<!DOCTYPE html>

<html>

<head>



	<!-- Title Tags

  	================================================== -->

	<meta charset="utf-8">

	<title>Bin There Dump That</title>

	<meta name="description" content="">

	<meta name="keywords" content="">



	<!-- CSS

  	================================================== -->

	<link rel="stylesheet" href="stylesheets/style.css">



	<!--[if lt IE 9]>

		<script src="https://html5shim.googlecode.com/svn/trunk/html5.js"></script>

	<![endif]-->



	<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">



</head>

<body>







	<!-- Container

	================================================== -->

	<div class="container">



		<!-- Logo

		================================================== -->

		<div class="logo">

			<img src="images/logo.png" alt="Bin There Dump That">

		</div><!-- End Logo -->



		<!-- Navigation

		================================================== -->

		<nav id="nav-wrap">



			<?php include("_menu.php"); ?>



		</nav><!-- End Navigation -->



		<!-- Content

		================================================== -->

		<div class="content">



			<h2 class="franchise">Order a Bin</h2>



			<h3 class="click-call"><a href="tel:985-327-7644">Click to Call</a></h3>



				<SCRIPT src="https://www.netvatise.com/validate.js" language="JavaScript" type="text/javascript"></SCRIPT>

				<form class="contact" action="confirm.php" method="POST" name="form">

								

				<label for="field[Name]">Name: <span style="color:red;">*</span></label>

				<input type="text" name="field[Name]" class="required" value="" />

						

				<label for="field[Email]">Email Address: <span style="color:red;">*</span></label>

				<input type="text" name="field[Email]" class="required" value="" />

										

				<label for="field[Phone Number]">Phone Number: <span style="color:red;">*</span></label>

				<input type="text" name="field[Phone Number]" class="required" value="" />

				

				<label for="field[Phone Number]">City: <span style="color:red;">*</span></label>

				<input type="text" name="field[City]" class="required" value="" />

						

				<label for="comments">Comments:</label>

				<textarea name="field[Comments]"></textarea>

						

				<input type="submit" name="submit" id="send_message" class="submitButton" value="Submit" />

				<input type="hidden" name="Subject" value="Order Bin" />

				

				</form>



		</div><!-- End Content -->



		<!-- Footer

		================================================== -->

		<footer>

			<p>&copy;<?php echo date("Y"); ?> Copyright. All Rights Reserved.<br>

				Website created by <a href="https://netvatise.com">Netvatise</a> | <a href="https://www.neworleansdumpsterrental.com/index.php?type=full">View Full Site</a></p>

		</footer><!-- End Footer -->

		

	</div><!-- End Container -->







	<!-- JS

	================================================== -->

	<script src="https://code.jquery.com/jquery-1.7.1.min.js"></script>

	<script src="javascripts/tabs.js"></script>

	<script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.7/jquery.min.js"></script>

	<script type="text/javascript">

		jQuery(document).ready(function($){



			/* prepend menu icon */

			$('#nav-wrap').prepend('<div id="menu-icon-green"><img src="images/navigation-bg.png" alt="Navigation"> Menu</div>');

			

			/* toggle nav */

			$("#menu-icon-green").on("click", function(){

				$("#nav").slideToggle();

				$(this).toggleClass("active");

			});



		});

	</script>



<!-- End Document

================================================== -->

</body>

</html>