What do you have in mind for the style and theme of the landing page?
Colors that match our logo. I like the colors of the sample as well.
Elements to include in the landing page
Please include a form like the attached sample page.
Also a nice large area for a phone number. Add the trust factors, add our logo. Please look at sample - we do provide the same service that this company does. Including the (we put you here area) expect for the reachlocal part.