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IMR_quote.html
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<!doctype html>
<!--[if lt IE 7]> <html class="no-js lt-ie9 lt-ie8 lt-ie7" lang="en"> <![endif]-->
<!--[if IE 7]> <html class="no-js lt-ie9 lt-ie8" lang="en"> <![endif]-->
<!--[if IE 8]> <html class="no-js lt-ie9" lang="en"> <![endif]-->
<!--[if gt IE 8]><!--> <html class="no-js" lang="en"> <!--<![endif]-->
<head>
<meta charset="utf-8">
<meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
<title>InsureMYRide - Bike Insurance Quote - HTML Prototype v1</title>
<meta name="description" content="">
<meta name="viewport" content="width=device-width">
<link rel="stylesheet" href="css/style.css">
<script src="js/libs/modernizr-2.5.3.min.js"></script>
</head>
<body id="quote-page">
<header>
<div class="top ">
<button>Exit</button>
<img class="logo" src="http://www.insuremyride.com.au/imr/sites/all/themes/imr/images/insure-my-ride.gif" />
</div>
<div class="bar">
<div class="bar-inner clearfix">
<h1>Bike insurance quote</h1>
<div class="progress">Step 1 of 3</div>
</div>
</div>
</header>
<div id="content" role="main">
<form class="form-quote" action="IMR_price.html">
<h2>Do you qualify for an online quote?</h2>
<fieldset>
<div class="question check">
<label for="qualifier-business">I do not use this bike for business purposes</label>
<input type="checkbox" class="wholecheck" id="qualifier-business"/>
</div>
<div class="question check">
<label for="qualifier-licence">No rider has had a car or bike licence cancelled or suspended within the last 3 years</label>
<input type="checkbox" class="wholecheck" id="qualifier-licence"/>
</div>
<div class="question check">
<label for="qualifier-insurance">No rider has had any insurance cancelled or refused within the last 5 years</label>
<input type="checkbox" class="wholecheck" id="qualifier-insurance"/>
</div>
<div class="question check">
<label for="qualifier-criminal">No rider has had criminal convictions imposed in the last 5 years</label>
<input type="checkbox" class="wholecheck" id="qualifier-criminal"/>
</div>
<div class="question check">
<label for="qualifier-pds">I agree that the correct <a target="_blank" href="http://www.insuremyride.com.au/imr/motorcycle-policy-document">PDS</a> is being made available to me by this website and agree to the <a target="_blank" href="http://www.insuremyride.com.au/imr/online-terms-and-privacy-statement">Online Terms and Privacy Statement</a></label>
<input type="checkbox" class="wholecheck" id="qualifier-pds"/>
</div>
</fieldset>
<small>You must be able to check (✓) each question above to be eligible to purchase insurance from InsureMyRide.</small>
<h2>Insurance details</h2>
<fieldset>
<div class="question">
<label>What <a href="#?q=2">type of insurance</a> would you like?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="insurance-type"/>Comprehensive</label>
<label class="toggle-btn"><input type="radio" name="insurance-type"/>Third Party</label>
<label class="toggle-btn"><input type="radio" name="insurance-type"/>Theft</label>
</div>
<small>For a CTP(Greenslip) quote, please proceed to the <a href="https://gioctpgreenslip.suncorp.com.au/ctponline/imrquote?execution=e2s1">NSW CTP quote</a> page.</small>
</div>
<div class="question">
<label for="">Date your cover will commence:</label>
<div class="datefield">
<input name="startdate" class="day" type="tel" maxlength="2" placeholder="DD" value="16"/> /
<input name="startdate" class="month" type="tel" maxlength="2" placeholder="MM" value="07"/>/
<input name="startdate" class="year" type="tel" maxlength="4" placeholder="YYYY" value="2012"/>
</div>
</div>
<div class="question">
<label for="insurance-rating">What is your existing <a href="#?q=3">insurance rating</a>?</label>
<select id="insurance-rating">
<option>No current insurance or None 0%</option>
<option>25% No Claim Bonus - Rating 4</option>
<option>45% No Claim Bonus - Rating 3</option>
<option>55% No Claim Bonus - Rating 2</option>
<option>65% No Claim Bonus - Rating 1</option>
</select>
</div>
</fieldset>
<h2>Type of bike</h2>
<fieldset>
<div class="question" id="bikeyear">
<label>Year of manufacture:</label>
<select>
<option value="">Please select...</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
</select>
</div>
<div class="question" id="bikemake">
<label>Bike make:</label>
<select>
<option value="">Please select...</option>
<option value="APR">Aprilia</option>
<option value="ARQ">Arqin</option>
<option value="ATK">ATK</option>
<option value="AUG">MV Agusta</option>
<option value="BEN">Benelli</option>
<option value="BET">Beta</option>
<option value="BIM">Bimota</option>
<option value="BMW">BMW</option>
<option value="BOC">Bolwell Scoota</option>
<option value="BOH">Bolwell Hartford</option>
<option value="BOI">Bollini</option>
<option value="BOL">Bolwell PGO</option>
<option value="BOM">Bombardier</option>
<option value="BOS">Bolwell Sunbird</option>
<option value="BRP">BRP</option>
<option value="BUE">Buell</option>
<option value="BUG">BUG</option>
<option value="BUL">Bultaco</option>
<option value="CAG">Cagiva</option>
<option value="CFM">CFMoto</option>
<option value="CZM">CZ</option>
<option value="DAE">Daelim</option>
<option value="DER">Derbi</option>
<option value="DUC">Ducati</option>
<option value="ENF">Enfield</option>
<option value="EVT">EVT</option>
<option value="GAS">Gas Gas</option>
<option value="GIL">Gilera</option>
<option value="HAR">Harley-Davidson</option>
<option value="HBG">Husaberg</option>
<option value="HNT">Hunter</option>
<option value="HON">Honda</option>
<option value="HUS">Husqvarna</option>
<option value="HYO">Hyosung</option>
<option value="ITA">Italjet</option>
<option value="JAW">Jawa</option>
<option value="KAW">Kawasaki</option>
<option value="KAZ">Kazuma</option>
<option value="KTM">KTM</option>
<option value="KYM">Kymco</option>
<option value="LAM">Lambretta</option>
<option value="LAR">LARO</option>
<option value="LAV">Laverda</option>
<option value="LML">LML Vespa</option>
<option value="MAI">Maico</option>
<option value="MAT">Matchless</option>
<option value="MBA">Motobella</option>
<option value="MCS">McSkuta</option>
<option value="MEG">Megelli</option>
<option value="MNT">Montessa</option>
<option value="MOB">Motobecane</option>
<option value="MOG">Moto Guzzi</option>
<option value="MOJ">MOJO</option>
<option value="MOM">Moto Morini</option>
<option value="MUZ">MUZ</option>
<option value="MZA">MZ</option>
<option value="NOR">Norton</option>
<option value="OSA">Ossa</option>
<option value="OSS">OSSA</option>
<option value="PEU">Peugeot</option>
<option value="PGA">Pagsta</option>
<option value="PGO">PGO</option>
<option value="PIA">Piaggio</option>
<option value="POL">Polaris</option>
<option value="QJ-">QJ</option>
<option value="RAZ">Razor By E-Ton</option>
<option value="REN">ROYAL ENFIELD</option>
<option value="SAC">Sachs</option>
<option value="SCO">Scorpa</option>
<option value="SCP">SCP</option>
<option value="SEC">Secma</option>
<option value="SES">SYM</option>
<option value="SHE">Sherco</option>
<option value="SUZ">Suzuki</option>
<option value="TGB">TGB</option>
<option value="THU">Thumpster</option>
<option value="TM-">TM</option>
<option value="TOR">Torino</option>
<option value="TRI">Triumph</option>
<option value="VER">Vertemati</option>
<option value="VES">Vespa</option>
<option value="VIC">Victory</option>
<option value="VMO">VMOTO</option>
<option value="VOR">VOR</option>
<option value="YAM">Yamaha</option>
<option value="ZER">Zero</option>
</select>
</div>
<div class="question" id="bikemodel">
<label>Bike model:</label>
<small class="preptext">Please select a Year and Make first</small>
<select class="hidden">
<option>Please select...</option>
<option value="DIAVEL">DIAVEL</option>
<option value="HYPERMOTARD">HYPERMOTARD</option>
<option value="MONSTER">MONSTER</option>
<option value="MULTISTRADA">MULTISTRADA</option>
<option value="SPORTCLASSIC">SPORTCLASSIC</option>
<option value="STREETFIGHTER">STREETFIGHTER</option>
<option value="1098 R">1098 R</option>
<option value="1198 MY10">1198 MY10</option>
<option value="1198 R">1198 R</option>
<option value="1198 S">1198 S</option>
<option value="1198 SP">1198 SP</option>
<option value="1199 PANIGALE">1199 PANIGALE</option>
<option value="848 EVO">848 EVO</option>
</select>
</div>
<div class="question" id="exactbike">
<label>Exact bike:</label>
<small class="preptext">Please select a Year, Make and Model first</small>
<div id="exactbikeoptions" class="toggle-btn-grp hidden">
<label class="toggle-btn"><input type="radio" name="exactbike"/>2012 DUCATI STREETFIGHTER MY11 SPORTS , , 1099 CC</label>
<label class="toggle-btn"><input type="radio" name="exactbike"/>2012 DUCATI STREETFIGHTER S MY11 SPORTS , , 1099 CC</label>
<label class="toggle-btn"><input type="radio" name="exactbike"/>2012 DUCATI STREETFIGHTER 848 SPORTS , , 849 CC</label>
<small class="block"></small>
</div>
</div>
</fieldset>
<h2>About your bike</h2>
<fieldset>
<div class="question horiz">
<div class="horiz-left"><label for="postcode">Postcode where your bike is usually parked each night:</label></div>
<div class="horiz-right"><input id="postcode" class="sml" type="tel" maxlength="4"/></div>
</div>
<div class="question">
<label>Is your bike registered?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="registered"/>Yes</label>
<label class="toggle-btn"><input type="radio" name="registered"/>No</label>
</div>
</div>
<div class="question">
<label>Does your bike have an <em>Alarm</em>, <em>Data dot</em>, <em>Immobilizer</em> or <em>Tracking device</em>?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="security"/>Yes</label>
<label class="toggle-btn"><input type="radio" name="security"/>No</label>
</div>
</div>
<div class="question">
<label>Is your bike fully owned and paid off?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="paidoff"/>Yes</label>
<label class="toggle-btn"><input type="radio" name="paidoff"/>No</label>
</div>
</div>
</fieldset>
<h2>Bike usage</h2>
<fieldset>
<div class="question horiz">
<div class="horiz-left"><label for="postcode">What age is the youngest regular rider?</label></div>
<div class="horiz-right"><input id="postcode" class="sml" type="tel" maxlength="2"/></div>
</div>
<div class="question">
<label>How often is your bike usually used?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="bike-usage"/>Commuting: 5 or more days a week</label>
<label class="toggle-btn"><input type="radio" name="bike-usage"/>Recreation: less than 5 days a week</label>
</div>
</div>
<div class="question">
<label>Have you been riding for more than one year?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="ride-year"/>Yes</label>
<label class="toggle-btn"><input type="radio" name="ride-year"/>No</label>
</div>
</div>
<div class="question">
<label>Have you completed an <a href="#?q=1">approved</a> advanced rider course?</label>
<div class="toggle-btn-grp">
<label class="toggle-btn"><input type="radio" name="course"/>Yes</label>
<label class="toggle-btn"><input type="radio" name="course"/>No</label>
</div>
</div>
</fieldset>
<button class="submit">Get Quote</button>
</form>
</div>
<script src="js/libs/jquery-1.7.1.min.js"></script>
<script src="js/libs/jquery.autotab-1.1b.js"></script>
<script src="js/script.js"></script>
</body>
</html>