<?php
/*
Template Name: lead
*/
get_header();?>
<div class="PageTitleSection">
<div class="container">
<h2>Rate Inquiry Page</h2>
</div>
</div>
<div class="leadRateInquiryForm">
 <div class="Lead_form_content" align="center">
 <div class="container">
 	 <h4>Trip Details</h4>
             <div class="mytable tripDetails">
            <div class="row">
                <div class="col-sm-6">
                  <div class="infLableWrap"> <span class="leftLabel dateLeftIcon">PU Date :</span> <span class="rightColumnValue">Feb 23rd, 2019</span> </div>
                  </div>
                  <div class="col-sm-6">
                 <div class="infLableWrap"> <span class="leftLabel timeIcon">Time :</span> <span class="rightColumnValue">
                  12:30PM - 05:30PM (5 Hrs)
                    </span> </div>
                   </div>
                   </div>
            
            
            <div class="row">
                <div class="col-sm-4 col-xs-8">
                  <div class="infLableWrap"> <span class="leftLabel serviceIcon">Prom / School Event</span> </div>
                </div>
                <div class="col-sm-4 col-xs-4">
                  <div class="infLableWrap"> <span class="leftLabel noOfpeopleIcon">5</span> </div>
                </div>
                
                <div class="col-sm-4 col-xs-12">
                  <div class="infLableWrap"> <span class="leftLabel typeOfVehicleIcon">Sedan & SUVs</span> </div>
                </div>
                </div>
              
             <div class="row">
                <div class="col-sm-6">
                  <div class="infLableWrap"> <span class="leftLabel addressIcon">Pickup Address :</span> <span class="rightColumnValue">2488 Pheasant Hollow Drive, West Sacramento, CA, 95691
                    </span> </div>
                    </div>
                    <div class="col-sm-6">
                  <div class="infLableWrap"> <span class="leftLabel addressIcon">Drop-Off Address :</span> <span class="rightColumnValue">2488 Pheasant Hollow Drive, West Sacramento, CA, 95691
                    </span> </div>
                    
                </div>
              </div>
            </div>
             </div>
         <div class="additionalServicesWrp">
         <div class="container">
        <div class="row">
          <div class="col-lg-12">
            <h4>Additional Services</h4>
            <div class="hideContentDiv">
            <div class="mytable additionalServices">            
              <div class="row">
                <div class="col-sm-4">
                  <div class="centerTitle photography"> Check box to get into for Photography.
                    <div class="checkBoxRow">
                      <input name="chkPG" id="chkPG" type="checkbox">
                      <input name="pickup_date_ph" id="pickup_date_ph" type="text" placeholder="Date of event" class="datepicker " >
                    </div>
                  </div>
                </div>
                <div class="col-sm-4">
                  <div class="centerTitle djservice"> Check box to get into for DJ Services.
                    <div class="checkBoxRow">
                      <input name="chkDJ" id="chkDJ" type="checkbox">
                      <input name="pickup_date_dj" id="pickup_date_dj" type="text" placeholder="Date of event" class="datepicker ">
                    </div>
                  </div>
                </div>
                <div class="col-sm-4">
                  <div class="centerTitle eventPlanningIcon"> Check box to get into for Event Planning.
                    <div class="checkBoxRow">
                      <input name="chkEP" id="chkEP" type="checkbox">
                      <input name="pickup_date_ep" id="pickup_date_ep" type="text" placeholder="Date of event" class="datepicker ">
                    </div>
                  </div>
                </div>
              </div>
            </div>
            </div>
            <div class="btnRowDiv text-center"> <a href="#" class="viewAllExpand">View More<span class="moreServiceIcon">moreService</span></a> </div>
            
            
          </div>
        </div>
        </div>
        </div>
        
          <div class="leadcustomerDetailsWrp">
        <div class="container">
        <h4>Customer Details</h4>
        <div class="Lead_form_content contactForm">
         <div class="row mobClear">
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 fordesktop">
            <div class="ash-form">
              <label>First Name:<strong><font color="#FF0000" size="+1">*</font></strong></label>
              <input name="cst_name" id="cst_name" type="text" class="form-control sel" placeholder="First Name">
            </div>
          </div>
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 fordesktop">
            <div class="ash-form">
              <label>Last Name:<strong><font color="#FF0000" size="+1">*</font></strong></label>
              <input name="cst_name_1" id="cst_name_1" type="text" class="form-control sel" placeholder="Last Name">
            </div>
          </div>
          
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-6 for-mobile">
            <div class="ash-form">
             <input name="cst_name" id="cst_name" type="text" class="form-control sel" placeholder="Name">
            </div>
          </div>
          
           <div class="col-lg-6 col-md-6 col-sm-6 col-xs-6 for-mobile">
           <div class="ash-form">
            <input name="cst_phone" id="cst_phone" type="text" class="form-control sel" placeholder="Phone">
            </div> 
          </div>
          
           <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 for-mobile">
            <div class="ash-form">
             <input name="cst_email" id="cst_email" type="text" class="form-control sel" placeholder="Email Address">
            </div>
          </div>
          
          
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 fordesktop">
            <div class="ash-form">
              <label>Email Address:<strong><font color="#FF0000" size="+1">*</font></strong></label>
              <input name="cst_email" id="cst_email" type="text" class="form-control sel" placeholder="Email">
            </div>
          </div>
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12 fordesktop">
            <div class="ash-form">
              <label>Phone Number</label>
              <input name="cst_phone" id="cst_phone" type="text" class="form-control sel" placeholder="Phone">
            </div>
          </div>
          <div class="col-lg-6 col-md-6 col-sm-6 col-xs-12" style="display:none;">
            <div class="ash-form">
              <label>Mobile<strong><font color="#FF0000" size="+1">*</font></strong></label>
              <input name="cst_mobile" id="cst_mobile" type="text" class="form-control sel" placeholder="Mobile">
            </div>
          </div>
          <div class="col-lg-12">
            <div class="ash-form textArea">
              <label>Remarks:</label>
              <textarea class="span12 elastic" id="cst_remark" rows="4" name="cst_remark" placeholder="Remarks: write here">
</textarea>
            </div>
          </div>
          <div class="col-lg-12">
            <div class="ash-form btnRow">
              <button type="submit" class="new-ashbutton">Send Your Enquiry</button>
            </div>
          </div>
        </div>
        </div>
        
        </div> 
        </div>       
        </div>
        </div>
        
      <?php get_footer();?>