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<%
' Copyright © 2003 Paul Hammes
'
' declare assign variables ---------------------------------------------------------------------------------------------
'
STRcompany = Request.Form("info_company")
STRcontact = Request.Form("info_contact")
STRaddress = Request.Form("info_address")
STRcity = Request.Form("info_city")
STRstate = Request.Form("info_state")
STRzip = Request.Form("info_zip")
STRphone = Request.Form("info_phone")
STRemail = Request.Form("info_email")
STRinsurance = Request.Form("claim_ins")
STRcountry = Request.Form("claim_country")
STRlocation = Request.Form("claim_location")
STRvalue = Request.Form("claim_value")
STRestamount = Request.Form("claim_estamount")
STRcommodity = Request.Form("claim_com")
STRtext = Request.Form("textarea")
STRinscity = Request.Form("claim_city")
STRno = Request.Form("claim_no")
STRclaimper = Request.Form("claim_per")
STRclaimphone = Request.Form("claim_phone")
if Request.Form("action")= "" then
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<%
end if
' --- --- --- --- --- ----- end if action = empty
'
if Request.Form("action")= "send" then
STRregion = STRcountry
if STRregion = "austria" then
STRemailcode = 1
end if
if STRregion = "benelux" then
STRemailcode = 1
end if
if STRregion = "germany" then
STRemailcode = 1
end if
if STRregion = "spain" then
STRemailcode = 1
end if
if STRregion = "newzealand" then
STRemailcode = 1
end if
if STRregion = "portugal" then
STRemailcode = 1
end if
if STRregion = "latinamerica" then
STRemailcode = 1
end if
if STRregion = "fareast" then
STRemailcode = 1
end if
if STRregion = "china" then
STRemailcode = 1
end if
if STRregion = "india" then
STRemailcode = 1
end if
if STRregion = "seasia" then
STRemailcode = 1
end if
if STRregion = "australia" then
STRemailcode = 1
end if
if STRemailcode = 1 then
STRsendmail = "paul.hammes@eimc.com"
STRsendpers = "Paul E. Hammes"
else
STRsendmail = "tiina.medel@eimc.com"
STRsendpers = "Tiina Ruhlandt Medel"
end if
STRmessage1 = " CONTACT INFORMATION:" & vbNewLine & "Company: " & STRcompany & vbNewLine & "Contact Person: " & STRcontact & vbNewLine & STRaddress & vbNewLine & STRcity & vbNewLine & STRstate & vbNewLine & STRzip & vbNewLine & STRphone & vbNewLine & STRemail & vbNewLine & "INSURANCE INFORMATION:" & vbNewLine & "Insurance Company: " & STRinsurance & vbNewLine & "City: " & STRinscity & vbNewLine & "Country/Region: " & STRcountry & vbNewLine & "Policy/Cert No.: " & STRno & vbNewLine & vbNewLine & "LOSS INFORMATION:" & vbNewLine & "Cargo: " & STRcommodity & vbNewLine & "Location of Cargo: " & STRlocation & vbNewLine & "Contact person: " & STRclaimper & vbNewLine & "Phone number: " & STRclaimphone & vbNewLine & "$ Value: " & STRvalue & vbNewLine & "Estimated Loss Amount: " & STRestamount & vbNewLine & "Loss/Damage: " & STRtext
STRmessage2 = "** THIS IS AN AUTOMATED MESSAGE, DO NOT REPLY TO THIS EMAIL. **" & vbNewLine & "Thank you for using EIMC E-Claim online claims reporting. Your Claim request has been forwarded to our staff and someone will get back to you within one business day." & vbNewLine & vbNewLine & "Below is the information you provided please review it and make sure all information is correct." & vbNewLine & "CONTACT INFORMATION:" & vbNewLine & "Company: " & STRcompany & vbNewLine & "Contact Person: " & STRcontact & vbNewLine & STRaddress & vbNewLine & STRcity & vbNewLine & STRstate & vbNewLine & STRzip & vbNewLine & STRphone & vbNewLine & STRemail & vbNewLine & vbNewLine & "INSURANCE INFORMATION:" & vbNewLine & "Insurance Company:" & STRinsurance & vbNewLine & "City: " & STRinscity & vbNewLine & "Country/Region: " & STRcountry & vbNewLine & "Policy/Cert No.: " & STRno & vbNewLine & vbNewLine & "LOSS INFORMATION:" & vbNewLine & "Cargo: " & STRcommodity & vbNewLine & "Location of Cargo: " & STRlocation & vbNewLine & "Contact person: " & STRclaimper & vbNewLine & "Phone number: " & STRclaimphone & vbNewLine & "$ Value: " & STRvalue & vbNewLine & "Estimated Loss Amount: " & STRestamount & vbNewLine & "Loss/Damage: " & STRtext & vbNewLine & vbNewLine & "If you have any questions or concerns please contact " & STRsendpers & " at the following address: " & STRsendmail
'
'
Dim NewMailObj2
Set NewMailObj2 = Server.CreateObject("CDONTS.NewMail")
NewMailObj2.Send STRemail, STRemail, "EIMC E-Claim", STRmessage2
' the confirmation email from/to the email address supplied in the form
'
Set NewMailObj2 = Nothing
Dim NewMailObj1
Set NewMailObj1 = Server.CreateObject("CDONTS.NewMail")
NewMailObj1.Send STRemail, STRsendmail, "E-Claim", STRmessage1
' the claim email from the address supplied in the form to recipient depending on region
'
Set NewMailObj1 = Nothing
Response.Write("Thank you for your business." & vbNewLine & "A confirmation e-mail has been send to the e-mail address provided.")
end if
'
'Information work ---------------------------------------------------------------------------------------------------
'
if Request.Form("action")= "submitted" then
'display inputed information -----------------------------------------------------------------------------------------
'
'
Response.Write("CONTACT INFORMATION:
")
if STRcompany = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Company: " & STRcompany & "
")
if STRcontact = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Contact Person: " & STRcontact & "
")
if STRaddress = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Address: " & STRaddress & "
")
if STRcity = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("City: " & STRcity & "
")
if STRstate = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("State: " & STRstate & "
")
if STRzip = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Zip Code: " & STRzip & "
")
if STRphone = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Phone number: " & STRphone & "
")
if STRemail = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("E-mail: " & STRemail & "
")
Response.Write("INSURANCE INFORMATION:
")
if STRinsurance = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Insurance Company: " & STRinsurance & "
")
if STRinscity = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("City: " & STRinscity & "
")
if STRcountry = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Country/Region: " & STRcountry & "
")
if STRno = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Policy/Certificate No.: " & STRno & "
")
Response.Write("LOSS INFORMATION:
")
if STRcommodity = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Cargo: " & STRcommodity & "
")
if STRlocation = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Location of Cargo: " & STRlocation & "
")
if STRvalue = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Contact Person: " & STRclaimper & "
")
if STRvalue = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Phone number: " & STRclaimphone & "
")
if STRvalue = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Value of Shipment: " & STRvalue & "
")
if STRestamount = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Estimated Loss Amount: " & STRestamount & "
")
if STRtext = "" then
STRcolor = "FF0000"
STRerror = 1
else
STRcolor = "000000"
end if
Response.Write("Loss/Damage: " & STRtext & "
")
Response.Write("
")
' if error ------------------------------------------------------------------------------------------------------------
'
if STRerror = 1 then
Response.Write("Please Re-enter the following information:")
%>
<%
' If no error -----------------------------------------------------------------------------------------------------
'
else
'
'
%>
<%
end if
' (above) end if no error
'
end if
' (above) end if action = submitted
'
%>
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