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: 235" valign="top">Address:</td><td>
<input type="text" name="Field2" id="Field2" value="<?php echo $_POST["Field2"]; ?>" required placeholder="Required" size="60" /><br>
<input type="text" name="Field3" id="Field3" value="<?php echo $_POST["Field3"]; ?>" size="60" /></td></tr>
<input type="text" name="Field4" id="Field4" value="<?php echo $_POST["Field4"]; ?>" size="60" /></td></tr>
<tr><td style="width: 235px">Postal Code:</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"> </td><td> </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="Field6" id="Field6" value="<?php echo $_POST["Field6"]; ?>" required placeholder="Required" size="60" /></td></tr>
<tr><td style="width: 235" valign="top">Address:</td><td>
<input type="text" name="Field7" id="Field7" value="<?php echo $_POST["Field7"]; ?>" required placeholder="Required" size="60" /><br>
<input type="text" name="Field8" id="Field8" value="<?php echo $_POST["Field8"]; ?>" size="60" /><br>
<input type="text" name="Field9" id="Field9" value="<?php echo $_POST["Field9"]; ?>" size="60" /></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"> </td><td> </td></tr>
<tr><td colspan="2"><b>The client intends to proceed with the following project and works:</b></td></tr>
<tr><td colspan="2">
<input type="text" name="Field11" id="Field11" value="<?php echo $_POST["Field11"]; ?>" required placeholder="Required" size="80" /><br>
<input type="text" name="Field12" id="Field12" value="<?php echo $_POST["Field12"]; ?>" size="80" /><br>
<input type="text" name="Field13" id="Field13" value="<?php echo $_POST["Field13"]; ?>" size="80" /></td></tr>
<tr><td>Professional Fees ( expressed as a lump sum in Rands, or as a percentage of the cost of works, or as an hourly rate) <i>All figures exclude Tax</i></td>
<td><input type="text" name="Field14" id="Field14" value="<?php echo $_POST["Field14"]; ?>" size="60" /></td></tr>
<tr><td>Expenses and Costs (expressed as a lump sum in Rands, or as a percentage of the Professional Fee) <i>All figures exclude Tax</i></td>
<td><input type="text" name="Field15" id="Field15" value="<?php echo $_POST["Field15"]; ?>" size="60" /></td></tr>
<tr><td>The time for the completion of the services is</td>
<td><input type="text" name="Field16" id="Field16" value="<?php echo $_POST["Field16"]; ?>" size="30" /> weeks</td></tr>
</table>