@extends('maindash2')

@section('htmlheader_title')
	Rolloff Invoice Rec
@endsection


@section('content')

	<!--div class="container spark-screen"-->
		<div class="row">
			<div class="col-md-12">
				<div class="panel panel-default">
					<div class="panel-heading" align="center">Rolloff Compactors - Open Top Container Invoice Verification</div>
                        <div class="panel-body">
                        <br><br>
                            {!! Form::open(['url' => 'rolloffInvoices']) !!}
                                <div class="form-group">
                                    {!! Form::label('contract_id', 'Contract Id Number:') !!}
                                    {!! Form::text('contract_id', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('invoice_number', 'Invoice Number:') !!}
                                    {!! Form::text('invoice_number', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('invoice_date', 'Invoice Date:') !!}
                                    {!! Form::input('date','invoice_date', date('Y-m-d'), ['class' =>'form-control']) !!}
                                    {!! Form::label('rent', 'Rent:') !!}
                                    {!! Form::text('rent', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('number_of_hauls', 'Number Of Hauls:') !!}
                                    {!! Form::text('number_of_hauls', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('disposal', 'Disposal:') !!}
                                    {!! Form::text('disposal', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('total_tons', 'Total Tons:') !!}
                                    {!! Form::text('total_tons', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('fuel', 'Fuel:') !!}
                                    {!! Form::text('fuel', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('environmental', 'Environmental:') !!}
                                    {!! Form::text('environmental', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('admin', 'Admin:') !!}
                                    {!! Form::text('admin', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('tax', 'Tax:') !!}
                                    {!! Form::text('tax', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('misc_fee', 'Misc Fees:') !!}
                                    {!! Form::text('misc_fee', null, ['class' =>'form-control']) !!}
                                    {!! Form::label('notes', 'Notes:') !!}
                                    {!! Form::text('notes', null, ['class' =>'form-control']) !!}
                                    <br>
                            
                                <div class="form-group">
                                    {!! Form::submit('Add Invoice Data', ['class' => 'btn btn-primary form-control']) !!}
                                    
                                </div>
                            
                                </div>
                            
                            {!! Form::close() !!}
                            
                            @if($errors->any())
                            
                                <ul class="alert alert-danger">
                                    @foreach($errors->all() as $error)
                                    
                                    <li>{{ $error }}</li>
                                    
                                    @endforeach
                                </ul>
                                
                            @endif
                        
					</div><div class="panel-footer" align="center">Rolloff Data</div>
				</div>
			</div>
		</div>
	<!--/div-->
@endsection