Your IP : 216.73.217.79
<table border="0" width="900">
<tr><td colspan="2" align="center"><b>AGREEMENT BETWEEN:</b></td></tr>
<tr><td colspan="2" align="center"><b>THE CLIENT</b></td></tr>
<tr><td style="width: 235px">Name of Client:</td><td><input type="text" name="Field1" id="Field1" value="<?php echo $_POST["Field1"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Postal Address:</td><td><textarea name="Field2" id="Field2" required placeholder="Required" cols="50" rows="4"><?php echo $_POST["Field2"]; ?></textarea></td></tr>
<tr><td style="width: 235px">Postal Code:</td><td><input type="text" name="Field3" id="Field3" value="<?php echo $_POST["Field3"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Physical Address:</td><td><textarea name="Field4" id="Field4" required placeholder="Required" cols="50" rows="4"><?php echo $_POST["Field4"]; ?></textarea></td></tr>
<tr><td style="width: 235px">Tel:</td><td><input type="text" name="Field5" id="Field5" value="<?php echo $_POST["Field5"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Fax:</td><td><input type="text" name="Field6" id="Field6" value="<?php echo $_POST["Field6"]; ?>" size="60" /></td></tr>
<tr><td style="width: 235px">Email:</td><td><input type="text" name="Field7" id="Field7" value="<?php echo $_POST["Field7"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td colspan="2" align="center"><b>AND THE CONSULTING ENGINEER</b></td></tr>
<tr><td style="width: 235px">Name of Consulting Engineer:</td><td><input type="text" name="Field8" id="Field8" value="<?php echo $_POST["Field8"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Postal Address:</td><td><textarea name="Field9" id="Field9" required placeholder="Required" cols="50" rows="4"><?php echo $_POST["Field9"]; ?></textarea></td></tr>
<tr><td style="width: 235px">Postal Code:</td><td><input type="text" name="Field10" id="Field10" value="<?php echo $_POST["Field10"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Physical Address:</td><td><textarea name="Field11" id="Field11" required placeholder="Required" cols="50" rows="4"><?php echo $_POST["Field11"]; ?></textarea></td></tr>
<tr><td style="width: 235px">Tel:</td><td><input type="text" name="Field12" id="Field12" value="<?php echo $_POST["Field12"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Fax:</td><td><input type="text" name="Field13" id="Field13" value="<?php echo $_POST["Field13"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235px">Email:</td><td><input type="text" name="Field14" id="Field14" value="<?php echo $_POST["Field14"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td colspan="2"><b>The client intends to proceed with the following Project:</b></td></tr>
<tr><td colspan="2"><textarea name="Field15" id="Field15" required placeholder="Project name / description, Required" cols="80" rows="4"><?php echo $_POST["Field15"]; ?></textarea></td></tr>
<tr><td colspan="2" align="center"><strong><span lang="en-za">SPECIFIC DATA<br />
The following documents form part of this agreement:</span></strong></td></tr>
<tr><td style="width: 235px"><span lang="en-za">These standard
documents are included in the contract:<br />
- Specific Data<br />
- Conditions of Agreement<br />
- Appendix A1 - Scope of Services and Remuneration<br />
- Appendix A2 - Remuneration<br />
- Appendix A3 - Time for Completion</span></td><td>
<span lang="en-za">List any additional documents you will
include:<br />
<br />
</span>
<textarea name="Field16" id="Field16" placeholder="Additional Documents" cols="50" rows="4"><?php echo $_POST["Field16"]; ?></textarea></td></tr>
<tr><td style="width: 235px"><span lang="en-za">Amendments:</span></td><td>
<span lang="en-za">The following amendments to the Conditions of
Agreement will apply to this Agreement:<br />
<br />
<textarea name="Field17" id="Field17" placeholder="Amendments" cols="50" rows="4"><?php echo $_POST["Field17"]; ?></textarea></span></td></tr>
<tr><td style="width: 235px"><span lang="en-za">Conditions:</span></td><td>
<span lang="en-za">The following special conditions apply to
this Agreement:<br />
<br />
<textarea name="Field18" id="Field18" placeholder="Conditions" cols="50" rows="4"><?php echo $_POST["Field18"]; ?></textarea></span></td></tr>
<tr><td style="width: 235px"><span lang="en-za">Exceptional
Services:</span></td><td>
<span lang="en-za">The Scope of Services includes the following
Exceptional Services:<br />
<br />
<textarea name="Field19" id="Field19" placeholder="Exceptional Services" cols="50" rows="4"><?php echo $_POST["Field19"]; ?></textarea></span></td></tr>
<tr><td align="center" colspan="2"><span lang="en-za"><strong>
PROFESSIONAL INDEMNITY INSURANCE</strong></span></td></tr>
<tr><td style="width: 235px"><span lang="en-za">Limit of Indemnity
per Claim:</span></td><td>
R <input type="text" name="Field20" id="Field20" value="<?php echo $_POST["Field20"]; ?>" size="60" /></td></tr>
<tr><td style="width: 235px"><span lang="en-za">State whether the
Limit of Indemnity is <em>Aggregated</em> or <em>Unlimited</em>:</span></td><td>
<input type="text" name="Field21" id="Field21" value="<?php echo $_POST["Field21"]; ?>" size="60" /></td></tr>
<tr><td style="width: 235px"><span lang="en-za">Deductible:</span></td><td>
R <input type="text" name="Field22" id="Field22" value="<?php echo $_POST["Field22"]; ?>" size="60" /></td></tr>
</table>