<script src='https://www.google.com/recaptcha/api.js'></script>
<div class="modal-header">
    <button type="button" class="close" data-dismiss="modal">&times;</button>
    <h2 class="modal-title">Feedback</h2>
    <!--Click to select if we Exceeded, Met or Did Not meet your Expectations-->
</div>

<div id="displayMsg"></div>
    <form id="feedback-form" method="post" autocomplete="off" action="<?php echo $this->url('submit-feedback'); ?>">
    <div class="modal-body" style="height:500px; overflow:scroll;">
        <div class="row" style="padding:0 15px;">
            <div class="col-sm-12 plan price-one " style="background:#EFEFEF;">

                <div class="col-lg-12 feedback">
                    <label class="col-sm-12" style="text-align:left;">1. RESERVATION:- </label>
                    <div class="col-sm-3" >
                        Reservation is done through
                    </div>

                    <div class="col-sm-3" >
                        <input type="radio" name="reservation" value="website" checked="checked"/> Website
                    </div>

                    <div class="col-sm-3" >
                        <input type="radio" name="reservation" value="android_application" /> Android Application
                    </div>

                    <div class="col-sm-3" >
                        <input type="radio" name="reservation" value="call_center"/> Call Center
                    </div>
                </div>

                <div class="box website" style="display:block;">
                    <div class="col-lg-12 feedback">
                        <label class="col-sm-12" style="text-align:left;">
                            <strong> Website</strong>  </label>
                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate the booking process</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="web_booking_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="web_booking_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="web_booking_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="web_booking_rate" />Very Good</label>
                        </div>
                    </div>

                    <div class="col-lg-12 feedback">
                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate the confirmation process
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="web_confirm_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="web_confirm_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="web_confirm_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="web_confirm_rate" />Very Good</label>
                        </div>
                    </div>

                    <div class="col-lg-12 feedback">
                        <div class="col-sm-5" >
                            <label class="col-sm-12">Rate the process on Website</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="web_process_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="web_process_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="web_process_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="web_process_rate" />Very Good</label>
                        </div>
                    </div>

                    <div class="col-lg-12 feedback">
                        <div class="col-sm-5" >
                            <label class="col-sm-12">Over all how would you rate our services</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="web_service_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="web_service_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="web_service_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="web_service_rate" />Very Good</label>

                        </div>


                    </div>

                </div>

                <div class="box mobileaap">
                    <div class="col-lg-12 feedback">
                        <label class="col-sm-12" style="text-align:left;">
                            <strong>Android Application</strong>  </label>
                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate our App</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="android_app_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="android_app_rate" /> Average </label>
                            <label class="col-sm-3"><input type="radio" value="Good" name="android_app_rate" checked="checked"/> Good</label>
                            <label class="col-sm-3"><input type="radio" value="Very Good" name="android_app_rate" />Very Good</label>
                        </div>
                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate the booking process</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="android_booking_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="android_booking_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="android_booking_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="android_booking_rate" />Very Good</label>
                        </div>


                    </div>

                    <div class="col-lg-12 feedback">
                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate the confirmation process
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="android_confirm_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="android_confirm_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="android_confirm_rate" checked="checked"  /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="android_confirm_rate" />Very Good</label>

                        </div>
                    </div>

                    <div class="col-lg-12 feedback">
                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                Over all how would you rate our services
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="android_service_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="android_service_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="android_service_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="android_service_rate" />Very Good</label>
                        </div>
                    </div>

                </div>


                <div class="box callcenter">
                    <div class="col-lg-12 feedback">
                        <label class="col-sm-12" style="text-align:left;">
                            <strong>Call Center </strong>  </label>
                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate the booking process</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="call_book_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="call_book_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="call_book_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="call_book_rate" />Very Good</label>
                        </div>
                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate  our agent  to answer your question</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="call_agent_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="call_agent_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="call_agent_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="call_agent_rate" />Very Good</label>
                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">How do you rate our  agent to follow your instructions</label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="call_instruction_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="call_instruction_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="call_instruction_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="call_instruction_rate" />Very Good</label>
                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate the confirmation process
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="call_confirmation_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="call_confirmation_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="call_confirmation_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="call_confirmation_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                Over all how would you rate our services
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="call_services_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="call_services_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="call_services_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="call_services_rate" />Very Good</label>

                        </div>


                    </div>

                </div>



                <div class="col-lg-12 feedback">

                    <label class="col-sm-12" style="text-align:left;">
                        2. VEHICLES:- </label>

                </div>

                <div class="">
                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate the reporting of vehicle
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="vehicle_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="vehicle_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="vehicle_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="vehicle_rate" />Very Good</label>

                        </div>






                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate the vehicle as requested
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="requested_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="requested_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="requested_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="requested_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How was your special instructions followed
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="instruction_follow_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="instruction_follow_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="instruction_follow_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="instruction_follow_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How was the vehicle condition
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="vehicle_condition" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="vehicle_condition" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="vehicle_condition" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="vehicle_condition" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How was the Air-Conditioning effective
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="aircondition_effective_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="aircondition_effective_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="aircondition_effective_rate" checked="checked"  /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="aircondition_effective_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How was the cleanness and tidy of vehicle
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="cleanness_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="cleanness_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="cleanness_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="cleanness_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How Was the uniform and grooming
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="grooming_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="grooming_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="grooming_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="grooming_rate" />Very Good</label>

                        </div>


                    </div>

                </div>

                <div class="col-lg-12 feedback">

                    <label class="col-sm-12" style="text-align:left;">
                        2. BILLING:- </label>

                </div>

                <div class="">
                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate  the billing accuracy
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="accuracy_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="accuracy_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="accuracy_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="accuracy_rate" />Very Good</label>

                        </div>






                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How do you rate receiving  invoice on time
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="invoice_time_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="invoice_time_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="invoice_time_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="invoice_time_rate" />Very Good</label>

                        </div>



                    </div>

                    <div class="col-lg-12 feedback">

                        <div class="col-sm-5" >
                            <label class="col-sm-12">
                                How will you rate your receiving invoice
                            </label>
                        </div>

                        <div class="col-sm-6" >
                            <label class="col-sm-3"><input type="radio" value="Bad" name="receivingInv_rate" /> Bad </label>
                            <label class="col-sm-3"><input type="radio" value="Average" name="receivingInv_rate" /> Average </label>
                            <label class="col-sm-3"> <input type="radio" value="Good" name="receivingInv_rate" checked="checked" /> Good</label>
                            <label class="col-sm-3"> <input type="radio" value="Very Good" name="receivingInv_rate" />Very Good</label>

                        </div>


                    </div>

                    <div class="col-lg-12 feedback">

                    <div class="col-sm-5">
                        <div class="g-recaptcha" data-sitekey="<?php echo $captchaKey; ?>"></div>
                        <div class="captcha-error" style="color:#a94442;"><?php echo $this->error; ?></div>
                    </div>

                    </div>

                    <div class="col-sm-12">
                    <div class="col-lg-12" style="color:#000; text-align:center;">
                        <!-- <a href="#topheader" class="btn btn-primary"  role="button" id="local" onclick="booking_local();">Submit</a> -->
                        <input type="submit" value="submit" name="submit" class="btn btn-primary" onclick="submitForm('#feedback-form', event);">
                    </div>
                </div>

                </div>
            </div>
        </div>
    </div>
</form>
<div class="modal-footer" style=" padding-top:2px !important;">
    <button type="button" class="btn btn-default" data-dismiss="modal">Close</button>
</div>