<%@ Page Language="C#" AutoEventWireup="true" CodeBehind="buybx.aspx.cs" Inherits="QiZhanBang.Web.buybx" %>
<%@ Register src="sitefooter.ascx" tagname="sitefooter" tagprefix="uc1" %>
<%@ Import Namespace="QiZhanBang.Core" %>
<%@ Import Namespace="QiZhanBang.Core.Model" %>
<%@ Import Namespace="QiZhanBang.Core.Factory" %>
<!DOCTYPE html>
<html lang="zh-CN">
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">
<meta name="Keywords" content="" />
<meta name="Description" content="" />
<title><%= SiteName %> - 保险订单</title>
<link rel="stylesheet" href="images/bootstrap.min.css" />
<link rel="stylesheet" href="images/font-awesome.min.css" />
<link rel="stylesheet" type="text/css" href="images/swiper.min.css" />
<link rel="stylesheet" href="images/ectouch.css" />
<link rel="stylesheet" href="images/style.css" />
<link rel="stylesheet" href="images/user.css">
<script type="text/javascript" src="js/jquery.min.js" ></script> 
<!-- 新加上传样式s -->
<link href="images/bootstrap.css" rel="stylesheet" />
<link href="images/bootstrap-fileupload.min.css" rel="stylesheet" />
<!-- 新加上传样式e -->
</head>
<body>
<!-- 头部s -->
<div class="ect-bg">
<header class="ect-header ect-margin-tb ect-margin-lr text-center ect-bg icon-write"> <a href="javascript:history.go(-1)" class="pull-left ect-icon ect-icon1 ect-icon-history"></a> <span>保险订单</span> <a href="index.aspx" class="pull-right ect-icon ect-icon1 ect-icon-homes icon-write"></a></header>
</div>
<!-- 头部e -->

<!-- 开始 -->

<form name="formEdit" action="buybxdeal.aspx" method="post" onSubmit="return userEdit()" enctype="multipart/form-data">
 <div class="upimgbox">
 
 <p style=" text-align: center; padding: 1em 0;">
车险报价请提供以下资料，我们将尽快为您报价，系统默认上一年购买险种，如有特殊要求请留言，谢谢！
</p>

<li>
<h6>车主姓名： <span>(必填)</span></h6>
<input class="upimgboxinputa" name="ownername" type="text" placeholder="请输入车主姓名"  value="">
</li>
 
<li>
<h6>车主手机号： <span>(必填)</span></h6>
<input class="upimgboxinputa" name="tel" type="text" placeholder="请输入您的手机号"  value="">
</li>
 
<li>
<h6>请上传行驶证正面照片： <span>(必填)</span></h6>
<div class="form-group">
<div class="fileupload fileupload-new" data-provides="fileupload">
<div class="fileupload-new thumbnail" style="width: 130px; height: 75px;"><img src="images/demoUpload.jpg" alt="" /></div>
<div class="fileupload-preview fileupload-exists thumbnail" style="max-width: 130px; max-height: 150px; line-height: 20px;"></div>
<div>
<span class="btn btn-file btn-primary"><span class="fileupload-new" style="color:#fff;">点击选择图片</span><span class="fileupload-exists" style="color:#fff;">重新选择</span><input type="file" name="jszfrontpic" /></span>
<a href="#" class="btn btn-danger fileupload-exists" data-dismiss="fileupload" style="color:#fff;">移除图片</a>
</div>
</div>
</div>
</li>

<li>
<h6>请上传行驶证反面照片： <span>(必填)</span></h6>
<div class="form-group">
<div class="fileupload fileupload-new" data-provides="fileupload">
<div class="fileupload-new thumbnail" style="width: 130px; height: 75px;"><img src="images/demoUpload.jpg" alt="" /></div>
<div class="fileupload-preview fileupload-exists thumbnail" style="max-width: 130px; max-height: 150px; line-height: 20px;"></div>
<div>
<span class="btn btn-file btn-primary"><span class="fileupload-new" style="color:#fff;">点击选择图片</span><span class="fileupload-exists" style="color:#fff;">重新选择</span><input type="file" name="jszbackpic" /></span>
<a href="#" class="btn btn-danger fileupload-exists" data-dismiss="fileupload" style="color:#fff;">移除图片</a>
</div>
</div>
</div>
</li>

<li>
<h6>请上传身份证正面照片： <span>(必填)</span></h6>
<div class="form-group">
<div class="fileupload fileupload-new" data-provides="fileupload">
<div class="fileupload-new thumbnail" style="width: 130px; height: 75px;"><img src="images/demoUpload.jpg" alt="" /></div>
<div class="fileupload-preview fileupload-exists thumbnail" style="max-width: 130px; max-height: 150px; line-height: 20px;"></div>
<div>
<span class="btn btn-file btn-primary"><span class="fileupload-new" style="color:#fff;">点击选择图片</span><span class="fileupload-exists" style="color:#fff;">重新选择</span><input type="file" name="sfzfrontpic" /></span>
<a href="#" class="btn btn-danger fileupload-exists" data-dismiss="fileupload" style="color:#fff;">移除图片</a>
</div>
</div>
</div>
</li>

<li>
<h6>请上传身份证反面照片： <span>(必填)</span></h6>
<div class="form-group">
<div class="fileupload fileupload-new" data-provides="fileupload">
<div class="fileupload-new thumbnail" style="width: 130px; height: 75px;"><img src="images/demoUpload.jpg" alt="" /></div>
<div class="fileupload-preview fileupload-exists thumbnail" style="max-width: 130px; max-height: 150px; line-height: 20px;"></div>
<div>
<span class="btn btn-file btn-primary"><span class="fileupload-new" style="color:#fff;">点击选择图片</span><span class="fileupload-exists" style="color:#fff;">重新选择</span><input type="file" name="sfzbackpic" /></span>
<a href="#" class="btn btn-danger fileupload-exists" data-dismiss="fileupload" style="color:#fff;">移除图片</a>
</div>
</div>
</div>
</li>

<li>
<h6>请上传营业执照或事业单位法人证书： <span><br />(公司或单位车辆需提供资料)</span></h6>
<div class="form-group">
<div class="fileupload fileupload-new" data-provides="fileupload">
<div class="fileupload-new thumbnail" style="width: 130px; height: 75px;"><img src="images/demoUpload.jpg" alt="" /></div>
<div class="fileupload-preview fileupload-exists thumbnail" style="max-width: 130px; max-height: 150px; line-height: 20px;"></div>
<div>
<span class="btn btn-file btn-primary"><span class="fileupload-new" style="color:#fff;">点击选择图片</span><span class="fileupload-exists" style="color:#fff;">重新选择</span><input type="file" name="companypic" /></span>
<a href="#" class="btn btn-danger fileupload-exists" data-dismiss="fileupload" style="color:#fff;">移除图片</a>
</div>
</div>
</div>
</li>

<li class="hzpingtia">
<h6>保险公司：</h6>

<%
    int itemindex = 1;
    System.Data.DataTable dtLinks = LinkFactory.GetList(9);
    foreach (System.Data.DataRow drLnk in dtLinks.Rows)
    {
%>
<div class="bsradioitem">
<input id="bsitem<%=itemindex %>" type="radio" name="bsitem" value="<% = drLnk["linkname"].ToString()%>">
<label for="bsitem<%=itemindex %>"><% = drLnk["linkname"].ToString()%></label>
</div>
<%
    itemindex++;
    } %>
</li>

<li class="hzpingtia">
<h6>合作平台：</h6>
<%
    itemindex = 1;
    dtLinks = LinkFactory.GetList(8);
    foreach (System.Data.DataRow drLnk in dtLinks.Rows)
    {
%>
<div class="radioitem">
<input id="item<%=itemindex %>" type="radio" name="item" value="<% = drLnk["linkname"].ToString()%>">
<label for="item<%=itemindex %>"><img src="<% = drLnk["includepic"].ToString()%>" alt=""/></label>
</div>
<%
    itemindex++;
    } %>
</li>

<li>
<h6>合作平台ID号：</h6>
<input class="upimgboxinputa" name="bxcompanyid" type="text" placeholder="请输入您的合作平台ID号"  value="">
</li>

<li>
<h6>个人要求：(请务必写清楚您的特殊要求)</h6>
<textarea class="upimgboxinputs"  rows="3" name="message"></textarea>
</li>

<input name="act" type="hidden" value="profile" />
<div class="two-btn ect-padding-tb ect-padding-lr ect-margin-tb text-center">
<input name="submit" type="submit" value="确认提交" class="btn btn-info ect-btn-info ect-colorf ect-bgmmm" /> <!-- 点击后链接bao1.html -->
</div>

</div>
 
</form>

<script src="js/jquery-1.10.2.js"></script>
<script src="js/bootstrap.js"></script>
<script src="js/bootstrap-fileupload.js"></script>

<!-- 结束 -->
<div id="copyright"><%= SiteName %> 版权所有</div>
<!-- 底部菜单s -->            
<footer>
<nav class="ect-nav ect-bg icon-write"><ul class="ect-diaplay-box text-center">
  <li class="ect-box-flex"><a href="procate.aspx"><i class="ect-icon ect-icon-cate"></i>商品分类</a></li>
  <li class="ect-box-flex"><a href="prolist.aspx?pc=1"><i class="ect-icon ect-icon-search"></i>金币商城</a></li>
  <li class="ect-box-flex"><a href="index.aspx"><i class="ect-icon ect-icon-home"></i>首页</a></li>
  <li class="ect-box-flex"><a href="prolist.aspx?pc=2"><i class="ect-icon ect-icon-flow"></i>积分兑换</a></li>
  <li class="ect-box-flex"><a href="user.aspx"><i class="ect-icon ect-icon-user"></i>个人中心</a></li>
</ul>
</nav>
</footer>
<div style="padding-bottom:4.2em;"></div>
<!-- 底部菜单e -->
<a id="tophone" href="tel:<%= shoptel %>"><i class="fa fa-phone"></i></a>
</body>
</html>
