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+ <!DOCTYPE html>
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+ <!--[if lt IE 7]> <html class="no-js lt-ie9 lt-ie8 lt-ie7"> <![endif]-->
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+ <!--[if IE 7]> <html class="no-js lt-ie9 lt-ie8"> <![endif]-->
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+ <!--[if IE 8]> <html class="no-js lt-ie9"> <![endif]-->
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+ <!--[if gt IE 8]> <html class="no-js"> <!--<![endif]-->
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+ < html >
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+
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+ < head >
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+ < meta charset ="utf-8 ">
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+ < meta http-equiv ="X-UA-Compatible " content ="IE=edge ">
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+ < title > Test website</ title >
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+ < meta name ="description " content ="">
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+ < meta name ="viewport " content ="width=device-width, initial-scale=1 ">
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+ < link rel ="stylesheet " href ="custom.css ">
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+ < link rel ="stylesheet " href ="jquery-ui.css ">
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+ < link rel ="stylesheet " href ="nav.css ">
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+ </ head >
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+
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+ < body >
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+ < nav >
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+ < ul >
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+ < li >
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+ < a href ="# " class ="button-nav add "> Test Insurer</ a >
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+ < div class ="dialog " style ="display:none ">
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+ < div class ="title "> Add Event</ div >
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+ </ div >
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+ </ li >
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+ < li class ="radio ">
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+ < a href ="# " class ="button-nav active "> Home</ a >
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+
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+ < a href ="# " class ="button-nav "> Products</ a >
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+
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+ < a href ="# " class ="button-nav "> Company</ a >
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+ </ li >
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+ </ ul >
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+ </ div >
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+ </ nav >
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+ <!--[if lt IE 7]>
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+ <p class="browsehappy">You are using an <strong>outdated</strong> browser. Please <a href="#">upgrade your browser</a> to improve your experience.</p>
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+ <![endif]-->
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+ < div >
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+ < h1 > Quotation Request</ h1 >
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+ < h2 > Demo Insurer Quotation Form: < span id ="demoName "> </ span > </ h2 >
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+ </ div >
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+
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+ < hr />
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+ < div class ="getquote-ui container main ">
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+
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+ < div id ="PageButtonsTop " class ="submit_buttons SummaryButtons ">
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+ < input type ="button " class ="rounded Back QuestionPage_Back " name ="QuestionPage_Back " value ="Back "
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+ onclick ="selectPreviousPage(); this.blur(); return false; ">
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+ < input type ="button " class ="rounded Next QuestionPage_Next " name ="QuestionPage_Next " value ="Next "
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+ onclick ="selectNextPage(); this.blur(); return false; ">
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+ < input type ="button " class ="rounded QuestionPage_Save " name ="SubmitQuote " value ="Finish "
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+ onclick ="this.blur(); return submitQuote(); ">
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+ </ div >
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+ < div id ="ctl00_MainContent_divGetQuote ">
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+ < div id ="pages ">
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+ < div class ="page page_PageCalculation selected_page " id ="page_PageCalculation "
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+ style ="min-height: 404px; ">
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+ < div id ="questions_page_PageCalculation " class ="questions ">
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+ < h1 class ="PageTitle "> Basic company details< span class ="Multiple "> </ span > </ h1 >
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+
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+
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+
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+ < div id ="question_1 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Company Name:</ div >
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+ < input type ="text " id ="question_in_1 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div id ="question_2 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Status of entity:</ div >
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+ < input type ="text " id ="question_in_2 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div id ="question_10 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Primary Industry Sector:</ div >
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+ < input type ="text " id ="question_in_10 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div id ="question_3 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Primary Address (Address, County, Postcode, Country)</ div >
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+ < input type ="text " id ="question_in_3 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div id ="question_4 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Date Established (DD/MM/YYYY)</ div >
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+ < input type ="text " id ="question_in_4 " value ="" class ="">
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+ </ div >
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+
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+
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+ < input type ="hidden " id ="trigger_LossofRent " name ="trigger_LossofRent " value ="">
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+ < div id ="question_LossofRent " class ="question Money RISKGROUP_ID_5593 "> < input type ="hidden "
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+ id ="questionName_LossofRent " class ="questionName " value ="LossofRent ">
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+ < div class ="text "> Last 12 Months Gross Revenue: </ div >
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+ < span class ="char_label prefix "> £</ span > < input tabindex ="1 " type ="text " id ="LossofRent "
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+ name ="LossofRent " value ="0 " class ="number_input cover Money "> < span
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+ class ="char_label suffix "> </ span >
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+ < input type ="hidden " id ="LossofRent_rate " name ="LossofRent_rate " class ="rate " value ="0 ">
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+ < input type ="hidden " id ="LossofRent_result " name ="LossofRent_result " class ="result "
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+ value ="0 ">
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+ </ div >
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+
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+ < div id ="question_6 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Description of Business Activites:</ div >
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+ < input type ="text " id ="question_in_6 " value ="" class ="">
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+ </ div >
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+
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+ < div class ="question SmallTitle ">
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+ < h5 > < u > < b > Employees</ b > </ u > </ h5 >
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+ < div class ="info_text "> </ div >
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+ </ div >
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+
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+
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+ < input type ="hidden " id ="trigger_2313Employees " name ="trigger_2313Employees " value ="">
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+ < div id ="question_2313Employees " class ="question Number RISKGROUP_ID_5593 "> < input type ="hidden "
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+ id ="questionName_2313Employees " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Number of Employees</ div >
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+ < input tabindex ="1 " type ="text " id ="2313Employees " name ="2313Employees " value ="0 "
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+ class ="number_input cover Number ">
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+ </ div >
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+
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+ < div id ="question_11 " class ="question YesNo ">
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+ < div class ="text "> All employees (inc. LOSC, trainees, apprentices) paid below PAYE
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+ threshold:</ div >
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+ < label class ="radio " for ="question_y_11 ">
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+ < input tabindex ="1 " type ="radio "
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+ onclick ="this.blur(); document.getElementById('question_12_d').style=null "
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+ name ="2313disclosheader4 " id ="question_y_11 " value ="Yes " class ="radio "> < span
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+ class ="radioMark ">
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+ </ span > Yes
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+ </ label >
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+ < label class ="radio " for ="question_n_11 "> < input tabindex ="1 " type ="radio "
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+ onclick ="this.blur(); document.getElementById('question_12_d').style='display: none;' "
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+ name ="2313disclosheader4 " id ="question_n_11 " value ="No " checked ="checked "
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+ class ="radio "> < span class ="radioMark "> </ span > No
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+ </ label >
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+ < input type ="hidden " name ="ignore-2313disclosheader4 " value ="" class ="radio-default ">
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+ </ div >
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+ < input type ="hidden " id ="trigger_2313CCJdetails " name ="trigger_2313CCJdetails " value ="HIDDEN ">
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+ < div id ="question_12_d " class ="question TextArea trigger_question RISKGROUP_ID_0 "
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+ style ="display: none; ">
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+ < div class ="text "> Please provide full details:</ div >
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+ < textarea tabindex ="1 " id ="question_12 " name ="2313CCJdetails " rows ="5 "
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+ class ="text_input "> </ textarea >
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+ </ div >
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+
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+
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+
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+
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+
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+ < div id ="question_5 " class ="question Number RISKGROUP_ID_5593 ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Employer PAYE No:</ div >
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+ < input type ="text " id ="question_in_5 " value ="" class ="">
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+ </ div >
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+
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+
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+ < input type ="hidden " id ="trigger_LossofRent_test " name ="trigger_LossofRent " value ="">
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+ < div id ="question_wageroll " class ="question Money RISKGROUP_ID_5593 "> < input type ="hidden "
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+ id ="questionName_wageroll " class ="questionName " value ="LossofRent ">
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+ < div class ="text "> Wageroll</ div >
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+ < span class ="char_label prefix "> £</ span > < input tabindex ="1 " type ="text "
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+ id ="question_wageroll_input " name ="LossofRent " value ="0 "
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+ class ="number_input cover Money "> < span class ="char_label suffix "> </ span >
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+ < input type ="hidden " id ="question_wageroll_rate " name ="LossofRent_rate " class ="rate "
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+ value ="0 ">
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+ < input type ="hidden " id ="question_wageroll_result " name ="LossofRent_result " class ="result "
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+ value ="0 ">
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+ </ div >
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+
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+ < h1 class ="PageTitle "> Property< span class ="Multiple "> </ span > </ h1 >
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+
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+
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+ < div id ="question_23 " class ="question ">
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+ < input type ="hidden " class ="questionName " value ="">
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+ < div class ="text "> Name of Insured</ div >
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+ < input type ="text " id ="question_in_23 " value ="" class ="">
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+ </ div >
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+ < div class ="question TextArea trigger_question ">
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+ < div class ="text "> Risk Address:</ div >
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+ < textarea tabindex ="1 " id ="question_30 " rows ="5 " class ="text_input "> </ textarea >
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+ </ div >
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+
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+
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+ < div id ="question_24 " class ="question ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Approx. Year Built</ div >
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+ < input type ="text " id ="question_in_24 " value ="" class ="">
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+ </ div >
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+ < div id ="question_25 " class ="question ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> No. of Floors: </ div >
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+ < input type ="text " id ="question_in_25 " value ="" class ="">
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+ </ div >
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+ < div id ="question_26 " class ="question ">
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+ < input type ="hidden " class ="questionName " value ="">
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+ < div class ="text "> What fire prevention precautions/equipment do you have in place?</ div >
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+ < input type ="text " id ="question_in_26 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div class ="question YesNo " style ="background-image: none; background-color: rgba(0, 0, 0, 0); ">
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+ < div class ="text "> Is there any history of flood and/or subsidence or in an area susceptible to flood and/or subsidence?</ div >
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+ < label class ="check-container "> Yes
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+ < input id ="question_y_27 " type ="radio " value ="Yes " name ="question_27 ">
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ < label class ="check-container "> No
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+ < input id ="question_n_27 " type ="radio " value ="No " name ="question_27 " >
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ </ div >
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+
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+ < div id ="question_32 " class ="question YesNo ">
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+ < div class ="text "> Intruder Alarm:</ div >
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+ < label class ="radio " for ="question_y_32 ">
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+ < input tabindex ="1 " type ="radio "
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+ onclick ="this.blur(); document.getElementById('question_33').style=null "
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+ name ="question_32 " id ="question_y_32 " value ="Yes " class ="radio "> < span
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+ class ="radioMark ">
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+ </ span > Yes
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+ </ label >
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+ < label class ="radio " for ="question_n_32 "> < input tabindex ="1 " type ="radio "
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+ onclick ="this.blur(); document.getElementById('question_33').style='display: none;' "
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+ name ="question_32 " id ="question_n_32 " value ="No " checked ="checked "
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+ class ="radio "> < span class ="radioMark "> </ span > No
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+ </ label >
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+ < input type ="hidden " name ="ignore-2313disclosheader4 " value ="" class ="radio-default ">
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+ </ div >
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+ < input type ="hidden " id ="trigger_2313CCJdetails " name ="trigger_2313CCJdetails " value ="HIDDEN ">
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+ < div id ="question_33 " class ="question TextArea trigger_question RISKGROUP_ID_0 " style ="display: none; ">
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+ < div class ="text "> Fill out below:</ div >
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+ < textarea tabindex ="1 " id ="TBD " name ="2313CCJdetails " rows ="5 "
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+ class ="text_input "> </ textarea >
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+ </ div >
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+
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+ <!-- Subsection -->
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+ < div class ="question SmallTitle ">
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+ < h5 > < u > < b > Cover Required</ b > </ u > </ h5 >
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+ < div class ="info_text "> </ div >
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+ </ div >
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+
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+ < div id ="question_sum " class ="question Money RISKGROUP_ID_5593 ">
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+ < div class ="text "> Building Sum Insured </ div >
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+ < span class ="char_label prefix "> £</ span > < input tabindex ="1 " type ="text "
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+ id ="question_sum_input " name ="LossofRent " value ="0 "
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+ class ="number_input cover Money "> < span class ="char_label suffix "> </ span >
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+ </ div >
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+
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+
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+ < div id ="question_stock " class ="question Money RISKGROUP_ID_5593 ">
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+ < div class ="text "> Stock:</ div >
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+ < span class ="char_label prefix "> £</ span > < input tabindex ="1 " type ="text "
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+ id ="question_stock_input " name ="LossofRent " value ="0 "
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+ class ="number_input cover Money "> < span class ="char_label suffix "> </ span >
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+ </ div >
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+
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+
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+ < h1 class ="PageTitle "> Cyber< span class ="Multiple "> </ span > </ h1 >
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+
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+ < div class ="question YesNo " style ="background-image: none; background-color: rgba(0, 0, 0, 0); ">
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+ < div class ="text "> Please confirm whether multi-factor authentication is always enabled on all email accounts for remote access</ div >
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+ < label class ="check-container "> Yes
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+ < input id ="question_y_20 " type ="radio " value ="Yes " name ="question_20 ">
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ < label class ="check-container "> No
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+ < input id ="question_n_20 " type ="radio " value ="No " name ="question_20 " >
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ </ div >
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+
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+ < div class ="question YesNo " style ="background-image: none; background-color: rgba(0, 0, 0, 0); ">
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+ < div class ="text "> Do you maintain daily offline back-ups of all critical data?</ div >
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+ < label class ="check-container "> Yes
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+ < input id ="question_y_21 " type ="radio " value ="Yes " name ="question_21 ">
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ < label class ="check-container "> No
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+ < input id ="question_n_21 " type ="radio " value ="No " name ="question_21 " >
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ </ div >
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+
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+ < div class ="question YesNo " style ="background-image: none; background-color: rgba(0, 0, 0, 0); ">
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+ < div class ="text "> Are you compliant with the Payment Card Industry Data Security Standards</ div >
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+ < label class ="check-container "> Yes
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+ < input id ="question_y_22 " type ="radio " value ="Yes " name ="question_22 ">
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ < label class ="check-container "> No
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+ < input id ="question_n_22 " type ="radio " value ="No " name ="question_22 " >
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+ < span class ="checkmark "> </ span >
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+ </ label >
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+ </ div >
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+
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+ < div id ="question_7 " class ="question Number ">
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+ < input type ="hidden " class ="questionName " value ="2313Employees ">
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+ < div class ="text "> Please confirm the name of your Managed Service Provider (if applicable):
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+ </ div >
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+ < input type ="text " id ="question_in_7 " value ="" class ="">
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+ </ div >
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+
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+
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+ < div style ="height: 100px; "> </ div >
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+
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+
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+ </ div >
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+ </ div >
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+ </ div >
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+ </ div >
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+ </ div >
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+ </ body >
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+
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+ < script src ="main.js "> </ script >
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+
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+ </ html >
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