Data-Form/Application

We need an Insurance quote interface similar to that of Insureme.com. Our home page and various other pages will have a generic form asking the type of insurance a customer is interested in and zip code. The type of insurance will be chosen from a drop down menu which will need to forward the customer to an applicable Quote Form upon clicking Submit. The Zip Code will also need to auto fill for the customer in the applicable quote form. The quote forms themselves will need to add/remove questions based on answers provided by customers. The questions will need to be broken down into sections and a meter should show the customer how far along they are in the questionnaire. Additionally, incorrect answer formatting will need to be validated before proceeding to the next section of the quote form. Additionally, the form process will need to be protected by SSL. Specifically, we need an Insurance Quote Form for each of the following types of insurance: Health, Auto, Home, Renters, Motorcycle, Life, Long-Term Care Each quote form needs to record data entry into a database and automatically email the information to a specified email address. Specific information will be provided for what information we need to gather in each quote form. Additionally, we will need the quote forms to be installed in an existing web page to ensure the site is aesthetically appealing. Functionality is a must. Again, a perfect example of what we are looking for is the quote system used by [login to view URL] and other websites alike. The second phase of the project is an admin interface in which the data from the quote forms can be assigned to user accounts and managed in an admin setting. This phase will be contracted after the customer quote forms are completed. We would like to contract to the same person for both projects but separately.