document.write("<center>")
// Put the VeriPay URL here:
document.write("<form name='orderform' action='http://secure.xilo.com/veripay/veripay.xilo' method=post>")

document.write("<table>");

document.write("<tr class='head'><td><b>Image</b></td><td width=100><b>Code</b></td><td width=200><b>Description</b></td><td width=70><b>Each</b></td><td width=50><b>Qty</b></td><td width=100><b>Amount</b></td></tr>");

for(i=0; i<maxitems; i++)
{
	if( code[i] == "" ) break;

	document.write("<tr class='body'><td>")

	if( image[i] != "" )
	{
		if( url[i] != "" ) document.write("<a href='" + url[i] + "'>")
		document.write("<img src='" + image[i] + "' border=0>")
		if( url[i] != "") document.write("</a>")
	}
	else document.write("&nbsp;")
	
	document.write("</td><td>")
	
	if( url[i] != "" ) document.write("<a href='" + url[i] + "'>")
	
	document.write(code[i])
	
	if( url[i] != "" ) document.write("</a>")
	
	if( code[i] == "FRT" ) {
		document.write("</td><td>" + desc[i] + "</td><td> $" + price[i] + "</td><td><input size=3 maxlength=3 value=1 disabled'></td><td>$<input size=9 value='0.00' disabled></td></tr>");
	} else {
		document.write("</td><td>" + desc[i] + "</td><td> $" + price[i] + "</td><td><input size=3 maxlength=3 value=0 onChange='calculate()'></td><td>$<input size=9 value='0.00' disabled></td></tr>");
	}
}

document.write("<tr class='high'><td>&nbsp;</td><td colspan=4><b>Total</b></td><td><font size=+1>$</font><input name=total size=9 value='0.00' disabled></td></tr>");
document.write("<input type=hidden name='merchantID' value='" + merchantID + "'>");

document.write("<tr class='body'><td>&nbsp;</td><td colspan=5>")

document.write("<table>")
document.write("<tr><td>Contact Name:</td><td><input size=22 maxlength=40 name='CustName'></td></tr>")
document.write("<tr><td>Email:</td><td><input size=22 maxlength=50 name='CustEmailAddr'></td></tr>")
document.write("<tr><td>Telephone:</td><td><input size=22 name='CustomerPhone'></td></tr>")
document.write("<tr><td valign=top>Shipping Address:</td>")
document.write("<td><textarea name='ShipAddress' cols=24 rows=5></textarea></td></tr>")
document.write("<tr><td>&nbsp;</td><td><input type=button value='Order Now' onClick='go_veripay()'></td></tr>")
document.write("</table>")

document.write("</td></tr>")
document.write("</table>")
document.write("</center>")

document.write("<input type=hidden name='TaxRate' value='10'>")
document.write("<input type=hidden name='AmountCents'>")
document.write("<input type=hidden name='HiddenRef'>")
document.write("<input type=hidden name='Description' value='" + tx_description + "'>")
document.write("<input type=hidden name='CustAddress'>")
document.write("</form>")

calculate();