@extends('layouts.app')

@section('content')

    <div class="container">
        <div class="row justify-content-center">
            <div>
                {{ Breadcrumbs::render('insure.detail',$app->application_id) }}
                <div class="shadow card">
                    <div class="shadow-sm card-header fs-3 d-flex">
                        <span>詳細画面</span>
                        <div class="d-flex" style="margin:auto 0px auto auto">
                            <a class="fs-5 btn btn-secondary shadow-sm" href="{{ route('insure.preview', ['id' => $app->application_id]) }}" style="margin:auto 0px auto auto">プレビュー</a>
                            @if ($appview->isPending() || $appview->isPrint())
                            <a class="fs-5 btn btn-secondary shadow-sm ms-1" href="{{  route('insure.fix', ['id' => $app->application_id]) }}" style="margin:auto 0px auto auto">修正</a>                            
                            @endif
                            <button class="fs-5 btn btn-secondary shadow-sm ms-1" onclick="history.back();">戻る</button>
                        </div>
                    </div>
                    <div id="entryForm">
                        @csrf
                        <div class="card-body">
                            <div class="d-flex mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">種類</span>
                                <div class="form-check fs-5 my-2 ms-2">
                                    <input class="form-check-input" type="radio" name="kind" value="0"
                                        onchange="spChange()" id="k1" {{ $app->kind == '0' ? 'checked' : '' }} disabled>
                                    <label class="form-check-label" for="k1">通常</label>
                                </div>
                                <div class="form-check fs-5 my-2 ms-2">
                                    <input class="form-check-input" type="radio" name="kind" value="1"
                                        onchange="spChange()" id="k2" {{ $app->kind == '1' ? 'checked' : '' }} disabled>
                                    <label class="form-check-label" for="k2">特別加入（一人親方）</label>
                                </div>
                                <div class="form-check fs-5 my-2 ms-2">
                                    <input class="form-check-input" type="radio" name="kind" value="2"
                                        onchange="spChange()" id="k3" {{ $app->kind == '2' ? 'checked' : '' }} disabled>
                                    <label class="form-check-label" for="k3">下請特約・労務費率</label>
                                </div>
                                <div class="form-check fs-5 my-2 ms-2">
                                    <input class="form-check-input" type="radio" name="kind" value="3"
                                        onchange="spChange()" id="k4" {{ $app->kind == '3' ? 'checked' : '' }} disabled>
                                    <label class="form-check-label" for="k4">下請特約・従業員特定</label>
                                </div>
                            </div>
                            <div class="d-flex">
                                <div class="shadow-sm input-group mb-3">
                                    <span class="input-group-text bg-secondary-subtle fs-5 col-3">保険期間</span>
                                    <input id="st_date" name="st_date" type="date"
                                        value="{{ $app->start_date }}"
                                        class="form-control fs-5 text-center"
                                        pattern="[0-9]{4}-[0-9]{2}" onchange="dateChange()" disabled>
                                    <span class="input-group-text text-center col-2 fs-5 bg-secondary-subtle">午前０時</span>
                                    <span class="input-group-text bg-secondary-subtle">～</span>
                                    <span class="form-control fs-5 text-center bg-secondary-subtle">{{ \Carbon\Carbon::parse($app->end_date)->addDays(1)->format('Y/m/d') }}</span>
                                    <span class="input-group-text text-center col-2 fs-5 bg-secondary-subtle">午前０時</span>
                                </div>    
                            </div>
                            <div class="shadow-sm input-group mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">労働保険番号</span>
                                <div class="form-floating">
                                    <input type="text"
                                        class="form-control fs-5"
                                        name="prefecture" id="floatingInput1" maxlength="2" value="{{ $app->prefecture }}"
                                        placeholder="99" disabled>
                                    <label for="floatingInput1">府県</label>
                                </div>
                                <div class="form-floating" style="width: 70px;flex: none;">
                                    <input type="text" class="form-control fs-5 bg-secondary-subtle"
                                        name="remit" id="floatingInput2" maxlength="1" value="*"
                                        placeholder="9" disabled>
                                    <label for="floatingInput2">所掌</label>
                                </div>
                                <div class="form-floating" style="width: 70px;flex: none;">
                                    <input type="text"
                                        class="form-control fs-5 bg-secondary-subtle"
                                        name="jurisdiction" id="floatingInput3" maxlength="2"
                                        value="**" placeholder="99" disabled>
                                    <label for="floatingInput3">管轄</label>
                                </div>
                                <div class="form-floating col-2">
                                    <input type="text"
                                        class="form-control fs-5"
                                        name="core_number" id="floatingInput4" maxlength="6"
                                        value="{{ $app->core_number }}" placeholder="999999" disabled>
                                    <label for="floatingInput4">基幹番号</label>
                                </div>
                                <div class="form-floating">
                                    <input type="text"
                                        class="form-control fs-5"
                                        name="branch_number" id="floatingInput5" maxlength="3"
                                        value="{{ $app->branch_number }}" placeholder="999" disabled>
                                    <label for="floatingInput5">枝番号</label>
                                </div>
                                <div class="form-floating">
                                    <input type="text"
                                        class="form-control fs-5"
                                        name="serial_number" id="floatingInput6" maxlength="2"
                                        value="{{ $app->serial_number }}" placeholder="99" disabled>
                                    <label for="floatingInput6">追番</label>
                                </div>
                            </div>
                            <div class="shadow-sm input-group mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">事業場の名称</span>
                                <input type="text" class="form-control fs-5"
                                    name="workplacename" value="{{ $app->workspace }}" disabled>
                            </div>
                            <div class="d-flex">
                                <div class="col-6">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5">事業主の氏名</span>
                                        <input type="text" class="form-control fs-5"
                                            name="name" value="{{ $app->name }}" disabled>
                                    </div>
                                </div>
                            </div>
                            <div class="shadow-sm input-group mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">メールアドレス</span>
                                <input type="email" class="form-control fs-5"
                                    name="email" value="{{ $app->email }}" disabled>
                            </div>
                            <div class="d-flex">
                                <div class="col-4">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5">郵便番号</span>
                                        <input type="text"
                                            class="form-control fs-5"
                                            maxlength="3" name="post_number_1" value="{{ $app->post_number_1 }}" disabled>
                                        <span class="input-group-text bg-secondary-subtle">―</span>
                                        <input type="text"
                                            class="form-control fs-5"
                                            maxlength="4" name="post_number_2" value="{{ $app->post_number_2 }}" disabled>
                                    </div>
                                </div>
                                <div class="col-6">
                                    <div class="shadow-sm input-group mb-3 ms-1">
                                        <span class="input-group-text bg-secondary-subtle fs-5">電話番号</span>
                                                                                <input type="tel"
                                            class="form-control fs-5" name="tel"
                                            value="{{ $tels[0] ?? '' }}" disabled>
                                        <span class="input-group-text bg-secondary-subtle">―</span>
                                        <input type="tel"
                                            class="form-control fs-5" name="tel"
                                            value="{{ $tels[1] ?? '' }}" disabled>
                                        <span class="input-group-text bg-secondary-subtle">―</span>
                                        <input type="tel"
                                            class="form-control fs-5" name="tel"
                                            value="{{ $tels[2] ?? '' }}" disabled>
                                    </div>
                                </div>
                            </div>
                            <div class="shadow-sm input-group mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">事業場の所在地</span>
                                <input type="text" class="form-control fs-5"
                                    name="address" value="{{ $app->address1 }} {{ $app->address2 }}" disabled>
                            </div>
                            <div class="shadow-sm input-group mb-3">
                                <span class="input-group-text bg-secondary-subtle fs-5">事業コード</span>

                                <select id="code" name="code"
                                    class="form-control fs-5"
                                    onchange="inputChange()" disabled>
                                    <option value="02" {{ $app->code == '02' ? 'selected' : '' }}>02</option>
                                    <option value="03" {{ $app->code == '03' ? 'selected' : '' }}>03</option>
                                    <option value="11" {{ $app->code == '11' ? 'selected' : '' }}>11</option>
                                    <option value="12" {{ $app->code == '12' ? 'selected' : '' }}>12</option>
                                    <option value="21" {{ $app->code == '21' ? 'selected' : '' }}>21</option>
                                    <option value="23" {{ $app->code == '23' ? 'selected' : '' }}>23</option>
                                    <option value="24" {{ $app->code == '24' ? 'selected' : '' }}>24</option>
                                    <option value="25" {{ $app->code == '25' ? 'selected' : '' }}>25</option>
                                    <option value="26" {{ $app->code == '26' ? 'selected' : '' }}>26</option>
                                    <option value="31" {{ $app->code == '31' ? 'selected' : '' }}>31</option>
                                    <option value="32" {{ $app->code == '32' ? 'selected' : '' }}>32</option>
                                    <option value="33" {{ $app->code == '33' ? 'selected' : '' }}>33</option>
                                    <option value="34" {{ $app->code == '34' ? 'selected' : '' }}>34</option>
                                    <option value="35" {{ $app->code == '35' ? 'selected' : '' }}>35</option>
                                    <option value="36" {{ $app->code == '36' ? 'selected' : '' }}>36</option>
                                    <option value="37" {{ $app->code == '37' ? 'selected' : '' }}>37</option>
                                    <option value="38" {{ $app->code == '38' ? 'selected' : '' }}>38</option>
                                    <option value="41" {{ $app->code == '41' ? 'selected' : '' }}>41</option>
                                    <option value="42" {{ $app->code == '42' ? 'selected' : '' }}>42</option>
                                    <option value="44" {{ $app->code == '44' ? 'selected' : '' }}>44</option>
                                    <option value="45" {{ $app->code == '45' ? 'selected' : '' }}>45</option>
                                    <option value="46" {{ $app->code == '46' ? 'selected' : '' }}>46</option>
                                    <option value="47" {{ $app->code == '47' ? 'selected' : '' }}>47</option>
                                    <option value="48" {{ $app->code == '48' ? 'selected' : '' }}>48</option>
                                    <option value="49" {{ $app->code == '49' ? 'selected' : '' }}>49</option>
                                    <option value="50" {{ $app->code == '50' ? 'selected' : '' }}>50</option>
                                    <option value="51" {{ $app->code == '51' ? 'selected' : '' }}>51</option>
                                    <option value="52" {{ $app->code == '52' ? 'selected' : '' }}>52</option>
                                    <option value="53" {{ $app->code == '53' ? 'selected' : '' }}>53</option>
                                    <option value="54" {{ $app->code == '54' ? 'selected' : '' }}>54</option>
                                    <option value="55" {{ $app->code == '55' ? 'selected' : '' }}>55</option>
                                    <option value="56" {{ $app->code == '56' ? 'selected' : '' }}>56</option>
                                    <option value="57" {{ $app->code == '57' ? 'selected' : '' }}>57</option>
                                    <option value="58" {{ $app->code == '58' ? 'selected' : '' }}>58</option>
                                    <option value="59" {{ $app->code == '59' ? 'selected' : '' }}>59</option>
                                    <option value="60" {{ $app->code == '60' ? 'selected' : '' }}>60</option>
                                    <option value="61" {{ $app->code == '61' ? 'selected' : '' }}>61</option>
                                    <option value="62" {{ $app->code == '62' ? 'selected' : '' }}>62</option>
                                    <option value="63" {{ $app->code == '63' ? 'selected' : '' }}>63</option>
                                    <option value="64" {{ $app->code == '64' ? 'selected' : '' }}>64</option>
                                    <option value="66" {{ $app->code == '66' ? 'selected' : '' }}>66</option>
                                    <option value="71" {{ $app->code == '71' ? 'selected' : '' }}>71</option>
                                    <option value="72" {{ $app->code == '72' ? 'selected' : '' }}>72</option>
                                    <option value="73" {{ $app->code == '73' ? 'selected' : '' }}>73</option>
                                    <option value="74" {{ $app->code == '74' ? 'selected' : '' }}>74</option>
                                    <option value="81" {{ $app->code == '81' ? 'selected' : '' }}>81</option>
                                    <option value="90" {{ $app->code == '90' ? 'selected' : '' }}>90</option>
                                    <option value="91" {{ $app->code == '91' ? 'selected' : '' }}>91</option>
                                    <option value="93" {{ $app->code == '93' ? 'selected' : '' }}>93</option>
                                    <option value="94" {{ $app->code == '94' ? 'selected' : '' }}>94</option>
                                    <option value="95" {{ $app->code == '95' ? 'selected' : '' }}>95</option>
                                    <option value="96" {{ $app->code == '96' ? 'selected' : '' }}>96</option>
                                    <option value="97" {{ $app->code == '97' ? 'selected' : '' }}>97</option>
                                    <option value="98" {{ $app->code == '98' ? 'selected' : '' }}>98</option>
                                    <option value="99" {{ $app->code == '99' ? 'selected' : '' }}>99</option>
                                </select>
                                <span class="input-group-text col-9 bg-secondary-subtle fs-5" id="code_label">{{$app->code_name}}</span>
                            </div>
                            <div class="d-flex">
                                <div class="col-4">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5">割引適用事業場</span>
                                        <input type="text" class="form-control fs-5 "
                                        name="discount_1" value="{{ $app->sale }}" disabled>
                                        <span class="input-group-text bg-secondary-subtle fs-5">％</span>
                                    </div> 
                                </div>
                                <div class="col-4 ms-1 {{ $app->kind == '0' ? '' : 'd-none' }}">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5">基礎賃金総額</span>
                                        <input id="basic" name="basic" type="text"
                                            class="form-control fs-5 "
                                            onchange="sumvalChange()" value="{{ number_format($app->total_wage) }}" disabled>
                                        <span class="input-group-text bg-secondary-subtle fs-5">千円</span>
                                    </div>
                                </div>
                                <div class="col-6 ms-1 {{ $app->kind == '0' ? '' : 'd-none' }}">
                                    <div class="d-flex">
                                        <span class="input-group-text bg-secondary-subtle fs-5">特別加入者の有無</span>
                                        <div class="form-check fs-5 my-2 ms-2">
                                            <input
                                                class="form-check-input"
                                                type="radio" name="special_enrollee" value="0"
                                                onchange="spChange()" id="flexRadioDefault1"
                                                {{ $app->special_enrollee == '0' ? 'checked' : '' }} disabled>
                                            <label class="form-check-label" for="flexRadioDefault1">なし</label>
                                        </div>
                                        <div class="form-check fs-5 my-2 ms-2">
                                            <input
                                                class="form-check-input"
                                                type="radio" name="special_enrollee" value="1"
                                                onchange="spChange()" id="flexRadioDefault2"
                                                {{ $app->special_enrollee == '1' ? 'checked' : '' }} disabled>
                                            <label class="form-check-label" for="flexRadioDefault2">あり</label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div id="sp" class="d-none">
                                <div class="d-flex">
                                    <div class="">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者01</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name1" name="name1" value="{{ $app->name1 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name1">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value1" name="value1" value="{{ $app->value1 == 0 ? '' : number_format($app->value1) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value1">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                    <div class="ms-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者02</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name2" name="name2" value="{{ $app->name2 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name2">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value2" name="value2" value="{{ $app->value2 == 0 ? '' : number_format($app->value2) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value2">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者03</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name3" name="name3" value="{{ $app->name3 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name3">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value3" name="value3" value="{{ $app->value3 == 0 ? '' : number_format($app->value3) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value3">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                    <div class="ms-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者04</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name4" name="name4" value="{{ $app->name4 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name4">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value4" name="value4" value="{{ $app->value4 == 0 ? '' : number_format($app->value4) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value4">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者05</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name5" name="name5" value="{{ $app->name5 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name5">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value5" name="value5" value="{{ $app->value5 == 0 ? '' : number_format($app->value5) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value5">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                    <div class="ms-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者06</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name6" name="name6" value="{{ $app->name6 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name6">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value6" name="value6" value="{{ $app->value6 == 0 ? '' : number_format($app->value6) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value6">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者07</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name7" name="name7" value="{{ $app->name7 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name7">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value7" name="value7" value="{{ $app->value7 == 0 ? '' : number_format($app->value7) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value7">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                    <div class="ms-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者08</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name8" name="name8" value="{{ $app->name8 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name8">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value8" name="value8" value="{{ $app->value8 == 0 ? '' : number_format($app->value8) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value8">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者09</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name9" name="name9" value="{{ $app->name9 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name9">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value9" name="value9" value="{{ $app->value9 == 0 ? '' : number_format($app->value9) }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value9">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                    <div class="ms-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5">特別加入者10</span>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="name10" name="name10" value="{{ $app->name10 }}"
                                                    placeholder="氏名" disabled>
                                                <label for="name10">氏名</label>
                                            </div>
                                            <div class="form-floating">
                                                <input type="text"
                                                    class="form-control fs-5"
                                                    id="value10" name="value10" value="{{ $app->value10 == 0 ? '' : number_format($app->value10)  }}"
                                                    placeholder="給付基礎日額" onchange="sumChange()" disabled>
                                                <label for="value10">給付基礎日額</label>
                                            </div>
                                            <span class="input-group-text bg-secondary-subtle fs-5">円</span>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div id="sep" class="d-block col-8 mx-auto mb-3  {{ ($app->kind == '1' || $app->kind == '3') ? '' : 'd-none' }}">
                                <div class="col-8 m-auto">
                                    <span class="input-group-text bg-secondary-subtle fs-5 mb-3">加入者</span>
                                    <table class="table" id="sepsTable">
                                        <thead>
                                            <tr>
                                                <th scope="col">#</th>
                                                <th scope="col">加入者</th>
                                                <th scope="col">給付基礎日額</th>
                                                <th class="border-start" scope="col">保険料算定基礎額</th>
                                            </tr>
                                        </thead>
                                        <tbody class="table-group-divider">
                                                                                @forelse ($sep as $sj)
                                                                                    <tr>
                                                <td>{{ $sj->no ?? '' }}</td>
                                                <td>{{ $sj->name ?? '' }}</td>
                                                <td>{{ number_format($sj->value) ?? '' }}</td>
                                                <td class="border-start">{{ number_format($sj->value * 365) ?? '' }}</td>
                                            </tr>
                                        @empty

                                        @endforelse
                                        </tbody>
                                    </table>
                                </div>
                            </div>
                            <div class="d-flex {{ $app->kind == '2' ? 'd-none' : '' }}">
                                <div class="col-6">
                                    <div class="shadow-sm input-group mb-3">
                                        <span
                                            class="input-group-text bg-secondary-subtle fs-5 col-8">特別加入者保険料算定基礎額合計</span>
                                        <span id="sum_val_v"
                                            class="input-group-text bg-secondary-subtle fs-5 col-2 text-end d-block">{{ $sv == 0 ? number_format($app->sep_bt_amount) : number_format($sv)}}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">千円</span>
                                    </div>
                                </div>
                                <div class="col-6 ms-1">
                                    <div class="shadow-sm input-group mb-3 col-12">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-8">保険料算出基礎賃金総額</span>
                                        <span id="sum_basic_val_v"
                                            class="input-group-text bg-secondary-subtle fs-5 col-2 text-end d-block">{{ $sv == 0 ? number_format($app->pcb_wt_amount) : number_format($sv)}}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">千円</span>
                                    </div>
                                </div>
                            </div>
                            <div id="lcr" class="{{ $app->kind == '2' ? '' : 'd-none' }}">
                                <div class="d-flex">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-6">労保連労働災害保険加入直前の営業年度</span>
                                        <input id="tfy_start" type="date"
                                            value="{{ $app->tfy_start }}"
                                            class="form-control fs-5 text-center"
                                            pattern="[0-9]{4}-[0-9]{2}" disabled>
                                        <span class="input-group-text bg-secondary-subtle">～</span>
                                        <input id="tfy_end" type="date"
                                            value="{{ $app->tfy_end }}"
                                            class="form-control fs-5 text-center"
                                            pattern="[0-9]{4}-[0-9]{2}" disabled>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="col-4">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-6">①上記年度中の<br>完成工事高</span>
                                            <span id="tc_amount" class="form-control fs-5 d-flex align-items-center">{{ number_format($app->tc_amount) }}</span>
                                            <span class="input-group-text bg-secondary-subtle fs-5">千円</span>
                                        </div>
                                    </div>
                                    <div class="col-4 ps-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-6">②単独有期事業の<br>完成工事高</span>
                                            <span id="spc_amount" class="form-control fs-5 d-flex align-items-center">{{ number_format($app->spc_amount) }}</span>
                                            <span class="input-group-text bg-secondary-subtle fs-5">千円</span>
                                        </div>
                                    </div>
                                    <div class="col-4 ps-1">
                                        <div class="shadow-sm input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-6">③一括有期事業の<br>完成工事高</span>
                                            <span id="lsc_amount" class="form-control fs-5 d-flex align-items-center">{{ number_format($app->lsc_amount) }}</span>
                                            <span class="input-group-text bg-secondary-subtle fs-5">千円</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="d-flex">
                                    <div class="col-6">
                                        <div class="input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-8">下請事業の完成工事高（請負金額）</span>
                                            <span id="subcon_sum_1_v" class="input-group-text bg-secondary-subtle fs-5 col-2 text-end d-block">{{ number_format($app->tc_amount - ($app->spc_amount + $app->lsc_amount)) }}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">千円</span>
                                        </div>
                                    </div>
                                    <div class="col-6">
                                        <div class="input-group mb-3">
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-8">保険料算出の基礎となる賃金総額の見込額</span>
                                            <span id="subcon_sum_2_v" class="input-group-text bg-secondary-subtle fs-5 col-2 text-end d-block">{{ number_format($app->pcb_wt_amount) }}</span>
                                            <span class="input-group-text bg-secondary-subtle fs-5 col-2">千円</span>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class="col-6 d-none">
                                <div class="d-flex mb-3">
                                    <span class="input-group-text bg-secondary-subtle fs-5">脳・心臓疾患等の補償</span>
                                    <div class="form-check fs-5 my-2 ms-2">
                                        <input class="form-check-input"
                                            type="radio" name="" value="0"
                                            onchange="inputvalChange()" id="compensation1" disabled>
                                        <label class="form-check-label" for="compensation1">なし</label>
                                    </div>
                                    <div class="form-check fs-5 my-2 ms-2">
                                        <input class="form-check-input"
                                            type="radio" name="compensation" value="1"
                                            onchange="inputvalChange()" id="compensation2"
                                            checked disabled>
                                        <label class="form-check-label" for="compensation2">あり</label>
                                    </div>
                                </div>
                            </div>
                                                        <div class="form-control">
                                <div class="col-12">
                                    <div class="d-flex input-group">
                                        <span class="input-group-text bg-secondary-subtle fs-5">保険料:</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5">休業補償あり（1日当たり給付基礎日額の20%）、障害補償、死亡補償</span>
                                    </div>
                                </div>
                                <div class="d-flex mb-3 input-group">
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-1">
                                            <input class="form-check-input" type="radio" name="amount" value="IA"
                                                id="flexRadioDefault1-1" onchange="valChange()"
                                                {{ $app->pattern == 'IA' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">600日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ａ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IA">{{ number_format($app->IA) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-2">
                                            <input class="form-check-input" type="radio" name="amount" value="IIA"
                                                id="flexRadioDefault1-2" onchange="valChange()"
                                                {{ $app->pattern == 'IIA' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">800日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ａ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIA">{{ number_format($app->IIA) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-3">
                                            <input class="form-check-input" type="radio" name="amount" value="IIIA"
                                                id="flexRadioDefault1-3" onchange="valChange()"
                                                {{ $app->pattern == 'IIIA' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ａ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIIA">{{ number_format($app->IIIA) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-4">
                                            <input class="form-check-input" type="radio" name="amount" value="IAIB"
                                                id="flexRadioDefault1-4" onchange="valChange()"
                                                {{ $app->pattern == 'IAIB' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,200日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IAIB">{{ number_format($app->IAIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-5">
                                            <input class="form-check-input" type="radio" name="amount" value="IIAIIB"
                                                id="flexRadioDefault1-5" onchange="valChange()"
                                                {{ $app->pattern == 'IIAIIB' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,600日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIAIIB">{{ number_format($app->IIAIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-6">
                                            <input class="form-check-input" type="radio" name="amount"
                                                value="IIIAIIIB" id="flexRadioDefault1-6" onchange="valChange()"
                                                {{ $app->pattern == 'IIIAIIIB' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">2,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIIAIIIB">{{ number_format($app->IIIAIIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-7">
                                            <input class="form-check-input" type="radio" name="amount" value="IAIB2"
                                                id="flexRadioDefault1-7" onchange="valChange()"
                                                {{ $app->pattern == 'IAIB2' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,800日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <span id="IAIB2">{{ number_format($app->IAIBIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-8">
                                            <input class="form-check-input" type="radio" name="amount"
                                                value="IIAIIB2" id="flexRadioDefault1-8" onchange="valChange()"
                                                {{ $app->pattern == 'IIAIIB2' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">2,400日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <span id="IIAIIB2">{{ number_format($app->IIAIIBIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault1-9">
                                            <input class="form-check-input" type="radio" name="amount"
                                                value="IIIAIIIB2" id="flexRadioDefault1-9" onchange="valChange()"
                                                {{ $app->pattern == 'IIIAIIIB2' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">3,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ａ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <span id="IIIAIIIB2">{{ number_format($app->IIIAIIIBIIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                </div>
                                <div class="col-6">
                                    <div class="d-flex input-group">
                                        <span class="input-group-text bg-secondary-subtle fs-5">保険料:</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5">休業補償なし、障害補償、死亡補償</span>
                                    </div>
                                </div>
                                <div class="d-flex mb-3 input-group @error('amount') is-invalid @enderror">
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-1">
                                            <input class="form-check-input" type="radio" name="amount" value="IB"
                                                id="flexRadioDefault2-1" onchange="valChange()"
                                                {{ $app->pattern == 'IB' ? 'checked' : '' }} disabled>
                                            <div class="ms-2 me-auto">
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">600日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IB">{{ number_format($app->IB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-2">
                                            <input class="form-check-input" type="radio" name="amount" value="IIB"
                                                id="flexRadioDefault2-2" onchange="valChange()"
                                                {{ $app->pattern == 'IIB' ? 'checked' : '' }} disabled>
                                            <div class="ms-2 me-auto">
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">800日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIB">{{ number_format($app->IIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-3">
                                            <input class="form-check-input" type="radio" name="amount" value="IIIB"
                                                id="flexRadioDefault2-3" onchange="valChange()"
                                                {{ $app->pattern == 'IIIB' ? 'checked' : '' }} disabled>
                                            <div class="ms-2 me-auto">
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIIB">{{ number_format($app->IIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-4">
                                            <input class="form-check-input" type="radio" name="amount" value="IB2"
                                                id="flexRadioDefault2-4" onchange="valChange()"
                                                {{ $app->pattern == 'IB2' ? 'checked' : '' }} disabled>
                                            <div class="ms-2 me-auto">
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,200日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IB2">{{ number_format($app->IBIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-5">
                                            <input class="form-check-input" type="radio" name="amount" value="IIB2"
                                                id="flexRadioDefault2-5" onchange="valChange()"
                                                {{ $app->pattern == 'IIB2' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,600日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIB2">{{ number_format($app->IIBIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="h-100 list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-6">
                                            <input class="form-check-input" type="radio" name="amount" value="IIIB2"
                                                id="flexRadioDefault2-6" onchange="valChange()"
                                                {{ $app->pattern == 'IIIB2' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">2,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6"><br></div>
                                                <span id="IIIB2">{{ number_format($app->IIIBIIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-7">
                                            <input class="form-check-input" type="radio" name="amount" value="IB3"
                                                id="flexRadioDefault2-7" onchange="valChange()"
                                                {{ $app->pattern == 'IB3' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">1,800日</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅰ型Ｂ</div>
                                                <span id="IB3">{{ number_format($app->IBIBIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-8">
                                            <input class="form-check-input" type="radio" name="amount" value="IIB3"
                                                id="flexRadioDefault2-8" onchange="valChange()"
                                                {{ $app->pattern == 'IIB3' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">2,400日</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅱ型Ｂ</div>
                                                <span id="IIB3">{{ number_format($app->IIBIIBIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                    <div class="list-group flex-fill text-center">
                                        <label class="list-group-item justify-content-between align-items-center"
                                            for="flexRadioDefault2-9">
                                            <input class="form-check-input" type="radio" name="amount" value="IIIB3"
                                                id="flexRadioDefault2-9" onchange="valChange()"
                                                {{ $app->pattern == 'IIIB3' ? 'checked' : '' }} disabled>
                                            <div>
                                                <div class="fw-bold">死亡保障</div>
                                                <div class="fw-bold">3,000日</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <div class="fw-bold fs-6">Ⅲ型Ｂ</div>
                                                <span id="IIIB3">{{ number_format($app->IIIBIIIBIIIB) }}</span>円
                                            </div>
                                        </label>
                                    </div>
                                </div>
                            </div>
                            <div class="d-flex">
                                <div class="col-4 {{$appview->isContractAfer() ? '' : 'd-none' }}">
                                    <div class="shadow-sm input-group mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-3">申込日</span>
                                        <input name="appl_date" type="date" value="{{ $app->appl_date }}"
                                            class="form-control fs-5 text-center" disabled>
                                    </div>
                                </div>
                                <div class="col-6 ps-1 {{$appview->isContractAfer() ? '' : 'd-none' }}">
                                    <div class="d-flex mb-3">
                                        <span class="input-group-text bg-secondary-subtle fs-5">払込回数</span>
                                        <div class="form-check fs-5 my-2 ms-2">
                                            <input class="form-check-input"
                                                type="radio" name="payments" id="first_p" value="1"
                                                onchange="valChange()" {{ $app->count == '1' ? 'checked' : '' }} disabled>
                                            <label class="form-check-label" for="first_p">一括払</label>
                                        </div>
                                        <div class="form-check fs-5 my-2 ms-2">
                                            <input class="form-check-input"
                                                type="radio" name="payments" id="second_p" value="2"
                                                onchange="valChange()" {{ $app->count == '2' ? 'checked' : '' }} disabled>
                                            <label class="form-check-label" for="second_p">２回払</label>
                                        </div>
                                        <div class="form-check fs-5 my-2 ms-2">
                                            <input class="form-check-input"
                                                type="radio" name="payments" id="third_p" value="3"
                                                onchange="valChange()" {{ $app->count == '3' ? 'checked' : '' }} disabled>
                                            <label class="form-check-label" for="third_p">３回払</label>
                                        </div>
                                    </div>
                                </div>
                            </div>
                            <div class=" {{$appview->isContractAfer() ? 'd-flex' : 'd-none' }}">
                                <div class="col-4">
                                    <div class="shadow-sm input-group mb-3 col-4">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-4">１回目</span>
                                        <span name="first" id="first"
                                            class="input-group-text bg-secondary-subtle fs-5 col-6 text-end d-block">{{ !empty($app->ta1) ? number_format($app->ta1) : 0 }}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">円</span>
                                    </div>
                                </div>
                                <div class="col-4 ms-1">
                                    <div class="shadow-sm input-group mb-3 col-4">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-4">２回目</span>
                                        <span name="second" id="second"
                                            class="input-group-text bg-secondary-subtle fs-5 col-6 text-end d-block">{{ !empty($app->ta2) ? number_format($app->ta2) : 0 }}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">円</span>
                                    </div>
                                </div>
                                <div class="col-4 ms-1">
                                    <div class="shadow-sm input-group mb-3 col-4">
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-4">３回目</span>
                                        <span name="third" id="third"
                                            class="input-group-text bg-secondary-subtle fs-5 col-6 text-end d-block">{{ !empty($app->ta3) ? number_format($app->ta3) : 0 }}</span>
                                        <span class="input-group-text bg-secondary-subtle fs-5 col-2">円</span>
                                    </div>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <style>
        label:has(input[type="radio"]:checked) {
            background: #86b7fe;
        }
        .form-control:disabled{
          background-color: unset;
        }
        .form-check-input:disabled,.form-check-input[disabled]~.form-check-label, .form-check-input:disabled~.form-check-label{
          opacity:1;
        }
    </style>
        <script>

        function spChange() {
            const radio = document.getElementById('flexRadioDefault1');
            const sp = document.getElementById('sp');
            if (radio.checked) {
                sp.classList.add('d-none');
                sp.classList.remove('d-block');
            } else {
                sp.classList.add('d-block');
                sp.classList.remove('d-none');
            }
        }

        spChange();
        function submitAfterValidate() {
            const form = document.getElementById('entryForm');
            if (!form.reportValidity()) {
                return false;
            } else {
                form.submit();
            }
        }
    </script>
@endsection