File: /var/www/html/taxicamera/application/views/admin/layouts/driver/ajax_generate_agreement.php
<div class="company_detail_class">
<h4>Company <?php echo $company_cnt_no; ?>:</h4>
<div><button class="btn pull-right btn-danger delete_pro" id="delete"><i class="fa fa-trash-o font-small-3 mr-2 white"></i>Delete</button></div>
<p><strong>Item 1. Operator details</strong></p>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<label style="width:22%;float: left;line-height: 35px;">Company Name</label>
<select name="company_id[]" class="select_company" name="" style="width:42%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;">
<option value="">Select Company</option>
<?php foreach($company_list as $company){?>
<option value="<?=$company['company_id']?>"><?=$company['company_name']?></option>
<?php } ?>
</select>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 65%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Business name</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_business_name" name="compny_business_name[]" value="" type="text" placeholder="" readonly/>
</div>
<div style="width: 33%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Australian Business Number (ABN)</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_business_ABN" name="compny_business_ABN[]" type="text" placeholder="" readonly/>
</div>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 65%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Company name</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_name" name="compny_name[]" type="text" placeholder="" readonly/>
</div>
<div style="width: 33%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Australian Company Number (ACN)</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_ACN" name="compny_ACN[]" type="text" placeholder="" readonly/>
</div>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 49%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Telephone (business)</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_ph" name="compny_ph[]" type="text" placeholder="" readonly/>
</div>
<div style="width: 49%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Telephone (home)</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_home_ph" name="compny_home_ph[]" type="text" placeholder="" readonly/>
</div>
</div>
<input type="hidden" class="comp_rsp_name" value="">
<input type="hidden" class="comp_rsp_signature" value="">
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 98%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Email</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_email" name="compny_email[]" type="text" placeholder="" readonly/>
</div>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 63%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Operator accreditation number</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_accreditation_number" name="compny_accreditation_number[]" type="text" placeholder="" readonly/>
</div>
<div style="width: 35%;float: left;margin-right: 6px;">
<div class="form-group">
<label style="display: block;padding: 0 0 5px;">Expiry date</label>
<div class="input-group">
<div class="input-group-prepend">
<span class="input-group-text">
<span class="fa fa-calendar-o"></span>
</span>
</div>
<input type='text' style="width:75%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_expiry_date pickadate" name="compny_expiry_date[]" placeholder="DD/MM/YYYY" readonly/>
</div>
</div>
</div>
</div>
<p style="margin-bottom: 0;"><strong>Address Details:</strong>
<hr style="width: 98.8%; float: left;margin-bottom: .7rem;border: 0;border-top: 1px solid rgba(0,0,0,.1);">
</p>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 49%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Unit No. / Flat No.</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_flat_no" name="compny_flat_no[]" type="text" placeholder="" readonly/>
</div>
<div style="width: 49%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Street No.</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_street_no" name="compny_street_no[]" type="text" placeholder="" readonly/>
</div>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 98.6%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Street Name</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_street_name" name="compny_street_name[]" type="text" placeholder="" readonly/>
</div>
</div>
<div style="width:100%;display: inline-block;margin: 0 0 10px;">
<div style="width: 65%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Suburb</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_suburb" name="compny_suburb[]" type="text" placeholder="" readonly/>
</div>
<div style="width: 33%;float: left;margin-right: 6px;">
<label style="display: block;padding: 0 0 5px;width: 100%:">Postcode</label>
<input style="width:100%;border:1px solid #ccc;height: 35px;box-sizing: border-box;padding: 0 0 0 12px;" class="comp_postcode" name="compny_postcode[]" type="text" placeholder="" readonly/>
</div>
</div>
</div>