- disabled ||= false
.form-horizontal
  .form-group
    = f.label "Name of Agency:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :name, class: "form-control", disabled: disabled

  .form-group
    = f.label "Contact Name:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :contact_name, class: "form-control", disabled: disabled

  .form-group
    = f.label "Street Address:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :street_address, class: "form-control", disabled: disabled

  .form-group
    = f.label "City:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :city, class: "form-control", disabled: disabled

  .form-group
    = f.label "State:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :state, class: "form-control", disabled: disabled

  .form-group
    = f.label "Postal Code:", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :postal_code, class: "form-control", disabled: disabled

  .form-group
    = f.label "Phone Number", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :phone, class: "form-control", disabled: disabled

  .form-group
    = f.label "email", class: "col-sm-2 control-label"
    .col-sm-10
      = f.text_field :email, class: "form-control", disabled: disabled