@php $isNew = ! $company->exists; @endphp
<div class="modal-dialog" role="document"><div class="modal-content">
    {!! Form::open(['route' => $isNew ? 'vrc.insurance-companies.store' : ['vrc.insurance-companies.update', $company->id], 'method' => $isNew ? 'POST' : 'PUT', 'class' => 'vrc-form']) !!}
    <div class="modal-header"><button type="button" class="close" data-dismiss="modal">&times;</button><h4 class="modal-title">@lang('vrc::lang.insurance_company')</h4></div>
    <div class="modal-body">
        <div class="row">
            <div class="col-md-6"><div class="form-group">{!! Form::label('name', __('vrc::lang.name').' (EN):*') !!}{!! Form::text('name', $company->name, ['class'=>'form-control','required']) !!}</div></div>
            <div class="col-md-6"><div class="form-group">{!! Form::label('name_ar', __('vrc::lang.name').' (AR):') !!}{!! Form::text('name_ar', $company->name_ar, ['class'=>'form-control','dir'=>'rtl']) !!}</div></div>
        </div>
        <div class="row">
            <div class="col-md-4"><div class="form-group">{!! Form::label('contact', __('vrc::lang.contact').':') !!}{!! Form::text('contact', $company->contact, ['class'=>'form-control']) !!}</div></div>
            <div class="col-md-4"><div class="form-group">{!! Form::label('phone', __('vrc::lang.phone').':') !!}{!! Form::text('phone', $company->phone, ['class'=>'form-control']) !!}</div></div>
            <div class="col-md-4"><div class="form-group">{!! Form::label('email', __('vrc::lang.email').':') !!}{!! Form::email('email', $company->email, ['class'=>'form-control']) !!}</div></div>
        </div>
        <div class="checkbox"><label>{!! Form::checkbox('is_active', 1, (bool) $company->is_active) !!} @lang('vrc::lang.active')</label></div>
    </div>
    <div class="modal-footer"><button type="submit" class="btn btn-primary">@lang('messages.save')</button><button type="button" class="btn btn-default" data-dismiss="modal">@lang('messages.close')</button></div>
    {!! Form::close() !!}
</div></div>
