crystalriverinsurance.com
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34.69.219.172
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Submitted URL: http://seguroenespanolcercademi.com/
Effective URL: https://crystalriverinsurance.com/
Submission: On October 19 via api from NL — Scanned from NL
Effective URL: https://crystalriverinsurance.com/
Submission: On October 19 via api from NL — Scanned from NL
Form analysis 4 forms found in the DOM
#
<form id="quote-start-pnu6b3w" 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-pnu6b3w"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-pnu6b3w" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-pnu6b3w" :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-pnu6b3w">
<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-pnu6b3w" 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-pnu6b3w"> 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-pnu6b3w"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-pnu6b3w" 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-pnu6b3w">
<div x-show="type() === 'zip'">
<!-- start partial: shared/components/ui/text-input-label.hbs -->
<div class="relative w-full " :class="{}">
<input id="gaq-zip-pnu6b3w" 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-pnu6b3w"> 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-pnu6b3w"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-pnu6b3w" 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-oeflr6v" 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-oeflr6v"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-oeflr6v" name="field-auto" @change="selectProduct()" x-model="productKey" aria-controls="specific-location-info-oeflr6v" :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-oeflr6v">
<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-oeflr6v" 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-oeflr6v"> 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-oeflr6v"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-oeflr6v" 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-oeflr6v">
<div x-show="type() === 'zip'">
<!-- start partial: shared/components/ui/text-input-label.hbs -->
<div class="relative w-full " :class="{}">
<input id="gaq-zip-oeflr6v" 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-oeflr6v"> 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-oeflr6v"
class="font-mecherlesans-reg relative block h-12 w-full border-b border-sf-charcoal text-base text-sf-charcoal placeholder-current [&_select]:h-full [&_select]:w-full [&_select]:cursor-pointer [&_select]:appearance-none [&_select]:px-3 [&_select]:transition-shadow [&_select]:focus-within:outline-none [&_select]:focus-within:ring [&_select]:focus-within:ring-inset [&_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-oeflr6v" 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 && !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 (352) 795-4747" href="tel:3527954747" class="red-link">
(352) 795-4747
</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') && 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') && 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("message") ? $id("error", "message") : ""}`" :aria-required="hasError('message')"
@keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
<p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${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("message") ? $id("error", "message") : ""}`" :aria-required="hasError('message')"
@keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
<p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${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), "h-full")" 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("m2-file-upload-input")">
<span role="button" class="text-lg btn btn-secondary" :aria-controls="$id("m2-file-upload-input")" tabindex="0" @keydown.enter="$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("m2-file-upload-input")" 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 && !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 (352) 795-4747" href="tel:3527954747" class="red-link">
(352) 795-4747
</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') && 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') && 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("message") ? $id("error", "message") : ""}`" :aria-required="hasError('message')"
@keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
<p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${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("message") ? $id("error", "message") : ""}`" :aria-required="hasError('message')"
@keydown.debounce.750ms="validateMessage(), validateMessageLength()" @keydown.debounce.5ms="displayMessageLength()" :error="hasError('message')"></textarea>
<p id="char-limit" class="flex justify-end" aria-live="polite" x-text="`${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), "h-full")" 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("m2-file-upload-input")">
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purposes by State Farm Mutual Automobile Insurance Company, its subsidiaries and affiliates ("State Farm") or an independent contractor State Farm agent regarding insurance products and services using the phone number and/or email address you
have provided to State Farm, even if your phone number is listed on a Do Not Call Registry. You further agree that such contact may be made using an automatic telephone dialing system and/or prerecorded voice (message and data rates may
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representative in the agent's office, or by contacting the State Farm toll-free customer service line at
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W- 8:45am to 6:00pm
F- 8:45am to 4:00pm
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State Farm® Insurance Agent
RYAN LAMPASONA
4.8/5 average rating on Google (338 reviews)
OFFICE HOURS
M, T, TH 8:45am to 5:15pm
W- 8:45am to 6:00pm
F- 8:45am to 4:00pm
ADDRESS
867 NE 5th St (Hwy 44)
Crystal River, FL 34429
Between Dunkin Donuts & Racetrac Gas on the same side of Hwy 44.
Contact Us
Contact Us
Text Us
Map & Directions
Get ID Card
ABOUT ME
As a resident of Crystal River, FL and an active member of Citrus County, I
understand our customer's needs and goals. I value family and the relationships
our business creates in our community. Myself and my staff are eager to help you
find the perfect plans to protect your families through life insurance;
vehicles, boats and RVs through auto insurance; growing your business with our
small business insurance; securing your home with homeowners and renters
insurance; and helping you finance your future with our great loan and finance
options. Call me for a FREE quote today.
Proud Member of:
* Citrus County Chamber of Commerce
* Realtors Association of Citrus County
* Rotary International
…Read More
*
4.8/5 average rating on Google (338 reviews)
OFFICE HOURS
M, T, TH 8:45am to 5:15pm
W- 8:45am to 6:00pm
F- 8:45am to 4:00pm
*
INSURANCE PRODUCTS OFFERED
Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health, Pet
OTHER PRODUCTS
Banking, Mutual Funds, Annuities
FINRA’s BrokerCheck View Licenses
*
4.8/5 average rating on Google (338 reviews)
Contact Us
Contact Us
Text Us
Map & Directions
Get ID Card
WOULD YOU LIKE TO CREATE A PERSONALIZED QUOTE?
Select an Insurance Product
Select Product AutoMotorcycleHomeownersCondo OwnersRentersLifeMedicare
SupplementSupplemental HealthSmall BusinessPet Insurance
ZIP Code
State Selection
Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming
ZIP Code
State Selection
Your State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky
Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri
Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North
Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington
Washington, D.C. West Virginia Wisconsin Wyoming
Start a Quote Request a Quote
Continue a saved quote | Items needed for a quote
File a Claim Send Payment
* Auto Insurance
* Motorcycle Insurance
* Homeowners Insurance
* Condo Insurance
* Renters Insurance
* Business Insurance
* Life Insurance
* Pet Insurance
* Rec Vehicles Insurance
* Boat Insurance
*
See More
OFFICE INFO
OFFICE INFO
OFFICE HOURS
M, T, TH 8:45am to 5:15pm
W- 8:45am to 6:00pm
F- 8:45am to 4:00pm
ADDRESS
867 NE 5th St (Hwy 44)
Crystal River, FL 34429
Map & Directions
* PHONE
(352) 795-4747
* MOBILE
(352) 464-3210
LANGUAGES
English, Spanish
About Me
As a resident of Crystal River, FL and an active member of Citrus County, I
understand our customer's needs and goals. I value family and the relationships
our business creates in our community. Myself and my staff are eager to help you
find the perfect plans to protect your families through life insurance;
vehicles, boats and RVs through auto insurance; growing your business with our
small business insurance; securing your home with homeowners and renters
insurance; and helping you finance your future with our great loan and finance
options. Call me for a FREE quote today.
Proud Member of:
* Citrus County Chamber of Commerce
* Realtors Association of Citrus County
* Rotary International
Products
INSURANCE PRODUCTS OFFERED
Auto, Homeowners, Condo, Renters, Personal Articles, Business, Life, Health, Pet
OTHER PRODUCTS
Banking, Mutual Funds, Annuities
FINRA’s BrokerCheck View Licenses
OFFICE INFO
OFFICE INFO
OFFICE HOURS
M, T, TH 8:45am to 5:15pm
W- 8:45am to 6:00pm
F- 8:45am to 4:00pm
ADDRESS
867 NE 5th St (Hwy 44)
Crystal River, FL 34429
Map & Directions
* PHONE
(352) 795-4747
* MOBILE
(352) 464-3210
LANGUAGES
English, Spanish
Simple Insights®
SIMPLE INSIGHTS®
THE REAL CONSEQUENCES OF DRUNK DRIVING
THE REAL CONSEQUENCES OF DRUNK DRIVING
What's at stake if you're caught drunk driving? A lot. These tips help you avoid
the dangers of drinking and driving.
HOW TO PREVENT CAR THEFT
HOW TO PREVENT CAR THEFT
Tips to help prevent car theft and auto break-ins, including car alarm, VIN
etching, smart keys and more.
TIPS FOR PET SAFETY AT HOME AND IN THE CAR
TIPS FOR PET SAFETY AT HOME AND IN THE CAR
A few changes around your house and while you're driving can give your pets the
protection they need to stay well and happy for years to come.
View More Articles
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as social security numbers, credit/debit card number, or health/medical
information.
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Please attach only file(s) — Unsupported file types will not be delivered to the
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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.
Ryan Lampasona State Farm Insurance Agency is the premier provider for all of
your insurance needs in Citrus County, Florida. Our vision is to provide
exceptional services while keeping the customer’s interests as our primary goal.
Our team treats every customer in a caring, friendly and professional manner. We
offer Citrus County insurance for homeowners and renters, auto, business,
property, life & health. Additionally, we offer products for banking. Stop by
our office to learn more about products and services we offer to help life go
right. Contact us for all of your insurance and financial service needs,
conveniently located in Crystal River, Florida.
…Read More
Our team of licensed agents are ready to assist you in all of your insurance
needs! Call, email or stop by our Crystal River office for a FREE quote from one
of our knowledgeable and friendly team members.
Se habla Espanol
Samantha Suarez
License #P127289
Read bio
Bailey Copeland
License #W601799
Devin Watrous
License #W580565
Laynee Nadal
License #W771875
Alena Keller
License #W845043
Viewing team member 1 of 5
Samantha Suarez
License #P127289
Life Insurance Licensed
Viewing team member 2 of 5
Bailey Copeland
License #W601799
Viewing team member 3 of 5
Devin Watrous
License #W580565
Viewing team member 4 of 5
Laynee Nadal
License #W771875
Viewing team member 5 of 5
Alena Keller
License #W845043
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YOU CAN ALSO CALL US AT (352) 795-4747
preferred__alpha preferred__beta preferred__extra
CONTACT US
Your preferred method of contact
* Your Email
* Your Phone
Your Name*
Your Phone*
Your Email*
Your Message:*
For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.
Your preferred method of contact
* Your Email
* Your Phone
I'd like more info about: *
For your protection, please do not include sensitive personal information such
as social security numbers, credit/debit card number, or health/medical
information.
Your Message:*
Remove
Please attach only file(s) — Unsupported file types will not be delivered to the
agent.
Send Email
PLEASE CORRECT THE FOLLOWING:
By filling out the form, you are providing express consent by electronic
signature that you may be contacted by telephone (via call and/or text messages)
and/or email for marketing purposes by State Farm Mutual Automobile Insurance
Company, its subsidiaries and affiliates ("State Farm") or an independent
contractor State Farm agent regarding insurance products and services using the
phone number and/or email address you have provided to State Farm, even if your
phone number is listed on a Do Not Call Registry. You further agree that such
contact may be made using an automatic telephone dialing system and/or
prerecorded voice (message and data rates may apply). Your consent is not a
condition of purchase. By continuing, you agree to the terms of the disclosures
above.
Please note: Insurance coverage cannot be bound or changed via submission of
this online e-mail form or via voice mail. To make policy changes or request
additional coverage, please speak with a licensed representative in the agent's
office, or by contacting the State Farm toll-free customer service line at (855)
733-7333.
AGENT LICENSE FOR RYAN LAMPASONA
FL-E049585
If you are using a screen reader and having difficulty with this website please
call (352) 795-4747.
DISCLOSURES
Prices vary by state. Options selected by customer; availability, amount of
discounts, savings and eligibility may vary.
Securities are not FDIC insured, are not bank guaranteed and are subject to
investment risk, including possible loss of principal. Neither State Farm nor
its agents provide tax or legal advice. State Farm VP Management Corp. is a
separate entity from those State Farm and/or unaffiliated entities which provide
banking and insurance products. AP2024/07/0846
Securities distributed by State Farm VP Management Corp. State Farm VP
Management Corp. Customer Relationship Summary
Securities Supervisor address:3903 Northdale Blvd Ste 112W , Tampa, FL
33624-1853 Phone: 813-281-1685
Life Insurance and annuities are issued by State Farm Life Insurance Company.
(Not Licensed in MA, NY, and WI) State Farm Life and Accident Assurance Company
(Licensed in New York and Wisconsin) Home Office, Bloomington, Illinois.
Deposit products offered by U.S. Bank National Association. Member FDIC.
The creditor and issuer of this credit card is U.S. Bank National Association,
pursuant to a license from Visa U.S.A. Inc.
Pre-existing conditions: If you currently have a pet medical insurance policy,
switching carriers or purchasing a new policy may affect certain provisions such
as coverages for pre-existing conditions or deductibles already established
under your current policy. Let your State Farm® agent know if your existing
policy has provisions that might make it beneficial for you to keep.
Pet insurance products are underwritten in the United States by American Pet
Insurance Company and ZPIC Insurance Company, 6100-4th Ave. S, Seattle, WA
98108. Administered by Trupanion Managers USA, Inc. (CA license No. 0G22803, NPN
9588590). Terms and conditions apply, see full policy on Trupanion's website for
details. State Farm Mutual Automobile Insurance Company, its subsidiaries and
affiliates, neither offer nor are financially responsible for pet insurance
products. State Farm is a separate entity and is not affiliated with Trupanion
or American Pet Insurance.
State Farm (including State Farm Mutual Automobile Insurance Company and its
subsidiaries and affiliates) is not responsible for, and does not endorse or
approve, either implicitly or explicitly, the content of any third party sites
referenced in this material. Products and services are offered by third parties
and State Farm does not warrant the merchantability, fitness or quality of the
products and services of the third parties.
Like a good neighbor, State Farm is there.®
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(352) 795-4747
© Copyright State Farm Mutual Automobile Insurance Company 2024.
Viewing team member 1 of 5
Samantha Suarez
License #P127289
Life Insurance Licensed
Viewing team member 2 of 5
Bailey Copeland
License #W601799
Viewing team member 3 of 5
Devin Watrous
License #W580565
Viewing team member 4 of 5
Laynee Nadal
License #W771875
Viewing team member 5 of 5
Alena Keller
License #W845043
Previous Next
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" "