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<style>
@import url(http://fonts.googleapis.com/css?family=Source+Sans+Pro:200,300,400,700&subset=latin,latin-ext);
body {
	font-family: 'Source Sans Pro', sans-serif;
	font-size: 14px;
	color: #666;
	width: 100%;
	background: #ebebeb;
	padding: 0px;
	margin: 0px;
}
.nag {
	color: #303463;
	font-size:18px;
	font-weight: 700;
	padding: 0px 0px 15px 0px;
	background:url(../img/borderSzary.jpg) bottom left no-repeat;
}

/* ==========================================================================
   FORMULARZ
   ========================================================================== */		
	#formularz {
		z-index: 1;
		width: 100%;
		padding:30px
	}

	#formularz form input[type=text] {
		margin: 0; 
		padding: 0;
		width: 100%;
		height: 45px;
		line-height: 45px;
		font-size: 14px;
		text-indent: 15px;
		outline: none; border: none;
		margin-top: 11px;
		font-family: 'Source Sans Pro', sans-serif;
	}
	#formularz form textarea {
		float: left;
		height: 101px;
		outline: none; border: none;
		margin: 0; padding: 0;
		margin-top: 11px;
		width: 100%;
		font-size: 14px;
		padding: 13px 3%;
		font-family: 'Source Sans Pro', sans-serif;
	}
	#formularz form input[type=submit] {
		display: inline;
		width: 100%;
		height: 45px;
		border: none; outline: none;
		margin: 0; padding: 0;
		margin-top: 11px;
		background: #d61500;
		color: #fff;
		cursor: pointer;
		font-size: 14px;
	}
	#formularz form input[type=submit]:hover {
		background: #C00;
	}
	.left {
		float: left;
		width:45%;
		margin-right:20px;
	}
	.right {
		float: left;
		width: 45%;
	}
	.tekst {
		margin-top: 20px;
		font-size: 15px;
	}
	.komunikat {
		margin: 20px;
		padding: 20px;
		background: #faecec;
		border:1px solid #f4dede;
		font-weight: bold;
	}
	.komunikatOK {
		margin: 20px;
		padding: 20px;
		background: #f5fef3;
		border:1px solid #e2f4de;
		font-weight: bold;
	}
	.komunikatOK a{
		text-decoration: none;
		color: #c32026;
	}
	
	@media screen and (max-width: 680px) {
		#formularz form .left {
			float: none;
			width: 100%;
		}
		#formularz form .right {
			float: none;
			width: 100%;
			padding-right:20px;
		}
	}
</style>
<script src="http://ajax.googleapis.com/ajax/libs/jquery/1.8.2/jquery.min.js"></script>


<div id="formularz">
    <div class="nag">Wyślij zapytanie</div>
                    
    
    <div class="tekst"><b></b><br/>  ,   <el.: , email: </div>
    <form action="" method="POST">
        <div class="fluid2 left">
          
          <input type="text" name="name" placeholder="Imię, Nazwisko"    value="" alt="notempty" />
          <input type="text" name="firma" placeholder="Firma"    value="" alt="notempty" />
          <input type="text" name="tel"  placeholder="Telefon" value="" alt="notempty" />
          <input type="text" name="mail" placeholder="Email"   value="" alt="email" />
                          
        </div>
        <div class="fluid2 right">
          <textarea name="desc" placeholder="Treść zapytania..." alt=""></textarea>
          <input type="text" name="e_VCText" placeholder="Wpisz kod" value="" alt="" style="width:50%" />                          
          <span id="kod"><img src="../include/evisualconfirm/image.php" alt="Jezeli nie widzisz tego obrazka kliknij odswiez i spróbuj ponownie" align="middle" /></span>
          <img src="../img/refresh0.gif" alt="Odśwież kod z obrazka" title="Odśwież kod z obrazka" align="middle" onclick="odswiezKod();" style="cursor:pointer;" />     
          
          <input type="submit" name="submitDoFirmy" id="formSubmit" value="Wyślij Zapytanie">
        </div>
    </form>
    </div>
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