<form id="popt_form" action="https://www.ekomplex.cz/form/save_form.php" enctype="multipart/form-data" method="post" name="" target="_top"><input name="obor" type="hidden" value="2"> <input name="mesto" type="hidden" value="150">

<p>&nbsp;</p>

<p><!-- 

 

<tr class="mpform_radio  mpform_required"> 

 

<td class="mpform_title">Zadavatel<span class="mpform_required">*</span>:</td>

<td class="mpform_help"></td>

<td class="mpform_field">  <input class="mpform_radio" type="radio" id="wb_zadavatel_1" name="field[zadavatel]" value="FYZOSOBA"  />  <label for="wb_zadavatel_1" class="mpform_checkbox_label">osoba</label>  <br />        <input class="mpform_radio" type="radio" id="wb_zadavatel_2" name="field[zadavatel]" value="FIRMA"  />  <label for="wb_zadavatel_2" class="mpform_checkbox_label">firma</label>  <br />        <input class="mpform_radio" type="radio" id="wb_zadavatel_3" name="field[zadavatel]" value="INSTITUCE"  />  <label for="wb_zadavatel_3" class="mpform_checkbox_label">instituce</label>  <br />        <input class="mpform_radio" type="radio" id="wb_zadavatel_4" name="field[zadavatel]" value="JINE"  />  <label for="wb_zadavatel_4" class="mpform_checkbox_label">jiné</label>  </td>

</tr>

--> <input name="field[zadavatel]" type="hidden" value="JINE"></p>

 

<table border="0" cellspacing="0" cellpadding="2">

<tbody>

<tr>

<td class="mpform_heading" colspan="3"><label>Poptávka - Malíři a natěrači (CZ) (Bratislavský kraj)</label></td>

</tr>

<tr class="mpform_checkbox  mpform_required">

<td class="mpform_title">Předmět poptávky<span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field">

<ul id="ul_ob_0">

<li><input id="wb_347" name="field[obor]" type="radio" value="347"><label class="mpform_checkbox_label" for="wb_347">Drobné malířské a natěračské práce (do 2hodin)</label></li>

<li><input id="wb_72" name="field[obor]" type="radio" value="72"><label class="mpform_checkbox_label" for="wb_72">Malování interiérů</label></li>

<li><input id="wb_16" name="field[obor]" type="radio" value="16"><label class="mpform_checkbox_label" for="wb_16">Nástřiky stěn v interiérech</label></li>

<li><input id="wb_18" name="field[obor]" type="radio" value="18"><label class="mpform_checkbox_label" for="wb_18">Dekorativní malby</label></li>

<li><input id="wb_17" name="field[obor]" type="radio" value="17"><label class="mpform_checkbox_label" for="wb_17">Nátěry oken a dveří</label></li>

<li><input id="wb_15" name="field[obor]" type="radio" value="15"><label class="mpform_checkbox_label" for="wb_15">Nátěry radiátorů</label></li>

<li><input id="wb_83" name="field[obor]" type="radio" value="83"><label class="mpform_checkbox_label" for="wb_83">Nátěry ocelových konstrukcí</label></li>

<li><input id="wb_84" name="field[obor]" type="radio" value="84"><label class="mpform_checkbox_label" for="wb_84">Nátěry dřevěných konstrukcí</label></li>

<li><input id="wb_88" name="field[obor]" type="radio" value="88"><label class="mpform_checkbox_label" for="wb_88">Nátěry betonových konstrukcí</label></li>

<li><input id="wb_128" name="field[obor]" type="radio" value="128"><label class="mpform_checkbox_label" for="wb_128">Nátěry domovních fasád</label></li>

<li><input id="wb_85" name="field[obor]" type="radio" value="85"><label class="mpform_checkbox_label" for="wb_85">Nátěry střech</label></li>

<li><input id="wb_87" name="field[obor]" type="radio" value="87"><label class="mpform_checkbox_label" for="wb_87">Nátěry průmyslových podlah</label></li>

<li><input id="wb_86" name="field[obor]" type="radio" value="86"><label class="mpform_checkbox_label" for="wb_86">Protiplísňové nátěry</label></li>

<li><input id="wb_71" name="field[obor]" type="radio" value="71"><label class="mpform_checkbox_label" for="wb_71">Protipožární nátěry</label></li>

<li><input id="wb_89" name="field[obor]" type="radio" value="89"><label class="mpform_checkbox_label" for="wb_89">Hydroizolační nátěry</label></li>

<li><input id="wb_90" name="field[obor]" type="radio" value="90"><label class="mpform_checkbox_label" for="wb_90">AntiGrafitti nátěry</label></li>

<li><input id="wb_132" name="field[obor]" type="radio" value="132"><label class="mpform_checkbox_label" for="wb_132">Vnitřní omítky a štuky</label></li>

<li><input id="wb_134" name="field[obor]" type="radio" value="134"><label class="mpform_checkbox_label" for="wb_134">Nátěry výškových konstrukcí</label></li>

<li><input id="wb_137" name="field[obor]" type="radio" value="137"><label class="mpform_checkbox_label" for="wb_137">Tapetování</label></li>

<li><input id="wb_353" name="field[obor]" type="radio" value="353"><label class="mpform_checkbox_label" for="wb_353">Ostatní ne-poptávkové dotazy</label></li>

</ul>

</td>

</tr>

<tr class="mpform_textarea">

<td class="mpform_title"><label for="field_note">Text poptávky</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><textarea id="fiel_note" class="mpform_textarea" cols="50" name="field[note]" rows="15"></textarea></td>

</tr>

<tr>

<td class="mpform_heading" colspan="3"><label>Kontaktní informace zákazníka</label></td>

</tr>

<tr class="mpform_textfield  mpform_required">

<td class="mpform_title"><label for="wb_jmeno">Jméno, firma</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="wb_jmeno" class="mpform_text" name="field[jmeno]" type="text" value=""></td>

</tr>

<tr class="mpform_textfield  mpform_required">

<td class="mpform_title"><label for="wb_ulice">Ulice, č.p.</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="wb_ulice" class="mpform_text" name="field[ulice]" type="text" value=""></td>

</tr>

<tr class="mpform_textfield  mpform_required">

<td class="mpform_title"><label for="wb_obec">Obec</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="wb_obec" class="mpform_text" name="field[obec]" type="text" value=""></td>

</tr>

<tr class="mpform_textfield  mpform_required">

<td class="mpform_title"><label for="wb_telefon">Telefon</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="wb_telefon" class="mpform_text" name="field[telefon]" type="text" value=""></td>

</tr>

<tr class="mpform_email  mpform_required">

<td class="mpform_title"><label for="wb_email">E-mail</label><span class="mpform_required">*</span>:</td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="wb_email" class="mpform_email" name="field[email]" type="text" value=""></td>

</tr>

<tr class="mpform_textfield mpform_required" style="display: none;">

<td class="mpform_title"><label for="www">Toto pole nechte prázdné:</label></td>

<td class="mpform_help">&nbsp;</td>

<td class="mpform_field"><input id="www" class="mpform_text" name="www" type="text" value=""></td>

</tr>

<tr>

<td>&nbsp;</td>

<td>&nbsp;</td>

<td><input class="mpform_submit" name="submit" type="submit" value="Odeslat"></td>

</tr>

</tbody>

</table>

</form>