function verify() {
var themessage = "You are required to complete the following fields/sections: \n\n";

requirement = ""
len = document.form.insuranceradio.length
for (i = 0; i <len; i++) {
if (document.form.insuranceradio[i].checked) {
requirement = document.form.insuranceradio[i].value
}
}
if (requirement == "") {
themessage = themessage + "  You have to choose a requirement\n";
}

if (document.form.holdername.value=="") {
themessage = themessage + "  Insurance Holder Name\n";
}
if (document.form.holderpolicy.value=="") {
themessage = themessage + "  Insurance Holder Policy #\n";
}
if (document.form.addto.value=="") {
themessage = themessage + "  Certificate Holder Name\n";
}
if (document.form.addaddress.value=="") {
themessage = themessage + "  Certificate Holder Address\n";
}
if (document.form.addcitystatezip.value=="") {
themessage = themessage + "  Certificate Holder City/State/Zip\n";
}

for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.startdate.value=="")
themessage = themessage + "  Additional Insured - Start Date\n";
}

joblocation = ""
len = document.form.job_location.length
for (i = 0; i <len; i++) {
if (document.form.job_location[i].checked) {
joblocation = document.form.job_location[i].value
}
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && joblocation == "")
themessage = themessage + "  Additional Insured - Job Location\n";
}

for (i=1;i<document.form.job_location.length;i++){
if (document.form.job_location[0].checked==true && document.form.locationaddress.value=="")
themessage = themessage + "  Additional Insured - Job Location Address\n";
}

for (i=1;i<document.form.job_location.length;i++){
if (document.form.job_location[0].checked==true && document.form.locationcitystatezip.value=="")
themessage = themessage + "  Additional Insured - Job Location City/State/Zip\n";
}

for (i=1;i<document.form.job_location.length;i++){
if (document.form.job_location[1].checked==true && document.form.counties.value=="")
themessage = themessage + "  Additional Insured - Counties\n";
}


for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.jobdescription.value=="")
themessage = themessage + "  Additional Insured - Job Description\n";
}

residental = ""
len = document.form.resproject.length
for (i = 0; i <len; i++) {
if (document.form.resproject[i].checked) {
residental = document.form.resproject[i].value
}
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && residental == "")
themessage = themessage + "  Additional Insured - Is this a residential project?\n";
}

for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.duration.value=="")
themessage = themessage + "  Additional Insured - Job duration\n";
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.cost.value=="")
themessage = themessage + "  Additional Insured - Job cost\n";
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.typeofbusiness.value=="")
themessage = themessage + "  Additional Insured - Principal use of property\n";
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && document.form.subcontractout.value=="")
themessage = themessage + "  Additional Insured - Work Subcontracted Out\n";
}


for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && !document.form.relationship1.checked && !document.form.relationship2.checked && !document.form.relationship3.checked && !document.form.relationship4.checked && !document.form.relationship5.checked && !document.form.relationship6.checked && !document.form.relationship7.checked && !document.form.relationship8.checked && !document.form.relationship9.checked && !document.form.relationship10.checked && !document.form.relationship11.checked)
themessage = themessage + "  Additional Insured - Relationship\n";
}

exposure = ""
len = document.form.riskcover.length
for (i = 0; i <len; i++) {
if (document.form.riskcover[i].checked) {
exposure = document.form.riskcover[i].value
}
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && exposure == "")
themessage = themessage + "  Additional Insured - Exposure risk\n";
}

for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && !document.form.involvement1.checked && !document.form.involvement2.checked && !document.form.involvement3.checked && !document.form.involvement4.checked && !document.form.involvement5.checked && !document.form.involvement6.checked && !document.form.involvement7.checked)
themessage = themessage + "  Additional Insured - Job involvement\n";
}

for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && !document.form.jobtype1.checked && !document.form.jobtype2.checked && !document.form.jobtype3.checked && !document.form.jobtype4.checked)
themessage = themessage + "  Additional Insured - Job type\n";
}

contract = ""
len = document.form.aiwrite.length
for (i = 0; i <len; i++) {
if (document.form.aiwrite[i].checked) {
contract = document.form.aiwrite[i].value
}
}
for (i=1;i<document.form.insuranceradio.length;i++){
if (document.form.insuranceradio[1].checked==true && contract == "")
themessage = themessage + "  Additional Insured - Written contract\n";
}

//alert if fields are empty and cancel form submit
if (themessage == "You are required to complete the following fields/sections: \n\n") {
document.form.submit();
}
else {
alert(themessage);
return false;
   }
}