form.evaluation_form_wrapper[
  name="forms.evaluation"
  action="#{send_free_quote_path(format: 'json')}"
  method="POST"
  check-error="forms.evaluation"
  ng-submit="submit($event, forms.evaluation)"
  check-error-object="customer"
  autocomplete="off"
  novalidate="novalidate"
  ng-init="data.endpoint = '#{send_free_quote_path(format: 'json')}'"
]

  .field_item.ng-cloak ng-if="!signed"
    .subitem
      input[
        type="text"
        placeholder="#{t('free_quote.placeholder.name')}"
        ng-model="customer.customer_name"
        name="customer[customer_name]"
        autocomplete="name name"
        required=""
        ng-maxlength="130"
        display-error=""
        check-extra-symbols=""
        data-error-extra-symbols="#{t('errors.name.extra_symbols')}"
        data-error-required="#{t('errors.name.blank')}"
        data-error-maxlength="#{t('errors.name.too_long', count: 130)}"
      ]

    .subitem
      input[
        type="email"
        placeholder="#{t('free_quote.placeholder.email')}"
        ng-model="customer.customer_email"
        name="customer[customer_email]"
        display-error=""
        required=""
        check-email=""
        ng-maxlength="130"
        autocomplete="email"
        data-error-required="#{t('errors.email.blank')}"
        data-error-email="#{t('errors.email.invalid')}"
        data-error-maxlength="#{t('errors.email.too_long', count: 130)}"
        data-error-invalid="#{t('errors.email.invalid')}"
        data-error-taken="#{t('errors.email.taken_free_quote')}"
      ]

  .field_item.ng-cloak ng-if="!signed"
    .subitem.state_area_code
      select.flag_select[
        ng-model="data.country"
        ng-select2="countries"
        ng-options="country.title for country in countries"
        ng-options-class="css"
        required=""
        display-error=""
        data-language-list="true"
        data-theme="default country-select-free-quote f24"
        data-placeholder="#{t('free_quote.placeholder.country_code')}"
        data-error-required="#{t('errors.country_code.blank')}"
      ]

  .field_item.ng-cloak ng-if="!signed"
    .subitem
      input[
        name="customer[customer_phone_area]"
        type="text"
        required=""
        display-error=""
        only-numbers=""
        ng-maxlength="6"
        ng-model="data.phone_area"
        autocomplete="off"
        placeholder="#{t('free_quote.placeholder.phone_area')}"
        data-error-required="#{t('errors.phone_area.blank')}"
        data-error-minlength="#{t('errors.phone_area.too_short', count: 1)}"
        data-error-maxlength="#{t('errors.phone_area.too_long', count: 6)}"
      ]
    .subitem
      input[
        name="customer[customer_phone]"
        type="text"
        required=""
        display-error=""
        ng-minlength="6"
        ng-maxlength="14"
        limit-input="[0-9]{0,14}"
        ng-model="data.phone"
        placeholder="#{t('free_quote.placeholder.phone')}"
        autocomplete="mobile tel"
        data-error-required="#{t('errors.phone.blank')}"
        data-error-minlength="#{t('errors.phone.too_short', count: 6)}"
        data-error-maxlength="#{t('errors.phone.too_long', count: 14)}"
      ]

  .field_item
    textarea[
      name="customer[description]"
      placeholder="#{t('free_quote.placeholder.description')}"
      ng-model="customer.description"
      required=""
      ng-maxlength="1000"
      display-error=""
      data-error-required="#{t('errors.description.blank')}"
      data-error-maxlength="#{t('errors.description.too_long', count: 1000)}"
    ]

  .field_item.field_files[
    file-uploader="files"
    ng-model="data.files"
    data-drop-zone="#dragdrop"
    data-url="#{upload_free_quote_attachment_path}"
    data-remove-path="#{upload_free_quote_attachment_path(format: 'json')}"
  ]
    .upload_area#dragdrop
      a.button href="javascript:void(0);"
        = t 'free_quote.button.upload_file'
        input.upload_file_button type="file" value="Upload File"

      b = t 'free_quote.text.drag_drop'

    .upload_type_content.ng-cloak
      .upload_files_list
        ul.uploader-files
          li ng-repeat="file in keeper.files"
            a.upload_files_delete href="" rel="nofollow" ng-click="keeper.removeUploadedFile(file)"
            span = image_tag 'order_form/group.png'
            p ng-bind="file.filename"

          li ng-repeat="file in keeper.pending" ng-class="{'failed': file.error}"
            span ng-if="!file.error"
              = image_tag 'file_preloader.gif'
            p ng-bind="file.name"
              / = t('free_quote.load_type_text.loading')
            span ng-if="file.error"
              = t('free_quote.load_type_text.loading_failed')

    .note = t 'free_quote.text.notice'

  .field_item.agreement.ng-cloak ng-if="!signed"
    .checker[
    ]
      / ng-click="terms_agreement = !terms_agreement"
      span[
        ng-class="{
          checked: terms_agreement
        }"
      ]
        input[
          type="checkbox"
          id="terms_agreement"
          name="terms_agreement"
          required=""
          ng-model="terms_agreement"
        ]
    label[
      for="terms_agreement"
    ]
      = raw agreement_text('free_quote.terms.accept')
      .validation_error.agreement-error.ng-cloak[
        ng-if="forms.evaluation.terms_agreement.$touched"
        ng-hide="terms_agreement"
      ]
        = raw t('free_quote.terms.accept_error')

  input.button[
    type="submit"
    value="#{t('free_quote.button.get_free_quote')}"
    click="submit($event, forms.evaluation)"
    ng-disabled="loading"
    ng-disabled-with="#{t('free_quote.button.get_free_quote_pending')}"
    ng-submit="submit($event, forms.evaluation)"
  ]