

<div class="row">
    <div class="container">

        <ol class="breadcrumb">
            <li><a href="#">خصائص عامة</a></li>
            <li><a href="insurancecompany.php?do=show">شركات التأمين  </a></li>
            <li class="active">اضافة شركة </li>
        </ol>


        <div class="panel panel-default panel-m">
            <div class="panel-heading">
                <h3 class="panel-title">اضافة شركة</h3>
            </div>
            <div class="panel-body">


                <form class="form-horizontal" id="insuranceCompanyForm" role="form" action="insurancecompany.php?do=add" method="post"  enctype="multipart/form-data">

                    <div class="form-group">
                        <label for="txtName" class="col-lg-4 control-label">اسم الشركة </label>
                        <div class="col-lg-6">
                            <input type="text" name="companyName" id="companyName" class="form-control" placeholder="اسم الشركة" required="required"/>
                            <div class="clearfix"></div>
                        </div>
                        <span style="color: red;">*</span>
                        <span id="nameError" class=" alert-block alert-danger fade in" style="display:none ;padding: 5px 5px 5px 5px;">هذا الاسم مستخدم من قبل</span>
                    </div>



                    <div class="form-group">
                        <label for="txtName" class="col-lg-4 control-label">نسبة الخصم للشركة عند التحصيل </label>
                        <div class="col-lg-6">
                            <input type="text" name="discountPercent" id="discountPercent" class="form-control positivefloat" placeholder="نسبة الخصم"/>
                            <div class="clearfix"></div>
                        </div>
                        <span>%</span>
                    </div>

                    <!-- =================================================   -->


                    <div class="form-group">
                        <label for="txtAddress" class="col-lg-4 control-label">بداية التعاقد  </label>
                        <div class="col-lg-6">
                            <input type="text" name="contractStart" data-date-format="yyyy-mm-dd" id="contractStart" class="form-control awdatepicker" autocomplete="off"  placeholder="بداية التعاقد  "/>
                        </div>
                    </div>
                    <!-- =================================================   -->
                    <div class="form-group">
                        <label for="txtAddress" class="col-lg-4 control-label">نهاية  التعاقد  </label>
                        <div class="col-lg-6">
                            <input type="text" name="contractEnd" id="contractEnd" data-date-format="yyyy-mm-dd" class="form-control awdatepicker" autocomplete="off"  placeholder="نهاية التعاقد  "/>
                        </div>
                    </div>

                    <!-- =================================================   -->


                    <div class="form-group">
                        <label for="txtName" class="col-lg-4 control-label">صورة  التعاقد </label>
                        <div class="col-lg-6">
                            <input type="file" name="contractPhoto" id="contractPhoto" accept="image/*"     class="form-control" />
                        </div>
                    </div>

                    <!-- =================================================   -->

                    <div class="form-group">
                        <label for="txtMobile" class="col-lg-4 control-label">تعليمات الشركة </label>
                        <div class="col-lg-6">
                            <textarea class="form-control ckeditor" name="instruction" id="instruction"></textarea>

                        </div>
                    </div>


                    <!-- =================================================   -->

                    <div class="form-group">
                        <div class="col-lg-offset-2 col-lg-4">
                            <button type="button" id="saveInsCompany" data-edit="0" class="btn btn-primary pull-left">حفظ الامر</button>
                        </div>
                    </div>




                </form>
            </div>
        </div>




    </div>
</div>




