VT" :selected="'VT' === state">Vermont</option>
            <option value="VA" :selected="'VA' === state">Virginia</option>
            <option value="WA" :selected="'WA' === state">Washington</option>
            <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
            <option value="WV" :selected="'WV' === state">West Virginia</option>
            <option value="WI" :selected="'WI' === state">Wisconsin</option>
            <option value="WY" :selected="'WY' === state">Wyoming</option>
          </select>
          <div class="absolute right-4 pointer-events-none">
            <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
              </svg></div>
          </div>
        </div>
      </label>
      <!-- end partial: shared/components/ui/select-input-label.hbs -->
    </div>
  </div>
  <div class="w-full @lg:col-span-2 @2xl:col-span-1">
    <button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="btn btn-primary">
      <span x-show="!['business', 'motorcycle'].includes(productKey)">Start a Quote</span>
      <span x-show="['business', 'motorcycle'].includes(productKey)" style="display: none;">Request a Quote</span>
    </button>
  </div>
  <template x-if="errors.length > 0">
    <div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID">
      <template x-for="error in errors">
        <h3 class="p-3 border-2 font-med text-sf-red-700 bg-sf-red-100 border-sf-red-700 rounded-2xl" x-html="error"></h3>
      </template>
    </div>
  </template>
</form>

#

<form id="quote-start-2fw21he" 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-2fw21he"
      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-2fw21he" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-2fw21he" :aria-describedby="productSelected ? '' : describeErrorsID()" class="bg-white"
          aria-describedby="">
          <option value="" selected="" hidden="">Select Product</option>
          <template x-for="line in lineOptions">
            <option :value="line.key" x-text="line.label" :selected="line.key === productKey"></option>
          </template>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="auto">Auto</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="motorcycle">Motorcycle</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="homeowners">Homeowners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="condo">Condo Owners</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="renters">Renters</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="life">Life</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="medicare">Medicare Supplement</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="hospital">Supplemental Health</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="business">Small Business</option>
          <option :value="line.key" x-text="line.label" :selected="line.key === productKey" value="pet">Pet Insurance</option>
        </select>
        <div class="absolute right-4 pointer-events-none">
          <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
              <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
            </svg></div>
        </div>
      </div>
    </label>
    <!-- end partial: shared/components/ui/select-input-label.hbs -->
  </div>
  <template x-if="['zip', 'loc'].includes(type())">
    <div id="specific-location-info-2fw21he">
      <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-2fw21he" 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-2fw21he"> 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-2fw21he"
          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-2fw21he" 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-2fw21he">
    <div x-show="type() === 'zip'">
      <!-- start partial: shared/components/ui/text-input-label.hbs -->
      <div class="relative w-full " :class="{}">
        <input id="gaq-zip-2fw21he" 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-2fw21he"> 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-2fw21he"
        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-2fw21he" class="bg-white" x-model="state" name="field-state" aria-required="true" :aria-invalid="!isStateValid()" :aria-describedby="isStateValid() ? '' : describeErrorsID()" @keydown.enter.prevent="validate()"
            aria-describedby="">
            <option value="" selected="" hidden="">Your State</option>
            <option value="AL" :selected="'AL' === state">Alabama</option>
            <option value="AK" :selected="'AK' === state">Alaska</option>
            <option value="AZ" :selected="'AZ' === state">Arizona</option>
            <option value="AR" :selected="'AR' === state">Arkansas</option>
            <option value="CA" :selected="'CA' === state">California</option>
            <option value="CO" :selected="'CO' === state">Colorado</option>
            <option value="CT" :selected="'CT' === state">Connecticut</option>
            <option value="DE" :selected="'DE' === state">Delaware</option>
            <option value="FL" :selected="'FL' === state">Florida</option>
            <option value="GA" :selected="'GA' === state">Georgia</option>
            <option value="HI" :selected="'HI' === state">Hawaii</option>
            <option value="ID" :selected="'ID' === state">Idaho</option>
            <option value="IL" :selected="'IL' === state">Illinois</option>
            <option value="IN" :selected="'IN' === state">Indiana</option>
            <option value="IA" :selected="'IA' === state">Iowa</option>
            <option value="KS" :selected="'KS' === state">Kansas</option>
            <option value="KY" :selected="'KY' === state">Kentucky</option>
            <option value="LA" :selected="'LA' === state">Louisiana</option>
            <option value="ME" :selected="'ME' === state">Maine</option>
            <option value="MD" :selected="'MD' === state">Maryland</option>
            <option value="MA" :selected="'MA' === state">Massachusetts</option>
            <option value="MI" :selected="'MI' === state">Michigan</option>
            <option value="MN" :selected="'MN' === state">Minnesota</option>
            <option value="MS" :selected="'MS' === state">Mississippi</option>
            <option value="MO" :selected="'MO' === state">Missouri</option>
            <option value="MT" :selected="'MT' === state">Montana</option>
            <option value="NE" :selected="'NE' === state">Nebraska</option>
            <option value="NV" :selected="'NV' === state">Nevada</option>
            <option value="NH" :selected="'NH' === state">New Hampshire</option>
            <option value="NJ" :selected="'NJ' === state">New Jersey</option>
            <option value="NM" :selected="'NM' === state">New Mexico</option>
            <option value="NY" :selected="'NY' === state">New York</option>
            <option value="NC" :selected="'NC' === state">North Carolina</option>
            <option value="ND" :selected="'ND' === state">North Dakota</option>
            <option value="OH" :selected="'OH' === state">Ohio</option>
            <option value="OK" :selected="'OK' === state">Oklahoma</option>
            <option value="OR" :selected="'OR' === state">Oregon</option>
            <option value="PA" :selected="'PA' === state">Pennsylvania</option>
            <option value="RI" :selected="'RI' === state">Rhode Island</option>
            <option value="SC" :selected="'SC' === state">South Carolina</option>
            <option value="SD" :selected="'SD' === state">South Dakota</option>
            <option value="TN" :selected="'TN' === state">Tennessee</option>
            <option value="TX" :selected="'TX' === state">Texas</option>
            <option value="UT" :selected="'UT' === state">Utah</option>
            <option value="VT" :selected="'VT' === state">Vermont</option>
            <option value="VA" :selected="'VA' === state">Virginia</option>
            <option value="WA" :selected="'WA' === state">Washington</option>
            <option value="DC" :selected="'DC' === state">Washington, D.C.</option>
            <option value="WV" :selected="'WV' === state">West Virginia</option>
            <option value="WI" :selected="'WI' === state">Wisconsin</option>
            <option value="WY" :selected="'WY' === state">Wyoming</option>
          </select>
          <div class="absolute right-4 pointer-events-none">
            <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" fill="none" viewBox="0 0 12 7" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet">
                <path fill="currentColor" fill-rule="evenodd" d="M.293.293a1 1 0 0 1 1.414 0L6 4.586 10.293.293a1 1 0 1 1 1.414 1.414l-5 5a1 1 0 0 1-1.414 0l-5-5a1 1 0 0 1 0-1.414" clip-rule="evenodd"></path>
              </svg></div>
          </div>
        </div>
      </label>
      <!-- end partial: shared/components/ui/select-input-label.hbs -->
    </div>
  </div>
  <div class="w-full @lg:col-span-2 @2xl:col-span-1">
    <button @click.stop.prevent="validate()" type="button" :disabled="submitting" class="btn btn-primary">
      <span x-show="!['business', 'motorcycle'].includes(productKey)">Start a Quote</span>
      <span x-show="['business', 'motorcycle'].includes(productKey)" style="display: none;">Request a Quote</span>
    </button>
  </div>
  <template x-if="errors.length > 0">
    <div role="alert" aria-atomic="true" :id="ariaDescribedByErrorsID">
      <template x-for="error in errors">
        <h3 class="p-3 border-2 font-med text-sf-red-700 bg-sf-red-100 border-sf-red-700 rounded-2xl" x-html="error"></h3>
      </template>
    </div>
  </template>
</form>

POST

<form x-show="!sendResponse &amp;&amp; !sending" :action="`/contact${qs}`" method="post" aria-describedby="disclaimers">
  <h2 x-show="true" class="hidden text-2xl font-med md:block"> You can also call us at <a :id="$id('phone-link-contact-form')" aria-label="You can also call us at (214) 646-3325" href="tel:2146463325" class="red-link">
                        (214) 646-3325
                    </a>
  </h2>
  <!-- start partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <label x-id="['preferred__alpha']" :for="$id('preferred__alpha')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__alpha <input :id="$id('preferred__alpha')" type="url" name="preferred__alpha" tabindex="-1"
      x-model="form.preferred__alpha" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__beta']" :for="$id('preferred__beta')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__beta <input :id="$id('preferred__beta')" type="text" name="preferred__beta" tabindex="-1"
      x-model="form.preferred__beta" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__extra']" :for="$id('preferred__extra')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__extra <input :id="$id('preferred__extra')" type="checkbox" name="preferred__extra" tabindex="-1"
      x-model="form.preferred__extra" autocomplete="off" value="">
  </label>
  <!-- end partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <h2 class="text-2xl text-center mb-4 font-med md:hidden"> Contact Us </h2>
  <div class="flex flex-col min-w-0 md:mt-8 md:flex-row">
    <div class="w-full md:w-1/2 md:shrink-0 md:mr-8 lg:w-2/3 xl:m-0">
      <div class="flex flex-col w-full xl:flex-row">
        <div class="flex flex-col xl:h-full xl:justify-between xl:w-1/2 xl:pr-8">
          <div class="hidden mt-4 xl:block">
            <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
            <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
              <legend class="text-sm uppercase"> Your preferred method of contact </legend>
              <ul class="mt-2 flex flex-row">
                <li>
                  <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
                </li>
                <li>
                  <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
                </li>
              </ul>
            </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
          </div>
          <div class="xl:mt-6">
            <!-- start partial: shared/components/contact-forms/cf-contact-info.hbs -->
            <div class="flex flex-col w-full space-y-5" x-id="['contact-form-name', 'contact-form-phone', 'contact-form-email', 'contact-form-email-or-phone']">
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-name')" class="m2-form-input peer " name="contact-form-name" x-model="form.name" :aria-required="true" autocomplete="name" type="text" placeholder="Your Name" :aria-invalid="hasError('name')"
                  :aria-describedby="hasError('name') ? $id('error', 'name') : null" :error="hasError('name')" @keydown.debounce.750ms="validateName()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-name')"> Your Name<span aria-hidden="true" x-show="hasError('name')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-phone')" class="m2-form-input peer " name="contact-form-phone" x-model="form.phone" :aria-required="hasError('phone') &amp;&amp; form.pref == 'phone'" autocomplete="tel" type="text"
                  placeholder="Your Phone" :aria-invalid="hasError('phone')" :aria-describedby="hasError('phone') ? $id('error', 'phone') : null" :error="hasError('phone')" @keydown.debounce.750ms="validatePhone()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-phone')"> Your Phone<span aria-hidden="true" x-show="hasError('phone')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-email')" class="m2-form-input peer " name="contact-form-email" x-model="form.email" :aria-required="hasError('email') &amp;&amp; form.pref == 'email'" autocomplete="email" type="text"
                  placeholder="Your Email" :aria-invalid="hasError('email')" :aria-describedby="hasError('email') ? $id('error', 'email') : null" :error="hasError('email')" @keydown.debounce.750ms="validateEmail()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-email')"> Your Email<span aria-hidden="true" x-show="hasError('email')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-contact-info.hbs -->
          </div>
        </div>
        <div class="flex-col hidden xl:w-1/2 md:flex xl:flex-col-reverse xl:justify-end">
          <div class="h-full mt-5">
            <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
            <div class="relative h-full" x-id="[
        'md-contact-form-message'
    ]">
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full h-full" :class="{}">
                <textarea :id="$id('md-contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48 xl:h-full pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
                  :aria-describedby="`char-limit, md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
                  @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
                <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('md-contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
          </div>
          <div class="mt-4">
            <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
            <p class="text-xs" id="md-message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
            <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full md:w-1/2 lg:w-1/3 xl:justify-between xl:pl-8">
      <div class="mt-6 xl:hidden md:m-0">
        <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
        <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
          <legend class="text-sm uppercase"> Your preferred method of contact </legend>
          <ul class="mt-2 flex flex-row">
            <li>
              <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
            </li>
            <li>
              <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
            </li>
          </ul>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
      </div>
      <div class="flex w-full mt-4 xl:h-full">
        <!-- start partial: shared/components/contact-forms/cf-more-info.hbs -->
        <fieldset class="flex w-full flex-col" x-id="['contact-form-checkbox-input']">
          <legend class="mb-2 text-sm uppercase"> I'd like more info about: <span aria-hidden="true" x-show="hasError('message')"> * </span>
          </legend>
          <div class="grid sm:grid-flow-col sm:grid-cols-2 sm:grid-rows-3 md:grid-cols-1 md:grid-rows-6 xl:h-full">
            <template x-for="(i, k) in moreVals" :key="i.id">
              <div :id="$id(`contact-form-checkbox-${i.id}`)" class="m2-contact-form-checkbox">
                <input :id="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-input absolute h-0 w-0 overflow-hidden border-none p-0" x-model="form.more" type="checkbox"
                  :aria-describedby="hasError('message') ? $id('error', 'message') : null" :value="i.label" :aria-label="`${k + 1} of ${moreVals().length}, I'd like more info about ${i.label}`" :aria-invalid="hasError('more')"
                  @click="validateMessage()">
                <label :for="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-label flex cursor-pointer items-center rounded py-2 pl-8 transition-all hover:bg-sf-charcoal-100">
                  <svg viewBox="0 0 100 100" class="absolute left-1 h-4 w-4">
                    <path class="path" fill="none" stroke="#000" stroke-width="13" stroke-linecap="round" stroke-linejoin="round" stroke-miterlimit="10" d="M12.1 52.1l24.4 24.4 53-53"></path>
                  </svg>
                  <span class="text-sm" x-html="i.label"></span>
                </label>
              </div>
            </template>
          </div>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-more-info.hbs -->
      </div>
      <div class="mt-4 text-xs md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
        <p class="text-xs" id="message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
        <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
      </div>
      <div class="mt-5 md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
        <div class="relative h-full" x-id="[
        'contact-form-message'
    ]">
          <!-- start partial: shared/components/ui/text-input-label.hbs -->
          <div class="relative w-full h-full" :class="{}">
            <textarea :id="$id('contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48  pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
              :aria-describedby="`char-limit, message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
              @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
            <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$id('contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
            </label>
          </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
        </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
      </div>
    </div>
  </div>
  <div class="flex flex-col w-full mt-4 pt-3 md:flex-row xl:justify-end">
    <div class="md:w-1/2 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-file-input.hbs -->
      <div x-ref="contactFormAttachments" class="w-full" x-data="initFileInput()">
        <div x-show="$store.fileList.length" class="w-full mb-2 text-xl italic text-center border-b-2 border-gray-400 border-dashed" x-text="$store.fileList.length + ' attached file' + ($store.fileList.length > 1 ? 's:' : ':')">
        </div>
        <template x-for="(att, idx) in $store.fileList">
          <div :key="idx" class="relative my-2 grid w-full grid-cols-4 flex-nowrap bg-sf-charcoal-100 p-4">
            <div class="flex justify-center h-12 col-span-1 mr-4">
              <img x-show="checkType(att) === 'img'" :id="att.name" class="object-contain" :alt="att.name">
              <template x-if="checkType(att) != 'img'">
                <div x-html="svgIcon(checkType(att), &quot;h-full&quot;)" class="h-full">
                </div>
              </template>
            </div>
            <div class="flex flex-col justify-center col-span-3 mr-1">
              <div class="flex flex-row w-full mb-1">
                <span :aria-label="`This file is ${friendlySize(att.size)} in size`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 text-xs rounded-full w-max bg-sf-charcoal-200" x-html="friendlySize(att.size)"></span>
                <span :aria-label="`This file is a ${friendlyExtension(att.name)} file`" data-microtip-position="bottom-right" role="tooltip" class="px-2 py-1 ml-1 text-xs rounded-full w-max bg-sf-charcoal-200"
                  x-html="friendlyExtension(att.name)"></span>
              </div>
              <p class="text-sm truncate md:text-base" x-text="att.name">
              </p>
            </div>
            <a href="#" :title="`Cancel upload of ${att.name}`" @click.prevent="removeFile(idx)" class="absolute top-0 p-2 right-1">
                <span class="red-link whitespace-nowrap">
                    <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 12 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet"><path d="M8.57 8.43 7.429 9.571a.25.25 0 0 1-.359 0L6 8.501l-1.07 1.07a.25.25 0 0 1-.359 0L3.43 8.43a.25.25 0 0 1 0-.359l1.07-1.07-1.07-1.07a.25.25 0 0 1 0-.359l1.141-1.141a.25.25 0 0 1 .359 0L6 5.501l1.07-1.07a.25.25 0 0 1 .359 0L8.57 5.572a.25.25 0 0 1 0 .359L7.5 7.001l1.07 1.07a.25.25 0 0 1 0 .359M10.25 7c0-2.344-1.906-4.25-4.25-4.25S1.75 4.656 1.75 7 3.656 11.25 6 11.25 10.25 9.344 10.25 7M12 7A6 6 0 0 1 0 7a6 6 0 0 1 12 0"></path></svg></div>
                    Remove
                </span>
            </a>
          </div>
        </template>
        <div x-id="['m2-file-upload-input']">
          <label :for="$id(&quot;m2-file-upload-input&quot;)">
            <span role="button" class="text-lg btn btn-secondary" :aria-controls="$id(&quot;m2-file-upload-input&quot;)" tabindex="0" @keydown.enter="$refs['file-upload-input'].click()" @keydown.space="$refs['file-upload-input'].click()"
              x-text="`Add Attachments ${sizeRemainingMessage()}`">
            </span>
          </label>
          <input x-ref="file-upload-input" type="file" hidden="" :id="$id(&quot;m2-file-upload-input&quot;)" name="m2-cf-attachments" multiple="" :aria-disabled="tooManyBytes" :accept="acceptableFileTypes" @change="pickFiles($event.target.files)">
          <div class="mt-2 text-xs"> Please attach only <span x-text="readableExtensionList()"></span> file(s) — Unsupported file types will not be delivered to the agent. </div>
        </div>
      </div><!-- end partial: shared/components/contact-forms/cf-file-input.hbs -->
    </div>
    <div class="w-full mt-4 md:w-1/2 md:m-0 md:pl-8 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-submit.hbs -->
      <button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary"> Send Email </button><!-- end partial: shared/components/contact-forms/cf-submit.hbs -->
    </div>
  </div>
  <!-- start partial: shared/components/contact-forms/cf-errors.hbs -->
  <div x-show="hasErrors" role="alert" class="my-4 rounded-2xl bg-sf-red-100 p-4 text-sf-red-700">
    <!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
    <!-- "Please forgive this" -->
    <h3 class="font-semi mb-2 text-xl"> Please correct the following: </h3>
    <ul class="list-inside list-disc">
      <template x-for="(message, key) in errors" :key="$id('error', key)">
        <li class="mb-1" :id="$id('error', key)" x-html="message"></li>
      </template>
    </ul>
  </div><!-- end partial: shared/components/contact-forms/cf-errors.hbs -->
  <div id="disclaimers">
    <div class="mt-4">
      <!-- start partial: shared/components/contact-forms/cf-disclaimer.hbs -->
      <p :id="$id('cf-disclaimer')" class="text-xs leading-3"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email for marketing
        purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
        have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
        apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p><!-- end partial: shared/components/contact-forms/cf-disclaimer.hbs -->
    </div>
    <p class="mt-2" x-show="!false">
      <!-- start partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    </p>
    <p class="text-xs leading-3">
      <span class="font-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a licensed
      representative in the agent's office, or by contacting the State Farm toll-free customer service line at
      <span><a href="tel:8557337333" class="red-link" aria-label="Contact the State Farm toll-free customer service line at (855) 733-7333">(855) 733-7333</a>.</span>
    </p><!-- end partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    <p></p>
  </div>
</form>

POST

<form x-show="!sendResponse &amp;&amp; !sending" :action="`/contact${qs}`" method="post" aria-describedby="disclaimers">
  <h2 x-show="true" class="hidden text-2xl font-med md:block"> You can also call us at <a :id="$id('phone-link-contact-form')" aria-label="You can also call us at (214) 646-3325" href="tel:2146463325" class="red-link">
                        (214) 646-3325
                    </a>
  </h2>
  <!-- start partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <label x-id="['preferred__alpha']" :for="$id('preferred__alpha')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__alpha <input :id="$id('preferred__alpha')" type="url" name="preferred__alpha" tabindex="-1"
      x-model="form.preferred__alpha" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__beta']" :for="$id('preferred__beta')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__beta <input :id="$id('preferred__beta')" type="text" name="preferred__beta" tabindex="-1"
      x-model="form.preferred__beta" autocomplete="off" value="">
  </label>
  <label x-id="['preferred__extra']" :for="$id('preferred__extra')" class="absolute -left-[9999px] -top-[9999px] opacity-0 -z-10"> preferred__extra <input :id="$id('preferred__extra')" type="checkbox" name="preferred__extra" tabindex="-1"
      x-model="form.preferred__extra" autocomplete="off" value="">
  </label>
  <!-- end partial: shared/components/contact-forms/cf-more-prefs.hbs -->
  <h2 class="text-2xl text-center mb-4 font-med md:hidden"> Contact Us </h2>
  <div class="flex flex-col min-w-0 md:mt-8 md:flex-row">
    <div class="w-full md:w-1/2 md:shrink-0 md:mr-8 lg:w-2/3 xl:m-0">
      <div class="flex flex-col w-full xl:flex-row">
        <div class="flex flex-col xl:h-full xl:justify-between xl:w-1/2 xl:pr-8">
          <div class="hidden mt-4 xl:block">
            <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
            <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
              <legend class="text-sm uppercase"> Your preferred method of contact </legend>
              <ul class="mt-2 flex flex-row">
                <li>
                  <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
                </li>
                <li>
                  <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref"
                    @change="clearPrefErrors()">
                  <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
                </li>
              </ul>
            </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
          </div>
          <div class="xl:mt-6">
            <!-- start partial: shared/components/contact-forms/cf-contact-info.hbs -->
            <div class="flex flex-col w-full space-y-5" x-id="['contact-form-name', 'contact-form-phone', 'contact-form-email', 'contact-form-email-or-phone']">
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-name')" class="m2-form-input peer " name="contact-form-name" x-model="form.name" :aria-required="true" autocomplete="name" type="text" placeholder="Your Name" :aria-invalid="hasError('name')"
                  :aria-describedby="hasError('name') ? $id('error', 'name') : null" :error="hasError('name')" @keydown.debounce.750ms="validateName()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-name')"> Your Name<span aria-hidden="true" x-show="hasError('name')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-phone')" class="m2-form-input peer " name="contact-form-phone" x-model="form.phone" :aria-required="hasError('phone') &amp;&amp; form.pref == 'phone'" autocomplete="tel" type="text"
                  placeholder="Your Phone" :aria-invalid="hasError('phone')" :aria-describedby="hasError('phone') ? $id('error', 'phone') : null" :error="hasError('phone')" @keydown.debounce.750ms="validatePhone()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-phone')"> Your Phone<span aria-hidden="true" x-show="hasError('phone')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/contact-forms/cf-text-field.hbs -->
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full " :class="{}">
                <input :id="$id('contact-form-email')" class="m2-form-input peer " name="contact-form-email" x-model="form.email" :aria-required="hasError('email') &amp;&amp; form.pref == 'email'" autocomplete="email" type="text"
                  placeholder="Your Email" :aria-invalid="hasError('email')" :aria-describedby="hasError('email') ? $id('error', 'email') : null" :error="hasError('email')" @keydown.debounce.750ms="validateEmail()">
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('contact-form-email')"> Your Email<span aria-hidden="true" x-show="hasError('email')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
              <!-- end partial: shared/components/contact-forms/cf-text-field.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-contact-info.hbs -->
          </div>
        </div>
        <div class="flex-col hidden xl:w-1/2 md:flex xl:flex-col-reverse xl:justify-end">
          <div class="h-full mt-5">
            <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
            <div class="relative h-full" x-id="[
        'md-contact-form-message'
    ]">
              <!-- start partial: shared/components/ui/text-input-label.hbs -->
              <div class="relative w-full h-full" :class="{}">
                <textarea :id="$id('md-contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48 xl:h-full pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
                  :aria-describedby="`char-limit, md-message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
                  @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
                <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
                <label
                  class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
                  :for="$id('md-contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
                </label>
              </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
            </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
          </div>
          <div class="mt-4">
            <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
            <p class="text-xs" id="md-message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
            <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
          </div>
        </div>
      </div>
    </div>
    <div class="flex flex-col w-full md:w-1/2 lg:w-1/3 xl:justify-between xl:pl-8">
      <div class="mt-6 xl:hidden md:m-0">
        <!-- start partial: shared/components/contact-forms/cf-prefs.hbs -->
        <fieldset x-id="[
        'xl-contact-form-pref-email',
        'xl-contact-form-pref-phone',
        'xl-contact-form-pref',
    ]">
          <legend class="text-sm uppercase"> Your preferred method of contact </legend>
          <ul class="mt-2 flex flex-row">
            <li>
              <input :id="$id('xl-contact-form-pref-email')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="email" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-email')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Email </label>
            </li>
            <li>
              <input :id="$id('xl-contact-form-pref-phone')" class="m2-radio-input pointer-events-none absolute m-0 h-0 w-0 p-0 opacity-0" :name="$id('xl-contact-form-pref')" type="radio" value="phone" x-model="form.pref" @change="clearPrefErrors()">
              <label :for="$id('xl-contact-form-pref-phone')" class="m2-radio-label mr-4 inline-flex cursor-pointer select-none items-start text-sm leading-6"> Your Phone </label>
            </li>
          </ul>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-prefs.hbs -->
      </div>
      <div class="flex w-full mt-4 xl:h-full">
        <!-- start partial: shared/components/contact-forms/cf-more-info.hbs -->
        <fieldset class="flex w-full flex-col" x-id="['contact-form-checkbox-input']">
          <legend class="mb-2 text-sm uppercase"> I'd like more info about: <span aria-hidden="true" x-show="hasError('message')"> * </span>
          </legend>
          <div class="grid sm:grid-flow-col sm:grid-cols-2 sm:grid-rows-3 md:grid-cols-1 md:grid-rows-6 xl:h-full">
            <template x-for="(i, k) in moreVals" :key="i.id">
              <div :id="$id(`contact-form-checkbox-${i.id}`)" class="m2-contact-form-checkbox">
                <input :id="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-input absolute h-0 w-0 overflow-hidden border-none p-0" x-model="form.more" type="checkbox"
                  :aria-describedby="hasError('message') ? $id('error', 'message') : null" :value="i.label" :aria-label="`${k + 1} of ${moreVals().length}, I'd like more info about ${i.label}`" :aria-invalid="hasError('more')"
                  @click="validateMessage()">
                <label :for="$id('contact-form-checkbox-input', i.id)" class="m2-checkbox-label flex cursor-pointer items-center rounded py-2 pl-8 transition-all hover:bg-sf-charcoal-100">
                  <svg viewBox="0 0 100 100" class="absolute left-1 h-4 w-4">
                    <path class="path" fill="none" stroke="#000" stroke-width="13" stroke-linecap="round" stroke-linejoin="round" stroke-miterlimit="10" d="M12.1 52.1l24.4 24.4 53-53"></path>
                  </svg>
                  <span class="text-sm" x-html="i.label"></span>
                </label>
              </div>
            </template>
          </div>
        </fieldset><!-- end partial: shared/components/contact-forms/cf-more-info.hbs -->
      </div>
      <div class="mt-4 text-xs md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message-warning.hbs -->
        <p class="text-xs" id="message-warning"> For your protection, please do not include sensitive personal information such as social security numbers, credit/debit card number, or health/medical information. </p>
        <!-- end partial: shared/components/contact-forms/cf-message-warning.hbs -->
      </div>
      <div class="mt-5 md:hidden">
        <!-- start partial: shared/components/contact-forms/cf-message.hbs -->
        <div class="relative h-full" x-id="[
        'contact-form-message'
    ]">
          <!-- start partial: shared/components/ui/text-input-label.hbs -->
          <div class="relative w-full h-full" :class="{}">
            <textarea :id="$id('contact-form-message')" ref="message" x-model="form.message" class="m2-form-input peer h-48  pa11y-ignore" placeholder="Your Message:" :maxlength="MAX_MESSAGE_LENGTH" :aria-invalid="hasError('message')"
              :aria-describedby="`char-limit, message-warning ${hasError(&quot;message&quot;) ? $id(&quot;error&quot;, &quot;message&quot;) : &quot;&quot;}`" :aria-required="hasError('message')"
              @keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
            <p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${remainingCharacters}`"></p>
            <label
              class="font-semi peer-placeholder-shown:font-reg peer-focus:font-semi absolute -top-4 left-0 cursor-default text-xs text-sf-charcoal transition-all peer-placeholder-shown:left-3 peer-placeholder-shown:top-3 peer-placeholder-shown:cursor-text peer-placeholder-shown:select-none peer-placeholder-shown:text-base peer-focus:-top-4 peer-focus:left-0 peer-focus:cursor-default peer-focus:text-xs peer-focus:text-sf-charcoal"
              :for="$id('contact-form-message')"> Your Message:<span aria-hidden="true" x-show="hasError('message')">*</span>
            </label>
          </div><!-- end partial: shared/components/ui/text-input-label.hbs -->
        </div><!-- end partial: shared/components/contact-forms/cf-message.hbs -->
      </div>
    </div>
  </div>
  <div class="flex flex-col w-full mt-4 pt-3 md:flex-row xl:justify-end">
    <div class="md:w-1/2 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-file-input.hbs -->
      <div x-ref="contactFormAttachments" class="w-full" x-data="initFileInput()">
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        <template x-for="(att, idx) in $store.fileList">
          <div :key="idx" class="relative my-2 grid w-full grid-cols-4 flex-nowrap bg-sf-charcoal-100 p-4">
            <div class="flex justify-center h-12 col-span-1 mr-4">
              <img x-show="checkType(att) === 'img'" :id="att.name" class="object-contain" :alt="att.name">
              <template x-if="checkType(att) != 'img'">
                <div x-html="svgIcon(checkType(att), &quot;h-full&quot;)" class="h-full">
                </div>
              </template>
            </div>
            <div class="flex flex-col justify-center col-span-3 mr-1">
              <div class="flex flex-row w-full mb-1">
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                <span class="red-link whitespace-nowrap">
                    <div class="svg-outer"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 12 14" class="svg-inner" aria-hidden="true" style="fill: currentColor; " preserveAspectRatio="xMinYMid meet"><path d="M8.57 8.43 7.429 9.571a.25.25 0 0 1-.359 0L6 8.501l-1.07 1.07a.25.25 0 0 1-.359 0L3.43 8.43a.25.25 0 0 1 0-.359l1.07-1.07-1.07-1.07a.25.25 0 0 1 0-.359l1.141-1.141a.25.25 0 0 1 .359 0L6 5.501l1.07-1.07a.25.25 0 0 1 .359 0L8.57 5.572a.25.25 0 0 1 0 .359L7.5 7.001l1.07 1.07a.25.25 0 0 1 0 .359M10.25 7c0-2.344-1.906-4.25-4.25-4.25S1.75 4.656 1.75 7 3.656 11.25 6 11.25 10.25 9.344 10.25 7M12 7A6 6 0 0 1 0 7a6 6 0 0 1 12 0"></path></svg></div>
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            </a>
          </div>
        </template>
        <div x-id="['m2-file-upload-input']">
          <label :for="$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($event.target.files)">
          <div class="mt-2 text-xs"> Please attach only <span x-text="readableExtensionList()"></span> file(s) — Unsupported file types will not be delivered to the agent. </div>
        </div>
      </div><!-- end partial: shared/components/contact-forms/cf-file-input.hbs -->
    </div>
    <div class="w-full mt-4 md:w-1/2 md:m-0 md:pl-8 xl:w-1/3">
      <!-- start partial: shared/components/contact-forms/cf-submit.hbs -->
      <button @click="submit" type="button" :aria-disabled="isSendDisabled()" class="btn btn-primary"> Send Email </button><!-- end partial: shared/components/contact-forms/cf-submit.hbs -->
    </div>
  </div>
  <!-- start partial: shared/components/contact-forms/cf-errors.hbs -->
  <div x-show="hasErrors" role="alert" class="my-4 rounded-2xl bg-sf-red-100 p-4 text-sf-red-700">
    <!-- The only way ATs will read all of the text below on failed validation is if they are rendered as <p> elements -->
    <!-- "Please forgive this" -->
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    <ul class="list-inside list-disc">
      <template x-for="(message, key) in errors" :key="$id('error', key)">
        <li class="mb-1" :id="$id('error', key)" x-html="message"></li>
      </template>
    </ul>
  </div><!-- end partial: shared/components/contact-forms/cf-errors.hbs -->
  <div id="disclaimers">
    <div class="mt-4">
      <!-- start partial: shared/components/contact-forms/cf-disclaimer.hbs -->
      <p :id="$id('cf-disclaimer')" class="text-xs leading-3"> By filling out the form, you are providing express consent by electronic signature that you may be contacted by telephone (via call and/or text messages) and/or email for marketing
        purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
        have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
        apply). Your consent is not a condition of purchase. By continuing, you agree to the terms of the disclosures above. </p><!-- end partial: shared/components/contact-forms/cf-disclaimer.hbs -->
    </div>
    <p class="mt-2" x-show="!false">
      <!-- start partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    </p>
    <p class="text-xs leading-3">
      <span class="font-bold"> Please note: </span> Insurance coverage cannot be bound or changed via submission of this online e-mail form or via voice mail. To make policy changes or request additional coverage, please speak with a licensed
      representative in the agent's office, or by contacting the State Farm toll-free customer service line at
      <span><a href="tel:8557337333" class="red-link" aria-label="Contact the State Farm toll-free customer service line at (855) 733-7333">(855) 733-7333</a>.</span>
    </p><!-- end partial: shared/components/contact-forms/cf-coverage-disclaimer.hbs -->
    <p></p>
  </div>
</form>

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Mon-Thu
10am - 7pm
Fri
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Sat-Sun
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Call or text us 24 hours a day!
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INSURANCE PRODUCTS OFFERED

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


View Licenses
State Farm® Insurance Agent


BETO RODRIGUEZ


RODRIGUEZ INS AND FIN SVC INC


4.8/5 average rating on Google (22 reviews)


OFFICE HOURS


Closed Today

Mon-Thu
10am - 7pm
Fri
10am - 5pm
Sat-Sun
Closed
After Hours by Appointment


ADDRESS

1015 S Hampton Road Suite 102
Dallas, TX 75208-7826

Corner of Hampton and Clarendon, next to 7 Eleven


Contact Us

Contact Us

Text Us

Map & Directions

Get ID Card


ABOUT ME

Hello!

Welcome to Beto Rodriguez State Farm! At our agency, we are dedicated to being a
community leader in Dallas, TX and educating our customers on the insurance
options we have available to them. I am proud to be a small business owner in
Oak Cliff.

As a business in Dallas County, we strive to do our part in making a difference
in our community. I am proud to be a member of the Oak Cliff Chamber of
Commerce, where I can help get involved on decision for our community.

At Beto Rodriguez State Farm, we are licensed in property and casualty
insurance, life insurance, home insurance, small business insurance, and health
insurance. Our first office has received multiple achievements for our excellent
service throughout the years, such as:

· Ambassador Travel Qualifier

· Chairman Circle Qualifier

· Honor Club Qualifier

· SVP Club Qualifier

· Small Business Premier Club Qualifier

I am a husband and father to a very curious and outgoing toddler. I love
spending time with my family and friends. I enjoy road bike and mountain bike
riding on my free time.

Come chat with us at our office in Oak Cliff or call us any time.

…Read More
 * 
 * 
 * 


4.8/5 average rating on Google (22 reviews)


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4.8/5 average rating on Google (22 reviews)

Contact Us

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WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?

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

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

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

Start a Quote Request a Quote




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File a Claim Send Payment
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 * Homeowners Insurance
 * Condo Insurance
 * Renters Insurance
 * Business Insurance
 * Life Insurance
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   See More
   


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Closed Today

Mon-Thu
10am - 7pm
Fri
10am - 5pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!


ADDRESS

1015 S Hampton Road Suite 102
Dallas, TX 75208-7826

Map & Directions
   


 * PHONE
   
   (214) 646-3325
   
   
   
   
   
   
   
   
   


LANGUAGES

English, Spanish


About Me


Hello!

Welcome to Beto Rodriguez State Farm! At our agency, we are dedicated to being a
community leader in Dallas, TX and educating our customers on the insurance
options we have available to them. I am proud to be a small business owner in
Oak Cliff.

As a business in Dallas County, we strive to do our part in making a difference
in our community. I am proud to be a member of the Oak Cliff Chamber of
Commerce, where I can help get involved on decision for our community.

At Beto Rodriguez State Farm, we are licensed in property and casualty
insurance, life insurance, home insurance, small business insurance, and health
insurance. Our first office has received multiple achievements for our excellent
service throughout the years, such as:

· Ambassador Travel Qualifier

· Chairman Circle Qualifier

· Honor Club Qualifier

· SVP Club Qualifier

· Small Business Premier Club Qualifier

I am a husband and father to a very curious and outgoing toddler. I love
spending time with my family and friends. I enjoy road bike and mountain bike
riding on my free time.

Come chat with us at our office in Oak Cliff or call us any time.


Products



INSURANCE PRODUCTS OFFERED

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


View Licenses


OFFICE INFO


OFFICE INFO


OFFICE HOURS


Closed Today

Mon-Thu
10am - 7pm
Fri
10am - 5pm
Sat-Sun
Closed
After Hours by Appointment
Call or text us 24 hours a day!


ADDRESS

1015 S Hampton Road Suite 102
Dallas, TX 75208-7826

Map & Directions
   


 * PHONE
   
   (214) 646-3325
   
   
   
   
   
   
   
   
   


LANGUAGES

English, Spanish


Simple Insights®



SIMPLE INSIGHTS®


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CREATE A MOVING TO-DO LIST


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Your Message:*

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

Your preferred method of contact
 * Your Email
 * Your Phone

I'd like more info about: *


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



Your Message:*


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


PLEASE CORRECT THE FOLLOWING:

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



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





Our mission is to be the leading insurance agency in Oak Cliff. Our customers
are our priority. We are committed to educating customers on insurance and
financial services.

Looking for a team that can assist you with your insurance needs? Look no
further! Our amazing team is her, eager to serve you with a cheerful spirit!

Adriana Medina

Account Manager

License #2914281

Josue Garcia

Office Manager

License #2021887

Viewing team member 1 of 2

Adriana Medina

Account Manager

License #2914281

Viewing team member 2 of 2

Josue Garcia

Office Manager

License #2021887


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Close



YOU CAN ALSO CALL US AT (214) 646-3325

preferred__alpha preferred__beta preferred__extra


CONTACT US

Your preferred method of contact
 * Your Email
 * Your Phone

Your Name*
Your Phone*
Your Email*



Your Message:*

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

Your preferred method of contact
 * Your Email
 * Your Phone

I'd like more info about: *


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



Your Message:*


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


PLEASE CORRECT THE FOLLOWING:

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



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






AGENT LICENSES FOR BETO RODRIGUEZ

TX-1961734
OK-3002538420

If you are using a screen reader and having difficulty with this website please
call (214) 646-3325.



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.

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

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

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

Like a good neighbor, State Farm is there.®
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Give Agent Roberto a call

(214) 646-3325
© Copyright State Farm Mutual Automobile Insurance Company 2024.

Viewing team member 1 of 2

Adriana Medina

Account Manager

License #2914281

Viewing team member 2 of 2

Josue Garcia

Office Manager

License #2021887


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Close