<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>Unbenanntes Dokument</title>
<script src="SpryAssets/SpryValidationTextField.js" type="text/javascript"></script>
<script src="SpryAssets/SpryValidationSelect.js" type="text/javascript"></script>
<link href="SpryAssets/SpryValidationTextField.css" rel="stylesheet" type="text/css" />
<link href="SpryAssets/SpryValidationSelect.css" rel="stylesheet" type="text/css" />
</head>
<script type="text/javascript" src="datetimepicker_css.js"></script>
<body>
<p>Felder mit einem (*) sind Pflichtfelder, ohne denen ein Absenden des Auftrags nicht möglich ist.</p>
<p> </p>
<form id="form1" name="form1" method="post" action="">
<table width="556" border="0">
<tr>
<td width="259">Auftraggeber</td>
<td width="287"> </td>
</tr>
<tr>
<td>Firma/ Name *:</td>
<td><span id="sprytextfield1">
<input name="ag_firma" type="text" id="ag_firma" size="40" />
</span></td>
</tr>
<tr>
<td>Strasse*:</td>
<td><span id="sprytextfield3">
<input name="ag_strasse2" type="text" id="ag_strasse2" size="40" />
</span></td>
</tr>
<tr>
<td>PLZ*:</td>
<td><span id="sprytextfield4">
<input name="ag_plz" type="text" id="ag_plz" size="6" />
</span></td>
</tr>
<tr>
<td>Ort*:</td>
<td><span id="sprytextfield5">
<input name="ag_ort" type="text" id="ag_ort" size="40" />
</span></td>
</tr>
<tr>
<td>Land*:</td>
<td><span id="spryselect1">
<select name="ag_land" id="ag_land">
<option value="wählen">Bitte wählen</option>
<option value="A">A</option>
<option value="AND">AND</option>
<option value="B">B</option>
<option value="BIH">BIH</option>
<option value="BY">BY</option>
<option value="CG">CG</option>
<option value="CH">CH</option>
<option value="CZ">CZ</option>
<option value="D">D</option>
<option value="DK">DK</option>
<option value="E">E</option>
<option value="EST">EST</option>
<option value="F">F</option>
<option value="FIN">FIN</option>
<option value="FL">FL</option>
<option value="GB">GB</option>
<option value="GE">GE</option>
<option value="GR">GR</option>
<option value="H">H</option>
<option value="HR">HR</option>
<option value="I">I</option>
<option value="IRL">IRL</option>
<option value="L">L</option>
<option value="LT">LT</option>
<option value="LV">LV</option>
<option value="M">M</option>
<option value="MA">MA</option>
<option value="MC">MC</option>
<option value="MK">MK</option>
<option value="N">N</option>
<option value="NL">NL</option>
<option value="P">P</option>
<option value="PL">PL</option>
<option value="RO">RO</option>
<option value="RSM">RSM</option>
<option value="RUS">RUS</option>
<option value="S">S</option>
<option value="SRB">SRB</option>
<option value="SK">SK</option>
<option value="SLO">SLO</option>
<option value="TR">TR</option>
<option value="UA">UA</option>
<option value="YU">YU</option>
</select>
</span></td>
</tr>
<tr>
<td>Ansprechpartner*:</td>
<td><span id="sprytextfield6">
<input name="ag_anp" type="text" id="ag_anp" size="40" />
</span></td>
</tr>
<tr>
<td>E-Mail*:</td>
<td><span id="sprytextfield7">
<input name="ag_email" type="text" id="ag_email" size="40" />
</span></td>
</tr>
<tr>
<td>Telefon*:</td>
<td><span id="sprytextfield8">
<input name="ag_tel" type="text" id="ag_tel" size="40" />
</span></td>
</tr>
<tr>
<td>Telefax:</td>
<td><input name="ag_fax" type="text" id="ag_fax" size="40" /></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>Absender</td>
<td> </td>
</tr>
<tr>
<td>Absender = Auftraggeber</td>
<td><input name="ab_au" type="checkbox" id="ab_au" value="Absender=Auftraggeber" /></td>
</tr>
<tr>
<td>Firma/Name*:</td>
<td><input name="ab_name" type="text" id="ab_name" size="40" /></td>
</tr>
<tr>
<td>Strasse*:</td>
<td><input name="ag_strasse" type="text" id="ag_strasse" size="40" /></td>
</tr>
<tr>
<td>PLZ*:</td>
<td><input name="ab_plz" type="text" id="ab_plz" size="6" /></td>
</tr>
<tr>
<td>Ort*:</td>
<td><label>
<input name="ab_ort" type="text" id="ab_ort" size="40" />
</label></td>
</tr>
<tr>
<td>Land*:</td>
<td><select name="ab_land2" id="ab_land2">
<option value="wählen">Bitte wählen</option>
<option value="A">A</option>
<option value="AND">AND</option>
<option value="B">B</option>
<option value="BIH">BIH</option>
<option value="BY">BY</option>
<option value="CG">CG</option>
<option value="CH">CH</option>
<option value="CZ">CZ</option>
<option value="D">D</option>
<option value="DK">DK</option>
<option value="E">E</option>
<option value="EST">EST</option>
<option value="F">F</option>
<option value="FIN">FIN</option>
<option value="FL">FL</option>
<option value="GB">GB</option>
<option value="GE">GE</option>
<option value="GR">GR</option>
<option value="H">H</option>
<option value="HR">HR</option>
<option value="I">I</option>
<option value="IRL">IRL</option>
<option value="L">L</option>
<option value="LT">LT</option>
<option value="LV">LV</option>
<option value="M">M</option>
<option value="MA">MA</option>
<option value="MC">MC</option>
<option value="MK">MK</option>
<option value="N">N</option>
<option value="NL">NL</option>
<option value="P">P</option>
<option value="PL">PL</option>
<option value="RO">RO</option>
<option value="RSM">RSM</option>
<option value="RUS">RUS</option>
<option value="S">S</option>
<option value="SRB">SRB</option>
<option value="SK">SK</option>
<option value="SLO">SLO</option>
<option value="TR">TR</option>
<option value="UA">UA</option>
<option value="YU">YU</option>
</select></td>
</tr>
<tr>
<td>Ansprechpartner:</td>
<td><input name="ab_anp2" type="text" id="ab_anp2" size="40" /></td>
</tr>
<tr>
<td>Telefon:</td>
<td><input name="ab_tel2" type="text" id="ab_tel2" size="40" /></td>
</tr>
<tr>
<td>Ladedatum/Uhrzeit*:</td>
<td><input name="datum" type="text" id="demo1" size="30" />
<a href="javascript: NewCssCal('demo1','ddmmmyyyy','arrow',true,24,false)"><img
src="/images/cal.gif" alt="Pick a date" name="datum" width="17" height="17" border="0" id="datum" /></a></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>Empfänger</td>
<td> </td>
</tr>
<tr>
<td>Empfänger = Auftraggeber:</td>
<td><input name="ab_au2" type="checkbox" id="ab_au2" value="Empfänger=Auftraggeber" /></td>
</tr>
<tr>
<td>Empfängerfirma/Name*:</td>
<td><input name="em_name" type="text" id="em_name" size="40" /></td>
</tr>
<tr>
<td>Strasse*:</td>
<td><input name="em_strasse" type="text" id="em_strasse" size="40" /></td>
</tr>
<tr>
<td>PLZ*:</td>
<td><input name="em_plz" type="text" id="em_plz" size="6" /></td>
</tr>
<tr>
<td>Ort*:</td>
<td><label>
<input name="em_ort" type="text" id="em_ort" size="40" />
</label></td>
</tr>
<tr>
<td>Land*:</td>
<td><select name="em_land" id="em_land">
<option value="wählen">Bitte wählen</option>
<option value="A">A</option>
<option value="AND">AND</option>
<option value="B">B</option>
<option value="BIH">BIH</option>
<option value="BY">BY</option>
<option value="CG">CG</option>
<option value="CH">CH</option>
<option value="CZ">CZ</option>
<option value="D">D</option>
<option value="DK">DK</option>
<option value="E">E</option>
<option value="EST">EST</option>
<option value="F">F</option>
<option value="FIN">FIN</option>
<option value="FL">FL</option>
<option value="GB">GB</option>
<option value="GE">GE</option>
<option value="GR">GR</option>
<option value="H">H</option>
<option value="HR">HR</option>
<option value="I">I</option>
<option value="IRL">IRL</option>
<option value="L">L</option>
<option value="LT">LT</option>
<option value="LV">LV</option>
<option value="M">M</option>
<option value="MA">MA</option>
<option value="MC">MC</option>
<option value="MK">MK</option>
<option value="N">N</option>
<option value="NL">NL</option>
<option value="P">P</option>
<option value="PL">PL</option>
<option value="RO">RO</option>
<option value="RSM">RSM</option>
<option value="RUS">RUS</option>
<option value="S">S</option>
<option value="SRB">SRB</option>
<option value="SK">SK</option>
<option value="SLO">SLO</option>
<option value="TR">TR</option>
<option value="UA">UA</option>
<option value="YU">YU</option>
</select></td>
</tr>
<tr>
<td>Ansprechpartner:</td>
<td><input name="em_anp" type="text" id="em_anp" size="40" /></td>
</tr>
<tr>
<td>Telefon:</td>
<td><input name="em_tel" type="text" id="em_tel" size="40" /></td>
</tr>
<tr>
<td>Entladedatum*:</td>
<td><input name="datum1" type="text" id="datum1" size="30">
<a href="javascript: NewCssCal('demo1','ddmmmyyyy','arrow',true,24,false)"><img
src="/images/cal.gif" alt="Pick a date" name="datum1" width="17" height="17" border="0" id="datum1"></a></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>Sendungsdaten</td>
<td> </td>
</tr>
<tr>
<td>Anzahl:</td>
<td><input name="sd_anzahl" type="text" id="sd_anzahl" size="40" /></td>
</tr>
<tr>
<td>Verpackung:</td>
<td><label>
<select name="sd_verpackung" id="sd_verpackung">
<option value="bitte Rücksprache">bitte Rücksprache</option>
<option value="EURO/ s">EURO/ s</option>
<option value="EWP">EWP</option>
<option value="Colli">Colli</option>
<option value="GiBo">GiBo</option>
<option value="Karton/ s">Karton/ s</option>
<option value="Kiste/ n">Kiste/ n</option>
<option value="Paket/ e">Paket/ e</option>
<option value="Palette/ n">Palette/ n</option>
<option value="Rolle/ n">Rolle/ n</option>
</select>
</label></td>
</tr>
<tr>
<td>Inhalt:</td>
<td><label>
<input name="sd_inhalt" type="text" id="sd_inhalt" size="40" />
</label></td>
</tr>
<tr>
<td>Abmessungen (in cm):</td>
<td><label>
<input name="sd_abmessung" type="text" id="sd_abmessung" size="40" />
</label></td>
</tr>
<tr>
<td>Gewicht (in kg):</td>
<td><label>
<input name="sd_gewicht" type="text" id="sd_gewicht" size="40" />
</label></td>
</tr>
<tr>
<td>Fahrzeugtyp:</td>
<td><label>
<select name="sd_fahrzeugtyp" id="sd_fahrzeugtyp">
<option value="PKW">PKW / Caddy</option>
<option value="Bus">Bus</option>
<option value="Transporter">Transporter</option>
<option value="Transporter mit Anhänger">Transporter mit Anhänger</option>
<option value="LKW 7,5t to.">LKW 7,5 to.</option>
<option value="LKW 7,5 to. mit Anhänger">LKW 7,5 to mit Anhänger</option>
<option value="LKW 12 to.">LKW 12 to.</option>
<option value="LKW 12 to. mit Anhänger">LKW 12 to. mit Anhänger</option>
<option value="LKW 40 to.">LKW 40 to.</option>
<option value="Air Charter">Air Charter</option>
</select>
</label></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>Besonderheiten</td>
<td> </td>
</tr>
<tr>
<td>Hebebühne erforderlich:</td>
<td><label>
<input name="hebebühne" type="checkbox" id="hebebühne" value="Hebebühne" />
</label></td>
</tr>
<tr>
<td>Kranbeladung:</td>
<td><label>
<input name="Kranbeladung" type="checkbox" id="Kranbeladung" value="kranbeladung" />
</label></td>
</tr>
<tr>
<td>Kofferfahrzeug:</td>
<td><label>
<input name="Kofferfahrzeug" type="checkbox" id="Kofferfahrzeug" value="Kofferfahrzeug" />
</label></td>
</tr>
<tr>
<td>Planenfahrzeug:</td>
<td><label>
<input name="Planenfahrzeug" type="checkbox" id="Planenfahrzeug" value="Planenfahrzeug" />
</label></td>
</tr>
<tr>
<td>Fahrzeug verplombar:</td>
<td><label>
<input name="plomben" type="checkbox" id="plomben" value="plomben" />
</label></td>
</tr>
<tr>
<td>Gefahrgut:</td>
<td><label>
<input name="gefahrgut" type="checkbox" id="gefahrgut" value="gefahrgut" />
</label></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td>sonstige Informationen</td>
<td> </td>
</tr>
<tr>
<td>Bemerkungen:</td>
<td><label>
<textarea name="message" id="message" cols="45" rows="10"></textarea>
</label></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td><label>
<input type="submit" name="Senden" id="Senden" value="Nachricht Senden" />
</label></td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
<tr>
<td> </td>
<td> </td>
</tr>
</table>
</form>
<script type="text/javascript">
<!--
var sprytextfield1 = new Spry.Widget.ValidationTextField("sprytextfield1");
var sprytextfield3 = new Spry.Widget.ValidationTextField("sprytextfield3");
var sprytextfield4 = new Spry.Widget.ValidationTextField("sprytextfield4");
var sprytextfield5 = new Spry.Widget.ValidationTextField("sprytextfield5");
var spryselect1 = new Spry.Widget.ValidationSelect("spryselect1");
var sprytextfield6 = new Spry.Widget.ValidationTextField("sprytextfield6");
var sprytextfield7 = new Spry.Widget.ValidationTextField("sprytextfield7");
var sprytextfield8 = new Spry.Widget.ValidationTextField("sprytextfield8");
//-->
</script>
</body>
</html>