ロケバスレンタル備品・消耗品 お見積りフォーム
meta-creation_date: 2017-06-19T15:49:33+09:00


<!--preface:ロケバスレンタル備品・消耗品 お見積りフォーム。株式会社城南交通ではロケーション活動中に必要と思われる各種レンタル備品を多数ご用意いたしました。 -->
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<form class="form-inline" id="mailformpro" name="mailformpro" action="//www.jonan-kotsu.com/
mailformpro/mailformpro.cgi" method="POST">
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<table class="mailform table table-striped table-hover customer" summary="mailform main">
<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
御社名/氏名
</th>
<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="text" name="御社名／ご担当者氏名" onkeyup="inputTyping(this.form.id,'フリガナ',event.keyCode,this)" required="required" />
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<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
フリガナ
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<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="text" name="フリガナ" required="required" />
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<div id="errormsg_フリガナ" class="mfp_err"></div>
</td>
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<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
Eメール</th>
<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="email" data-type="email" name="email" required="required" />
</div>
<div id="errormsg_email" class="mfp_err"></div>
</td>
</tr>
<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
確認のためもう一度</th>
<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="email" data-type="email" name="confirm_email" required="required" />
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<div id="errormsg_confirm_email" class="mfp_err"></div>
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<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
お電話番号</th>
<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="tel" data-type="tel" name="電話番号" required="required" />
</div>
<div id="errormsg_電話番号" class="mfp_err"></div>
</td>
</tr>
<tr class="mfptr">
<th>FAX番号</th>
<td>
<div class="okarea maxwidth">
<input class="form-control mfp" type="text" name="FAX番号" />
<div>
</td>
</tr>
<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
ご希望連絡方法</th>
<td>
<div class="okarea">
<select class="form-control mfp" name="ご希望連絡方法" required="required">
<option value="">選択してください。</option>
<option value="お電話">お電話</option>
<option value="FAX">FAX</option>
<option value="Eメール">Eメール</option>
</select>
</div>
<div id="errormsg_ご希望連絡方法" class="mfp_err"></div>
</td>
</tr>

<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
ご利用開始日</th>
<td>
<div class="okarea"><script type="text/javascript" src="//www.jonan-kotsu.com/js/start_date.js"></script></div>
<div id="errormsg_開始日" class="mfp_err"></div>
<div id="errormsg_最終日" class="mfp_err"></div>
</td>
</tr>
</table>
</div>


<h2 class="text-center marginbottom20">レンタル備品</h2>
<p class="text-center">{(単価×数量)＋(単価×数量)..}×日数 となります</p>

<input type="hidden" name="mfp_separator_r2" value="" />

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover customer" summary="mailform main">
<tr>
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>レンタル期間
</th>
<td>

<div class="okarea">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="レンタル期間" required="required"　data-format="$1日">



<!--
<select class="form-control" name="レンタル期間" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onBlur="keisan()" onchange="keisan()" required="required" data-format="$1日">
<option value="" selected>ご利用期間を選択してください。</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
</select>
-->
</div> 日
</td>
</tr>
</table>
</div>

<input type="hidden" name="mfp_separator_r3" value="" />

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover center" summary="mailform main">
<thead>
<tr>
<th class="center cell1">品名</th>
<th class="center cell2">単価</th>
<th class="center cell3">数量</th>
<th class="center cell4 hidden-xs">金額</th>
</tr>
</thead>
<tbody>
<tr>
<td>R001／ルーフキャリア（リヤ梯子付き）</td>
<td align="right">5400円</td>
<td class="nowrap">
<select class="form-control em" name="R001／ルーフキャリア（リヤ梯子付き）" onBlur="keisan()" onChange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental001f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R002／発電機（1500W）</td>
<td align="right">3240円</td>
<td class="nowrap">
<select class="form-control em" name="R002／発電機（1500W）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental002f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R003／発電機（2000W）</td>
<td align="right">5400円</td>
<td class="nowrap">
<select class="form-control em" name="R003／発電機（2000W）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental003f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R004／補給用ガソリンタンク</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R004／補給用ガソリンタンク" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental004f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R005／トランシーバー（登録局5W）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R005／トランシーバー（登録局5W）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental005f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R006／サロンテーブル後席用</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R006／サロンテーブル後席用" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental006f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R007／IHコンロ（1350W）</td>
<td align="right">4,320円</td>
<td class="nowrap">
<select class="form-control em" name="R007／IHコンロ（1350W）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental007f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R008／コーヒーメーカー（クイジナート製）</td>
<td align="right">5,400円</td>
<td class="nowrap">
<select class="form-control em" name="R008／コーヒーメーカー（クイジナート製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental008f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R009／コーヒーメーカー（カリタ製）</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R009／コーヒーメーカー（カリタ製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental009f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R010／湯沸かし器（ティファール製）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R010／湯沸かし器（ティファール製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental010f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R011／保温ポット（魔法瓶1.8L）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R011／保温ポット（魔法瓶1.8L）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental011f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R012／保温ポット（魔法瓶1.0L）</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R012／保温ポット（魔法瓶1.0L）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental012f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R013／折りたたみ自転車</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R013／折りたたみ自転車" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental013f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R014／アルミ脚立（10尺）</td>
<td align="right">5,400円</td>
<td class="nowrap">
<select class="form-control em" name="R014／アルミ脚立（10尺）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental014f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R015／アルミ脚立（6尺）</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R015／アルミ脚立（6尺）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental015f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R016／アルミ脚立（4尺）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R016／アルミ脚立（4尺）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental016f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R017／イージーアップテント（2m×2m）</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R017／イージーアップテント（2m×2m）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1張">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 張
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental017f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R018／パラソル（1.5m）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R018／パラソル（1.5m）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1本">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental018f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R019／ステップ（高さ20cm）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R019／ステップ（高さ20cm）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental019f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R020／クーラーボックス（特大・キャスター付き）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R020／クーラーボックス（特大・キャスター付き）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental020f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R021／クーラーボックス（大）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R021／クーラーボックス（大）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental021f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R022／クーラーボックス（小）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R022／クーラーボックス（小）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental022f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R023／姿見（ライト付き）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R023／姿見（ライト付き）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental023f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R024／姿見（ライト無し）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R024／姿見（ライト無し）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental024f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R025／卓上鏡（LEDライト付）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R025／卓上鏡（LEDライト付）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental025f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R026／卓上鏡（ライト無し）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R026／卓上鏡（ライト無し）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental026f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R027／メイク台（40cm×50cm）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R027／メイク台（40cm×50cm）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental027f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R028／メイク台（45.5cm×70cm）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R028／メイク台（45.5cm×70cm）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental028f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R029／折りたたみ長机（W1m80cm×D45cm）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R029／折りたたみ長机（W1m80cm×D45cm）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental029f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R030／丸テーブル（1m・プラスチック製）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R030／丸テーブル（1m・プラスチック製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental030f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R031／ディレクターズチェア</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R031／ディレクターズチェア" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental031f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R032／折りたたみパイプ椅子</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R032／折りたたみパイプ椅子" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental032f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R033／パイプ丸椅子</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R033／パイプ丸椅子" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1脚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
</select> 脚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental033f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R034／箱馬</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R034／箱馬" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental034f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R035／ワークライト（500W）</td>
<td align="right">1080円</td>
<td class="nowrap">
<select class="form-control em" name="R035／ワークライト（500W）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental035f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R036／大型懐中電灯（防水LED製）</td>
<td align="right">1,620円</td>
<td class="nowrap">
<select class="form-control em" name="R036／大型懐中電灯（防水LED製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental036f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R037／クリップライト（LED製）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R037／クリップライト（LED製）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental037f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>


<tr>
<td>R038／パイプハンガーラック</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R038／パイプハンガーラック" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental038f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R039／灰皿缶（ガンガン）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R039／灰皿缶（ガンガン）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental039f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R040／台車（耐荷重300kg）</td>
<td align="right">2,160円</td>
<td class="nowrap">
<select class="form-control em" name="R040／台車（耐荷重300kg）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental040f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R041／台車（耐荷重150kg）</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R041／台車（耐荷重150kg）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1台">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 台
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental041f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R042／ロングベンチコート</td>
<td align="right">1,080円</td>
<td class="nowrap">
<select class="form-control em" name="R042／ロングベンチコート" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1着">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 着
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental042f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R043／LED誘導棒（ニンジン）</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R043／LED誘導棒（ニンジン）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental043f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R044／コードリール4個口</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R044／コードリール4個口" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental044f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R045／防水コードリール4個口</td>
<td align="right">756円</td>
<td class="nowrap">
<select class="form-control em" name="R045／防水コードリール4個口" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental045f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R046／電動ドライバー（充電器付き）</td>
<td align="right">3,240円</td>
<td class="nowrap">
<select class="form-control em" name="R046／電動ドライバー（充電器付き）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental046f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R047／ブルーシート</td>
<td align="right">540円</td>
<td class="nowrap">
<select class="form-control em" name="R047／ブルーシート" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental047f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R048／ウエイト（砂袋）</td>
<td align="right">324円</td>
<td class="nowrap">
<select class="form-control em" name="R048／ウエイト（砂袋）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1袋">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 袋
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental048f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R049／スコップ</td>
<td align="right">324円</td>
<td class="nowrap">
<select class="form-control em" name="R049／スコップ" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1本">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental049f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R050／のこぎり</td>
<td align="right">324円</td>
<td class="nowrap">
<select class="form-control em" name="R050／のこぎり" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1本">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental050f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R051／くわ</td>
<td align="right">324円</td>
<td class="nowrap">
<select class="form-control em" name="R051／くわ" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1本">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental051f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R052／パイロン</td>
<td align="right">216円</td>
<td class="nowrap">
<select class="form-control em" name="R052／パイロン" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental052f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R053／養生用毛布</td>
<td align="right">324円</td>
<td class="nowrap">
<select class="form-control em" name="R053／養生用毛布" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental053f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R054／ブランケット（ひざ掛け）</td>
<td align="right">216円</td>
<td class="nowrap">
<select class="form-control em" name="R054／ブランケット（ひざ掛け）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental054f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>R055／
ほうき・ちりとり</td>
<td align="right">324円</td>
<td class="nowrap">

<input name="R055／ほうき・ちりとり" size="8" class="form-control mfp_element_number mfp_element_all" type="number" onblur="keisan()" onchange="keisan()" data-format="$1組">
<!--
<select class="form-control em" name="R055／ほうき・ちりとり" onchange="keisan()" data-format="$1組">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
</select> 組
-->

</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="rental055f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
</tbody>
</table>

<table class="mailform table table-striped table-condensed table-hover center marginbottom30" summary="mailform main">
<tbody>
<tr>
<td class="text-right nowrap">
<strong>合計</strong>
<input class="form-control sm" type="text" name="レンタル備品合計" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
<tr>
<td class="text-right nowrap">
<strong>合計×日数</strong>
<input class="form-control sm" type="text" name="レンタル料金合計" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
</tbody>
</table>
</div>

<h2 class="text-center marginbottom20">消耗品（単価×数量となります。）</h2>
<input type="hidden" name="mfp_separator_r4" value="">

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover center marginbottom30" summary="mailform main">
<thead>
<tr>
<th class="center cell1">品名</th>
<th class="center cell2">単価</th>
<th class="center cell3">数量</th>
<th class="center cell4 hidden-xs">金額</th>
</tr>
</thead>
<tbody>
<tr>
<td>E001／フェイスタオル（新品）</td>
<td>324円</td>
<td class="nowrap">
<select class="form-control em" name="E001／フェイスタオル（新品）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="expendable001f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>E002／バスタオル（新品）</td>
<td>1,080円</td>
<td class="nowrap">
<select class="form-control em" name="E002／バスタオル（新品）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="expendable002f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>E003／ウエス（新品）</td>
<td>108円</td>
<td class="nowrap">
<select class="form-control em" name="E003／ウエス（新品）" onclick="keisan()" onmouseout="keisan()" onmousedown="keisan()" onblur="keisan()" onchange="keisan()" data-format="$1枚">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 枚
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="expendable003f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>E004／紙コップ（100個入り）</td>
<td>540円</td>
<td class="nowrap">
<select class="form-control em" name="E004／紙コップ（100個入り）" onclick="keisan()" onmouseout="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select> 個
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="expendable004f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>E005／カセットボンベ（カセットコンロ用）</td>
<td>324円</td>
<td class="nowrap">
<select class="form-control em" name="E005／カセットボンベ（カセットコンロ用）" onclick="keisan()" onmouseout="keisan()" onchange="keisan()" data-format="$1個">
<option value="" selected>選択</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
</select> 個
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="expendable005f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

</tbody>
</table>
</div>


<h2 class="text-center marginbottom20">ドリンク類（単価×数量となります。）</h2>
<input type="hidden" name="mfp_separator_r5" value="">

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover center" summary="mailform main">
<thead>
<tr>
<th class="center cell1">品名</th>
<th class="center cell2">単価</th>
<th class="center cell3">数量</th>
<th class="center cell4 hidden-xs">金額</th>
</tr>
</thead>
<tbody>
<tr>
<td>D001／ミネラルウオーター（500ml）</td>
<td>110円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D001／ミネラルウオーター（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink001f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D002／炭酸ジュース（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D002／炭酸ジュース（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink002f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D003／オレンジジュース（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D003／オレンジジュース（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink003f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D004／お茶（綾鷹・500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D004／お茶（綾鷹・500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink004f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D005／お茶（爽健美茶・500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D005／お茶（爽健美茶・500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink005f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D006／お茶（サントリー伊右衛門・500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D006／お茶（サントリー伊右衛門・500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink006f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D007／お茶（サントリー烏龍茶・500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D007／お茶（サントリー烏龍茶・500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink007f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D008／コカ・コーラ（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D008／コカ・コーラ（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink008f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D009／アクエリアス（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D009／アクエリアス（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink009f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D010／オランジーナ（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D010／オランジーナ（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink010f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D011／レモンジーナ（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D011／レモンジーナ（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink011f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D012／CCレモン（500ml）</td>
<td>150円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D012／CCレモン（500ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink012f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D013／オロナミンC（120ml）</td>
<td>110円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D013／オロナミンC（120ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink013f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D014／レッドブル（185ml）</td>
<td>300円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D014／レッドブル（185ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink014f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D015／缶コーヒー（ブラック・190ml）</td>
<td>130円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D015／缶コーヒー（ブラック・190ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink015f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D016／缶コーヒー（ミルク砂糖入り・190ml）</td>
<td>130円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D016／缶コーヒー（ミルク砂糖入り・190ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink016f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D017／カフェオレ（190ml）</td>
<td>130円</td>
<td class="nowrap">
<input type="text" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D017／カフェオレ（190ml）" data-format="$1本"> 本
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink017f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>

<tr>
<td>D018／氷（ロックアイス）</td>
<td>200円</td>
<td class="nowrap">
<input type="text" maxlength="1" class="form-control em positive-integer antirc" pattern="[0-9]*" onKeyup="this.value=this.value.replace(/^[0]\d*$/,'');keisan()" onchange="keisan()" name="D018／氷（ロックアイス）" data-format="$1袋"> 袋
</td>
<td class="hidden-xs nowrap">
<input class="form-control em" type="text" id="drink018f" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
</tbody>
</table>

<table class="mailform table table-striped table-condensed table-hover center" summary="mailform main">
<tbody>
<tr>
<td class="text-right"><strong>消耗品・ドリンク類合計</strong>
<input class="form-control" type="text" name="消耗品・ドリンク類合計" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
</tbody>
</table>

</div>


<h2 class="text-center marginbottom20">概算御見積料金</h2>

<input type="hidden" name="mfp_separator_r6" value="">
<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover" summary="mailform main">
<tr>
<td class="text-center"><button type="button" onclick="keisan()" class="button button-moema button-size-m marginleft5 marginright5 margintop1em">再計算する</button>
</td>
</tr>
<tr>
<td class="text-center">
<strong>概算御見積料金</strong>
<input class="form-control" type="text" name="概算御見積料金" size="8" value="0" data-format="$1円" readonly="readonly"> 円
</td>
</tr>
</table>
</div>

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover customer" summary="mailform main">
<tr>
<th>その他</th>
<td>
<textarea class="form-control mfp" name="その他" rows="10" cols="60">
</textarea>
<div id="errormsg_その他" class="mfp_err"></div>
</td>
</tr>
</table>
</div>

<div class="marginbottom40">
<table class="mailform table table-striped table-condensed table-hover customer" summary="mailform main">
<tr class="mfptr">
<th>
<span class="h4label label label-danger pull-left" style="margin-top:0;">必須</span>
送信確認</th>
<td>
<label class="mfp">
<input id="kakunin" type="checkbox" required="required" data-exc="1" name="送信確認" value="送信チェック済み">上記送信内容を確認したら<br class="hidden-sm hidden-md hidden-lg" />チェックを入れてください</label>
<div id="errormsg_送信確認" class="mfp_err"></div>
</td>
</tr>
</table>
</div>


<div class="mfp_buttons clearfix">
<button type="reset" value="リセットする" class="button button-moema button-size-m marginleft5 marginright5">リセット</button>
<button type="submit" value="送信する" class="button button-moema button-size-m marginleft5 marginright5">送信する</button>
</div>

</form>

<script type="text/javascript" id="mfpjs" src="//www.jonan-kotsu.com/
mailformpro/mailformpro.cgi" charset="UTF-8"></script>
<!--[ここまでメールフォームプロ・本体]-->

</section>
</div>