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  1. <form action="" id="order-form" onsubmit="return false;">
  2.  
  3. <div class="orderformwrap">
  4.  
  5. <!-- Colo Plan -->
  6.  
  7. <div class="inner-order-box">
  8.  
  9. <h3>Colocation Package Details</h3>
  10.  
  11.  
  12. <table>
  13. <tr>
  14. <td>Datacenter Location</td>
  15. <td>
  16. <select id="datacenter" name='datacenter' onchange="calculateTotal()">
  17. <option value="vegas">SAS-70 / SSAE16 Type II Las Vegas Datacenter</option>
  18. <option value="seattle">SAS-70 / SSAE16 Type II Seattle Datacenter</option>
  19. </select>
  20.  
  21. </td>
  22. </tr>
  23.  
  24. <tr>
  25. <td>Colocation Size</td>
  26. <td>
  27. <select id="colosize" name='colosize' onchange="calculateTotal()">
  28. <option value="14">1/4 Cabinet or 10 U ($229)</option>
  29. <option value="12">1/2 Cabinet or 21 U ($399)</option>
  30. <option value="11">Full Cabinet or 42 U ($699) </option>
  31. <option value="31">Private Cage with 3 Racks ($2000) </option>
  32.  
  33. </select>
  34. </td>
  35. </tr>
  36.  
  37. <tr>
  38. <td>Power</td>
  39. <td>
  40. <select id="power" name='power' onchange="calculateTotal()">
  41. <option value="1c16">1 Curcuit; 120 Volts; 16 Amps</option>
  42. <option value="1c24">1 Curcuit; 120 Volts; 24 Amps ($135)</option>
  43. <option value="2c16">2 Curcuits; 120 Volts; 16 Amps ($135)</option>
  44. <option value="2c24">2 Curcuits; 120 Volts; 24 Amps ($250)</option>
  45. </select>
  46. </td>
  47. </tr>
  48.  
  49. <tr>
  50. <td>Bandwidth</td>
  51. <td>
  52. <select id="bandwidth" name='bandwidth' onchange="calculateTotal()">
  53. <option value="100">100Mbps Unmetered</option>
  54. <option value="200">200Mbps Unmetered ($99)</option>
  55. <option value="500">500Mbps Unmetered ($499) </option>
  56. <option value="1000">1Gbps Unmetered ($999) </option>
  57.  
  58. </select>
  59. </td>
  60. </tr>
  61.  
  62. <tr>
  63. <td>Service Start Date</td>
  64. <td>
  65. <input type="text" value="" placeholder="YYYY-MM-DD" id="datepicker" style="width:428px;" />
  66.  
  67. <p class="pbelow">You should get a <a href="https://wwwapps.ups.com/ctc/request?loc=en_US">shipping time estimate</a> so you know
  68. how long it will take for your server to arrive at our datacenter, also allow 24-48 hours for installation.
  69.  
  70. <script>
  71. $(function() {
  72. $( "#datepicker" ).datepicker();
  73. $('#ui-datepicker-div').wrap('<div class="ll-skin-melon"></div>');
  74. });
  75. </script>
  76.  
  77. </td>
  78. </tr>
  79. </table>
  80. </div>
  81.  
  82. <div class="inner-order-box">
  83.  
  84. <h3>Colo Addons & Extras</h3>
  85.  
  86.  
  87. <table>
  88. <tr>
  89. <td>Redundant Network</td>
  90. <td>
  91. <select id="rednetwork" name='rednetwork' onchange="calculateTotal()">
  92. <option value="none">No Redunant Network</option>
  93. <option value="100">100 Mbps Redunant Network ($99)</option>
  94. <option value="1000">1 Gbps Redunant Network ($199)</option>
  95. </select>
  96.  
  97. </td>
  98. </tr>
  99. <tr>
  100. <td>IPv4 Addresses</td>
  101. <td>
  102. <select id="ipv4" name='ipv4' onchange="calculateTotal()">
  103. <option value="8">8 IPv4 Addresses</option>
  104. <option value="16">16 IPv4 Addresses ($8)</option>
  105. <option value="32">32 IPv4 Addresses ($24)</option>
  106. <option value="64">64 IPv4 Addresses ($56)</option>
  107. <option value="128">128 IPv4 Addresses ($120)</option>
  108. </select>
  109. </td>
  110. </tr>
  111.  
  112. <tr>
  113. <td>Dedicated KVM</td>
  114. <td>
  115. <select id="kvm" name='kvm' onchange="calculateTotal()">
  116. <option value="0">No Dedicated KVM</option>
  117. <option value="1">1 Dedicated KVM ($25.00)</option>
  118. <option value="2">2 Dedicated KVM ($50.00)</option>
  119. <option value="3">3 Dedicated KVM ($75.00)</option>
  120. <option value="4">4 Dedicated KVM ($100.00)</option>
  121. <option value="5">5 Dedicated KVM ($125.00)</option>
  122. <option value="6">6 Dedicated KVM ($150.00)</option>
  123. <option value="7">7 Dedicated KVM ($175.00)</option>
  124. <option value="8">8 Dedicated KVM ($200.00)</option>
  125. <option value="9">9 Dedicated KVM ($225.00)</option>
  126. <option value="10">10 Dedicated KVM ($250.00)</option>
  127. <option value="20">20 Dedicated KVM ($500.00)</option>
  128. <option value="40">40 Dedicated KVM ($1000.00)</option>
  129. </select>
  130. </td>
  131. </tr>
  132.  
  133. <tr>
  134. <td>Remote Hands</td>
  135. <td>
  136. <select id="filling" name='filling' onchange="calculateTotal()">
  137. <option value="included">Included!</option>
  138. </select>
  139. </td>
  140. </tr>
  141.  
  142. <tr>
  143. <td>Server Management</td>
  144. <td>
  145. <select id="manage" name='manage' onchange="calculateTotal()">
  146. <option value="0">No Management</option>
  147. <option value="1">1 Server with Full Management ($50)</option>
  148. <option value="2">2 Servers with Full Management ($100)</option>
  149. <option value="3">3 Servers with Full Management ($150)</option>
  150. <option value="5">5 Servers with Full Management ($250)</option>
  151. <option value="10">1/4th Cabinet with Full Management ($500)</option>
  152. <option value="20">1/2th Cabinet with Full Management ($1000)</option>
  153. <option value="40">Full Cabinet with Full Management ($1500)</option>
  154.  
  155. </select>
  156. </td>
  157. </tr>
  158. </table>
  159. </div>
  160.  
  161.  
  162.  
  163. <div class="inner-order-box">
  164.  
  165. <h3>Personal Details</h3>
  166.  
  167.  
  168. <table class="personaldetails">
  169. <tr>
  170. <td>Full Name</td>
  171. <td><input type="text" value="" placeholder="" /></td>
  172. </tr>
  173.  
  174. <tr>
  175. <td>Company Name</td>
  176. <td><input type="text" value="" placeholder="" /></td>
  177. </tr>
  178.  
  179. <tr>
  180. <td>Email Address</td>
  181. <td><input type="text" value="" placeholder="" /></td>
  182. </tr>
  183.  
  184. <tr>
  185. <td>Address 1</td>
  186. <td><input type="text" value="" placeholder="" /></td>
  187. </tr>
  188.  
  189. <tr>
  190. <td>Address 2</td>
  191. <td><input type="text" value="" placeholder="" /></td>
  192. </tr>
  193.  
  194. <tr>
  195. <td>City</td>
  196. <td><input type="text" value="" placeholder="" /></td>
  197. </tr>
  198.  
  199. <tr>
  200. <td>State/Region</td>
  201. <td><select name="state" id="stateselect"><option value="">Choose One...</option><option>Alabama</option><option>Alaska</option><option>Arizona</option><option>Arkansas</option><option>California</option><option>Colorado</option><option>Connecticut</option><option>Delaware</option><option>District of Columbia</option><option>Florida</option><option>Georgia</option><option>Hawaii</option><option>Idaho</option><option>Illinois</option><option>Indiana</option><option>Iowa</option><option>Kansas</option><option>Kentucky</option><option>Louisiana</option><option>Maine</option><option>Maryland</option><option>Massachusetts</option><option>Michigan</option><option>Minnesota</option><option>Mississippi</option><option>Missouri</option><option>Montana</option><option>Nebraska</option><option>Nevada</option><option>New Hampshire</option><option>New Jersey</option><option>New Mexico</option><option>New York</option><option>North Carolina</option><option>North Dakota</option><option>Ohio</option><option>Oklahoma</option><option>Oregon</option><option>Pennsylvania</option><option>Rhode Island</option><option>South Carolina</option><option>South Dakota</option><option>Tennessee</option><option>Texas</option><option>Utah</option><option>Vermont</option><option>Virginia</option><option>Washington</option><option>West Virginia</option><option>Wisconsin</option><option>Wyoming</option></select></td>
  202. </tr>
  203.  
  204. <tr>
  205. <td>Zip Code</td>
  206. <td><input type="text" value="" placeholder="" /></td>
  207. </tr>
  208.  
  209. <tr>
  210. <td>Country</td>
  211. <td><select name="country" id="country">
  212. <option value="US">United States</option><option>Canada</option><option value="AF">Afghanistan</option><option value="AX">Aland Islands</option><option value="AL">Albania</option><option value="DZ">Algeria</option><option value="AS">American Samoa</option><option value="AD">Andorra</option><option value="AO">Angola</option><option value="AI">Anguilla</option><option value="AQ">Antarctica</option><option value="AG">Antigua And Barbuda</option><option value="AR">Argentina</option><option value="AM">Armenia</option><option value="AW">Aruba</option><option value="AU">Australia</option><option value="AT">Austria</option><option value="AZ">Azerbaijan</option><option value="BS">Bahamas</option><option value="BH">Bahrain</option><option value="BD">Bangladesh</option><option value="BB">Barbados</option><option value="BY">Belarus</option><option value="BE">Belgium</option><option value="BZ">Belize</option><option value="BJ">Benin</option><option value="BM">Bermuda</option><option value="BT">Bhutan</option><option value="BO">Bolivia</option><option value="BA">Bosnia And Herzegovina</option><option value="BW">Botswana</option><option value="BV">Bouvet Island</option><option value="BR">Brazil</option><option value="IO">British Indian Ocean Territory</option><option value="BN">Brunei Darussalam</option><option value="BG">Bulgaria</option><option value="BF">Burkina Faso</option><option value="BI">Burundi</option><option value="KH">Cambodia</option><option value="CM">Cameroon</option><option value="CA">Canada</option><option value="CV">Cape Verde</option><option value="KY">Cayman Islands</option><option value="CF">Central African Republic</option><option value="TD">Chad</option><option value="CL">Chile</option><option value="CN">China</option><option value="CX">Christmas Island</option><option value="CC">Cocos (Keeling) Islands</option><option value="CO">Colombia</option><option value="KM">Comoros</option><option value="CG">Congo</option><option value="CD">Congo, Democratic Republic</option><option value="CK">Cook Islands</option><option value="CR">Costa Rica</option><option value="CI">Cote D'Ivoire</option><option value="HR">Croatia</option><option value="CU">Cuba</option><option value="CW">Curacao</option><option value="CY">Cyprus</option></select></td>
  213. </tr>
  214.  
  215. <tr>
  216. <td>Phone Number</td>
  217. <td><input type="text" value="" placeholder="" /></td>
  218. </tr>
  219.  
  220. </table>
  221. </div>
  222.  
  223. <div class="inner-order-box">
  224. <input type="submit" value="SEND ORDER DETAILS" class="submitblue" onclick="calculateTotal()" /> &nbsp; &nbsp;
  225. <input type="reset" value="CANCEL" class="submitgrey" />
  226. </div>
  227.  
  228.  
  229. </div>
  230.  
  231.  
  232.  
  233. <div class="clear"></div>
  234.  
  235.  
  236.  
  237. </div>
  238.  
  239. <div class="right">
  240. <h4>YOUR TOTAL</h4>
  241.  
  242. <table>
  243. <tr>
  244. <td>Setup Fee:</td>
  245. <td>$0.00</td>
  246. </tr>
  247. <tr>
  248. <td>Price:</td>
  249. <td class="blue"><div id="totalPrice"></div></td>
  250. </tr>
  251. </table>
  252.  
  253. <div class="linebreak"></div>
  254.  
  255. <input type="submit" value="ORDER" class="submitblue" onclick="calculateTotal()" />
  256. <input type="reset" value="RESET" class="submitgrey" />
  257.  
  258. </form>
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