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<div class="text-lg lead fw-bold client-form-title mt-5 pt-5">New Client</div><br>
<div class="row p-5">
<div class="col-sm-6" style="border-right: 1px solid rgba(4, 4, 4, 0.253);">
<form action="" class="opacity-75 company-info">
<div class="form-group">
<label for="CompanyName">Company Name</label>
<input type="text" name="CompanyName" id="companyname" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="CompanyAddress">Company Address</label>
<input type="text" name="CompanyAddress" id="companyaddress" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="TIN">TIN</label>
<input type="text" name="TIN" id="tin" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="CompanyEmail">Company Email</label>
<input type="text" name="CompanyEmail" id="companyemail" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="CEO">CEO</label>
<input type="text" name="CEO" id="ceo" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="CEODateOfBirth">Date of Birth</label>
<input type="date" name="CEODateOfBirth" id="dob" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="CEOContactInformation">Contact Information <sup class="text-danger"><strong>(email or phone#)</strong></sup></label>
<input type="text" name="CEOContactInformation" id="ceoContactInformation" class="form-control rounded-0">
</div>
</form>
</div>
<div class="col-sm-6">
<div class="row">
<div class="col-sm-12">
<form action="" class="opacity-75 client-rep">
<div class="form-group">
<label for="RepresentativeName">Representative Name</label>
<input type="text" name="RepresentativeName" id="representative" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="RepresentativeContactInformation">Contact Information</label>
<input type="text" name="RepresentativeContactInformation" id="contactinfo" class="form-control rounded-0">
</div>
<div class="form-group">
<label for="RepresentativeDateOfBirth">Date of Birth</label>
<input type="date" class="form-control rounded-0" name="RepresentativeDateOfBirth" id="repDOB">
</div>
<div class="form-group">
<label for="RepresentativeAddress">Address</label>
<input type="text" class="form-control rounded-0" name="RepresentativeAddress" id="repAddress">
</div>
<div class="form-group">
<label for="RepresentativePosition">Position</label>
<input type="text" name="RepresentativePosition" id="position" class="form-control rounded-0">
</div>
</form>
</div><hr>
<div class="col-sm-12">
<div class="col-sm-12">
<span class="badge bg-transparent text-danger"><strong>*optional</strong></span>
<form action="" id="services">
<div class="row">
@foreach ($services as $item)
<div class="col-sm-3">
<input type="checkbox" name="Service[]" id="service-{{$item->id}}" value="{{$item->id}}">{{$item->Service}}
</div>
@endforeach
</div>
</form>
</div>
</div>
</div>
<button class="btn rounded-0 float-right mt-5 position-absolute submit-new-client" style="bottom: 0; right: 0; background-color: #063D58; color: whitesmoke;">Submit</button>
</div>
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