<?php

echo
'
<style>

.request-quotation{
border:solid 0px red;
width:90%;
}

.request-quotation form{
}

.request-quotation .asterisk{
color:red;
}

.request-quotation table{
border:solid 1px #eee;
}

.request-quotation table tr{
border-bottom:solid 1px #eee;
}

.request-quotation table td{
padding:10px;
}

.request-quotation table td.label-field{
width:250px;
}

.request-quotation table td.input-field{
width:500px;
display:block;
border:solid 0px red;
}

.request-quotation table td.input-field input[type="text"],
.request-quotation table td.input-field select,
.request-quotation table td.input-field textarea
{
width:90%;
display:block;
padding:7px;
}

.request-quotation table td.input-field .btn-submit-quotation,
.request-quotation table td.input-field input[type="submit"]{

width:50%;
padding:7px;

}

</style>

<div class="request-quotation">

<!--<h2>REQUEST QUOTATION</h2>-->
<p>
If you would like to receive product pricing information, please complete the form below. A Myers Power Products, Inc. representative
will contact you as soon as your request has been evaluated.
</p>
<br/>

<form method="post" action="?option=com_content&view=article&id=884">

<table>

<tr>
<td class="label-field">Required Fields <span class="asterisk">*</span></td>
<td class="input-field">&nbsp;</td>
</tr>

<tr>
<td class="label-field">Full Name <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="full-name" id="full-name" required></td>
</tr>

<tr>
<td class="label-field">Company Name <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="company-name" id="company-name" required></td>
</tr>

<tr>
<td class="label-field">Products <span class="asterisk">*</span></td>
<td class="input-field">
<select name="products" id="products" required>
<option selected="selected" value="">- Select Product -</option>
<option value="quote_pdc">Power Distribution Centers</option>
<option value="quote_enclosures">Custom Enclosures</option>
<option value="quote_medvoltage">Medium Voltage AC Power Solutions</option>
<option value="quote_breakers">Myers Circuit Breakers</option>
<option value="quote_lvswitchgear">Low Voltage Switchgear</option>
<option value="quote_lvpanels">Low Voltage Switchboards &amp; Panelboards</option>
<option value="quote_transit">Solutions for Transit</option>
<option value="quote_dcpower">DC Power Solutions (Non-Backup)</option>
<option value="quote_peds">Service Pedestals</option>
<option value="quote_fvr">FVR Outdoor Substation Circuit Breakers</option>
</select>
</td>
</tr>

<tr>
<td class="label-field">Market <span class="asterisk">*</span></td>
<td class="input-field" required>
<select name="market" id="market">
<option selected="selected" value="">- Select Market -</option>
<option value="U &amp; I">Utility &amp; Industrial</option>
<option value="Wind &amp; Solar">Wind &amp; Solar </option>
<option value="Transit">Rail &amp; Transit </option>
<option value="Traffic">Traffic</option>
<option value="Pedestals">Service Entrance Pedestals</option>
<option value="Commercial">Commercial &amp; Institutional</option>
</select>
</td>
</tr>

<tr>
<td class="label-field">Address <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="address" id="address" required></td>
</tr>

<tr>
<td class="label-field">City <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="city" id="city" required></td>
</tr>

<tr>
<td class="label-field">State </span></td>
<td class="input-field">
<!--<input type="text" name="state" id="state">-->
<select name="state" id="state" required>
<option selected="selected" value="">- Select -</option>
<option value="AL - Alabama">Alabama</option>
<option value="AK - Alaska">Alaska</option>
<option value="AZ - Arizona">Arizona</option>
<option value="AR - Arkansas">Arkansas</option>
<option value="CA - California">California</option>
<option value="CO - Colorado">Colorado</option>
<option value="CT - Connecticut">Connecticut</option>
<option value="DC - District of Columbia">District of Columbia</option>
<option value="DE - Delaware</">Delaware</option>
<option value="FL - Florida">Florida</option>
<option value="GA - Georgia">Georgia</option>
<option value="HI - Hawaii">Hawaii</option>
<option value="ID - Idaho">Idaho</option>
<option value="IL - Illinois">Illinois</option>
<option value="IN - Indiana">Indiana</option>
<option value="IO - Iowa">Iowa</option>
<option value="KS - Kansas">Kansas</option>
<option value="KY - Kentucky">Kentucky</option>
<option value="LO - Louisiana">Louisiana</option>
<option value="ME - Maine">Maine</option>
<option value="MD - Maryland">Maryland</option>
<option value="MA - Massachusetts">Massachusetts</option>
<option value="MI - Michigan">Michigan</option>
<option value="MN - Minnesota">Minnesota</option>
<option value="MS - Mississippi">Mississippi</option>
<option value="MO - Missouri">Missouri</option>
<option value="MT - Montana">Montana</option>
<option value="NE - Nebraska">Nebraska</option>
<option value="NV - Nevada">Nevada</option>
<option value="NH - New Hampshire">New Hampshire</option>
<option value="NJ - New Jersey">New Jersey</option>
<option value="NM - New Mexico">New Mexico</option>
<option value="NY - New York">New York</option>
<option value="NC - North Carolina">North Carolina</option>
<option value="ND - North Dakota">North Dakota</option>
<option value="OH - Ohio">Ohio</option>
<option value="OK - Oklahoma">Oklahoma</option>
<option value="OR - Oregon">Oregon</option>
<option value="PA - Pennsylvania">Pennsylvania</option>
<option value="PR - Puerto Rico">Puerto Rico</option>
<option value="RI - Rhode Island">Rhode Island</option>
<option value="SC - South Carolina">South Carolina</option>
<option value="SD - South Dakota">South Dakota</option>
<option value="TN - Tennessee">Tennessee</option>
<option value="TX - Texas">Texas</option>
<option value="UT - Utah">Utah</option>
<option value="VT - Vermont">Vermont</option>
<option value="VA - Virginia">Virginia</option>
<option value="WA - Washington">Washington</option>
<option value="WV - West Virginia">West Virginia</option>
<option value="WI - Wisconsin">Wisconsin</option>
<option value="WY - Wyoming">Wyoming</option>
</select>
</td>
</tr>

<tr>
<td class="label-field">Zip Code </span></td>
<td class="input-field"><input type="text" name="zip-code" id="zip-code"></td>
</tr>

<tr>
<td class="label-field">Phone <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="Phone" id="Phone" required></td>
</tr>

<tr>
<td class="label-field">Email <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="Email" id="Email" required></td>
</tr>

<tr>
<td class="label-field">Job Location <span class="asterisk">*</span></td>
<td class="input-field">
<!--<input type="text" name="job-location" id="job-location" required>-->
<select name="job-location" id="job-location" required>
<option selected="selected" value="">- Select -</option>
<option value="AL - Alabama">Alabama</option>
<option value="AK - Alaska">Alaska</option>
<option value="AZ - Arizona">Arizona</option>
<option value="AR - Arkansas">Arkansas</option>
<option value="CA - California">California</option>
<option value="CO - Colorado">Colorado</option>
<option value="CT - Connecticut">Connecticut</option>
<option value="DC - District of Columbia</">District of Columbia</option>
<option value="DE - Delaware">Delaware</option>
<option value="FL - Florida">Florida</option>
<option value="GA - Georgia">Georgia</option>
<option value="HI - Hawaii">Hawaii</option>
<option value="ID - Idaho">Idaho</option>
<option value="IL - Illinois">Illinois</option>
<option value="IN - Indiana">Indiana</option>
<option value="IO - Iowa">Iowa</option>
<option value="KS - Kansas">Kansas</option>
<option value="KY - Kentucky">Kentucky</option>
<option value="LO - Louisiana">Louisiana</option>
<option value="ME - Maine">Maine</option>
<option value="MD - Maryland">Maryland</option>
<option value="MA - Massachusetts">Massachusetts</option>
<option value="MI - Michigan">Michigan</option>
<option value="MN - Minnesota">Minnesota</option>
<option value="MS - Mississippi">Mississippi</option>
<option value="MO - Missouri">Missouri</option>
<option value="MT - Montana">Montana</option>
<option value="NE - Nebraska">Nebraska</option>
<option value="NV - Nevada">Nevada</option>
<option value="NH - New Hampshire">New Hampshire</option>
<option value="NJ - New Jersey">New Jersey</option>
<option value="NM - New Mexico">New Mexico</option>
<option value="NY - New York">New York</option>
<option value="NC - North Carolina">North Carolina</option>
<option value="ND - North Dakota">North Dakota</option>
<option value="OH - Ohio">Ohio</option>
<option value="OK - Oklahoma">Oklahoma</option>
<option value="OR - Oregon">Oregon</option>
<option value="PA - Pennsylvania">Pennsylvania</option>
<option value="PR - Puerto Rico">Puerto Rico</option>
<option value="RI - Rhode Island">Rhode Island</option>
<option value="SC - South Carolina">South Carolina</option>
<option value="SD - South Dakota">South Dakota</option>
<option value="TN - Tennessee">Tennessee</option>
<option value="TX - Texas">Texas</option>
<option value="UT - Utah">Utah</option>
<option value="VT - Vermont">Vermont</option>
<option value="VA - Virginia">Virginia</option>
<option value="WA - Washington">Washington</option>
<option value="WV - West Virginia">West Virginia</option>
<option value="WI - Wisconsin">Wisconsin</option>
<option value="WY - Wyoming">Wyoming</option>
</select>
</td>
</tr>

<tr>
<td class="label-field">End User Name <span class="asterisk">*</span></td>
<td class="input-field"><input type="text" name="end-user-name" id="end-user-name" required></td>
</tr>

<tr>
<td class="label-field">End User Type <span class="asterisk">*</span></td>
<td class="input-field">
<!--<input type="text" name="end-user-type" id="end-user-type" required>-->
<select name="end-user-type" id="end-user-type" required>
<option selected="selected" value="">- Select -</option>
<option value="Commercial &amp; Institutional">Commercial &amp; Institutional</option>
<option value="Rail and Transit">Rail and Transit</option>
<option value="Residential Products">Residential Products</option>
<option value="Utlity &amp; Industrial">Utlity &amp; Industrial</option>
<option value="Wind and Solar">Wind and Solar</option>
<option value="Others">Others</option>
</select>
</td>
</tr>

<tr>
<td class="label-field">RFP Number</td>
<td class="input-field"><input type="text" name="rfp-number" id="rfp-number"></td>
</tr>

<tr>
<td class="label-field">Description<span class="asterisk">*</span></td>
<td class="input-field"><textarea name="description" id="description" rows="10" required></textarea></td>
</tr>

<!-- <tr>
<td class="label-field">Upload Photo or File<span class="asterisk">*</span></td>
<td class="input-field"><input type="file" name="upload-file" id="upload-file"></td>
</tr> -->

<tr>
<td class="label-field">&nbsp;</td>
<td class="input-field"><button type="submit" name="btn-submit-quotation" id="btn-submit-quotation" class="btn-submit-quotation">Submit</button></td>
</tr>

</table>

</form>
</div><!-- request-quotation -->
';

?>