Write a simple iPhone, Android, and Windows application

We need a mobile application developed for use on iOS, Android, and Windows Mobile (phone gap is an acceptable solution) and submitted to all three app stores. We currently have development accounts for all 3 platforms, but will need you to submit the application to each market and make sure it meets any application restrictions. The application will be simple and will have essentially the same functionality as [login to view URL] allowing the user to process a fuel order with their customer number, location number, email, and phone number. The form data will be delivered via email to a company admin where they can contact the customer to confirm the order. In addition to the application an admin site page will need to be developed and be password protected, page concept is attached as (settings [login to view URL]). This admin page will need to allow the company admin to set weekend and weekday hours of operation times and phone numbers to be used on the "off hours" order screens details below. The application will need the following screens with the functionality as described: Splash screen (Splash [login to view URL] ) - The start screen which should be displayed as the application is loading Order form (Easy Order [login to view URL]) - Unless it is “after hours” (details below) this will the the screen displayed once the application loads - Customer Number will allow for data entry but display the last numbered entered - Location Number will allow for data entry but display the last numbered entered as well as a drop down option to display all numbers entered - Single and Recurring will be radio buttons with only one option selectable at a time - Email and phone number will both validate for appropriate information and will display the last data entered - Additional comments will be a text block - All fields with the exception of “additional comments” are required - When the user selects "send", all fields will be delivered via email Thank you screen (Thank [login to view URL]) - This screen will display after a successful form submit - “Send Another Order” will bring the user back to “Easy Order Form” screen - if the app is exited on this screen and reopened the “splash screen” or “Easy Order Form” screen will be displayed After Hours Order Form and Weekend Order Form (After Hours Order [login to view URL] and Weekend Order [login to view URL]) - During the times set on the settings admin webpage (settings [login to view URL]) this screen will be displayed once the application loads instead of the order form - Click here will automatically dial a 1-800 number which is set in the settings admin webpage For review purposes we would like to focus on iOS first and finalize any design and functionality before creating the android and windows versions.