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form-calculation.html
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<!DOCTYPE html>
<html lang="ru">
<head>
<meta charset="UTF-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta http-equiv="X-UA-Compatible" content="ie=edge">
<title>Форма расчета</title>
<link rel="stylesheet" href="css/bootstrap.css">
<link rel="stylesheet" href="css/style.css">
<link rel="stylesheet" href="css/all.min.css">
</head>
<body>
<div class="kurierchikof-rs-form-order">
<div class="container">
<div class="row">
<form class="form-horizontal col-sm-12">
<div class="form-group">
<h2 class="custom-form-head">Рассчитайте онлайн</h2>
<p class="custom-form-caption">Мы – это служба доставки, основной принцип работы которой –
оперативность и максимальный комфорт для клиента.</p>
</div>
<div class="form-group">
<div class="col-sm-12 do-flex do-justify-space-between do-align-end">
<div class="w-50 small-100">
<h4 class="custom-form-group-head">Адрес №1</h4>
<p class="custom-form-group-caption">Шаг 1. Откуда забираем? </p>
</div>
<button type="button" class="custom-btn-refresh do-flex do-justify-end do-align-end do-text-align-right p-b-20 btn-hidden">
<i class="fas fa-redo m-r-10 custom-form-group-refresh fa-fw"></i>
<span class="custom-form-group-refresh do-text-decoration-underline">Очистить</span>
</button>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-globe fa-fw custom-icon"></i>
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control">
<option selected>СПб</option>
<option>Москва</option>
<option>Екатеринбург</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-home fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Дом*">
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map-pin fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Квартира">
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-mobile fa-fw custom-icon"></i>
<input type="text" class="form-control phone" placeholder="Телефон*">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Для пригорода, например, Всеволожск">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<img class="custom-icon-metro" src="img/metro.svg" alt="">
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control">
<option selected>Метро</option>
<option>Калужская</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-calendar-alt fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="Дата">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map-marker-alt fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Улица*">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-user fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="ФИО*">
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-clock fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="с 8:00">
</div>
</div>
<div class="col-sm-6 col-md-2 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-clock fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="до 23:00">
</div>
</div>
<div class="col-sm-12 col-md-12">
<div class="inner-addon left-addon">
<i class="fas fa-comment-dots fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Комментарий: например, ООО «Ромашка» (красная дверь с торца дома)">
</div>
</div>
<div class="col-sm-12 do-flex do-align-cente m-t-15">
<div class="p-b-43 b-b-grey w-100">
<span class="custom-form-group-summary">Цена доставки: 289 рублей</span>
<button type="button"
class="custom-btn-summary"
data-toggle="popover"
data-trigger="focus"
data-placement="right">
<i class="fas fa-info-circle fa-fw custom-color-green m-t-3"></i>
</button>
</div>
</div>
</div>
<div class="form-group m-t-44">
<div class="col-sm-12 do-flex do-justify-space-between do-align-end">
<div class="w-50 small-100">
<h4 class="custom-form-group-head" style="margin-top: -2px;">Адрес №2</h4>
<p class="custom-form-group-caption">Шаг 2. Куда доставляем? </p>
</div>
<button type="button" class="custom-btn-refresh do-flex do-justify-end do-align-end do-text-align-right p-b-20 btn-hidden">
<i class="fas fa-redo m-r-10 custom-form-group-refresh fa-fw"></i>
<span class="custom-form-group-refresh do-text-decoration-underline">Очистить</span>
</button>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-globe fa-fw custom-icon"></i>
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control">
<option selected>СПб</option>
<option>Москва</option>
<option>Екатеринбург</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-home fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Дом*">
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map-pin fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Квартира">
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-mobile fa-fw custom-icon"></i>
<input type="text" class="form-control phone" placeholder="Телефон*">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Для пригорода, например, Всеволожск">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<img class="custom-icon-metro" src="img/metro.svg" alt="">
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control">
<option selected>Метро</option>
<option>Калужская</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-calendar-alt fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="Дата">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-map-marker-alt fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Улица*">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-user fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="ФИО*">
</div>
</div>
<div class="col-sm-6 col-md-2 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-clock fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="с 8:00">
</div>
</div>
<div class="col-sm-6 col-md-2 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-clock fa-fw custom-icon"></i>
<input type="text" class="form-control time" placeholder="до 23:00">
</div>
</div>
<div class="col-sm-12 col-md-12">
<div class="inner-addon left-addon">
<i class="fas fa-comment-dots fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Комментарий: например, ООО «Ромашка» (красная дверь с торца дома)">
</div>
</div>
</div>
<div class="form-group m-t-23">
<div class="col-sm-12">
<h4 class="custom-form-group-head">Что везем?</h4>
<p class="custom-form-group-caption">Укажите груз или услугу.</p>
</div>
<div class="col-sm-12 do-flex do-justify-center">
<div class="custom-order-num-wrapper">
<p class="custom-order-num">1</p>
</div>
<div class="container-fluid w-100">
<div class="form-group do-flex do-wrap do-direction-column m-0 m-b-0 w-100">
<div class="col-xs-12 do-flex do-wrap do-justify-center p-0">
<div class="w-325 col-xs-12 small-p-0 p-l-0 p-r-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-box-open fa-fw custom-icon"></i>
<input type="text" class="form-control" placeholder="Груз*">
</div>
</div>
<div class="col-xs-12 w-224 small-p-0 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-boxes fa-fw custom-icon"></i>
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control">
<option selected>Колличество, шт*</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
</select>
</div>
</div>
<div class="col-xs-12 w-224 small-p-0 p-r-7_5 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-tachometer-alt custom-icon"></i>
<input type="text" class="form-control" placeholder="Вес, грамм*">
</div>
</div>
<div class="col-xs-12 w-224 small-p-0 p-r-0 p-l-7_5">
<div class="inner-addon left-addon">
<i class="fas fa-ruble-sign custom-icon"></i>
<input type="text" class="form-control" placeholder="Ценность в рублях*">
</div>
</div>
</div>
<div class="col-xs-12 p-0">
<div class="w-100 do-flex do-align-center w-590-100 m-t-23">
<a href="#" class="do-flex custom-add-caption w-468-50">
<i class="fas fa-plus-circle m-t-3 fa-fw custom-icon"></i> 
<p class="custom-form-group-summary">Добавить груз</p> 
</a>
<a href="#" class=" do-flex custom-add-caption m-l-50 w-468-50 m-t-490-10">
<i class="fas fa-plus-circle m-t-3 fa-fw custom-icon"></i> 
<p class="custom-form-group-summary">Добавить адрес</p> 
</a>
<a href="#" class=" do-flex custom-add-caption m-l-50 w-468-50 m-t-490-10">
<i class="fas fa-map-marked fa-fw custom-icon"></i> 
<p class="custom-form-group-summary">Показать маршрут</p> 
</a>
<div class="m-l-50 w-468-50 m-t-490-10">
<div class="custom-form-group-summary do-flex do-wrap">
<div class="custom-add-caption">Цена доставки:</div> 
<div class="custom-add-caption" style="margin-right: 5px;">
289 рублей
<button type="button"
class="custom-btn-summary"
data-toggle="popover"
data-trigger="focus"
data-placement="right">
<i class="fas fa-info-circle fa-fw custom-color-green m-t-3"></i>
</button>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<button type="button" class="custom-btn-order-del">
<span class="custom-order-del"></span>
</button>
</div>
<div class="col-sm-12">
<div class="b-b-grey p-b-43 w-100"></div>
</div>
</div>
<div class="form-group m-t-44">
<div class="col-sm-12 do-flex do-justify-space-between do-align-end">
<div class="w-50 small-100">
<h4 class="custom-form-group-head" style="font-size: 30px;">Дополнительные услуги</h4>
<p class="custom-form-group-caption">Шаг 3. Выберите необходимые пункты</p>
</div>
<button type="button" class="custom-btn-refresh do-flex do-justify-end do-align-end do-text-align-right p-b-20 btn-hidden">
<i class="fas fa-redo m-r-10 custom-form-group-refresh fa-fw"></i>
<span class="custom-form-group-refresh do-text-decoration-underline">Очистить</span>
</button>
</div>
<div class="col-sm-6 col-md-6 do-flex do-direction-column do-align-start">
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input class="custom-checkbox" type="checkbox" value="option1">
<span class="custom-checkbox-text">Неудобный груз (> 100см)</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>95 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Требуется доставка в аэропорт</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>500 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Нужен опытный курьер</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>35 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option1">
<span class="custom-checkbox-text">Автоматическое завершение заказа</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>0 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Доставка без договора</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>45 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Осторожно! Хрупкий груз (торт, стекло, цветы и т.д.)</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>55 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option1">
<span class="custom-checkbox-text">Максимальный приоритет заказу</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>100 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Выделить для курьеров заказ цветом</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>50 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Подтвердить заказ перед доставкой</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>50 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Прислать SMS о вручении</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>5 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Забор со склада или из транспортной компании</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>75 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
</div>
<div class="col-sm-6 col-md-6 do-flex do-direction-column do-align-start">
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input class="custom-checkbox" type="checkbox" value="option1">
<span class="custom-checkbox-text">Отправка почтой России</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>95 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Ожидание на адресе +20 мин</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>500 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Нужен курьер на автомобиле</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>35 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option1">
<span class="custom-checkbox-text">Сделать фото товара</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>0 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Сделать фото чека</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>45 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Сделать фото акта выполненных работ</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>55 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option1">
<span class="custom-checkbox-text">«Свой» курьер</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>100 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text">Товар 18+</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>50 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option3">
<span class="custom-checkbox-text">Помощь в погрузке (более 15 кг)</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>50 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
<div class="w-100 do-flex do-justify-space-between do-align-center">
<label class="custom-checkbox custom-checkbox-label">
<input type="checkbox" value="option2">
<span class="custom-checkbox-text"> Помощь в разгрузке (более 15 кг)</span>
</label>
<a href="#" class="custom-checkbox-price-info"><span>5 руб</span> <i class="fas fa-question-circle"></i></a>
</div>
</div>
<div class="col-sm-12 do-flex do-align-cente m-t-20">
<div class="p-b-43 b-b-grey w-100 do-flex do-wrap">
<span class="custom-form-group-summary">Цена доставки:</span>
<span style="margin-right: 5px;">289 рублей</span>
<button type="button"
class="custom-btn-summary"
data-toggle="popover"
data-trigger="focus"
data-placement="right">
<i class="fas fa-info-circle fa-fw custom-color-green m-t-3"></i>
</button>
</div>
</div>
</div>
<div class="form-group m-t-44">
<div class="col-sm-12 do-flex do-justify-space-between do-align-end" style="margin-bottom: 4px;">
<div class="w-70 small-100">
<h4 class="custom-form-group-head" style="font-size: 30px;">Тип оплаты и контактная информация</h4>
<p class="custom-form-group-caption">Шаг 4. Для завершения заказа заполните свои контактные данные и информацию о посылке</p>
</div>
<button type="button" class="custom-btn-refresh do-flex do-justify-end do-align-end do-text-align-right p-b-20 btn-hidden">
<i class="fas fa-redo m-r-10 custom-form-group-refresh fa-fw"></i>
<span class="custom-form-group-refresh do-text-decoration-underline">Очистить</span>
</button>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<label for="inputDocuments" class="control-label m-b-8">Что везём (коротко)</label>
<div class="inner-addon left-addon">
<i class="fas fa-envelope-open fa-fw custom-icon"></i>
<input type="text" class="form-control" id="inputDocuments" placeholder="Документы, пакет и т.д.">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<label for="selectGetMoney" class="control-label m-b-8">Брать деньги за груз? </label>
<div class="inner-addon left-addon top-addon">
<i class="fas fa-money-bill-wave fa-fw custom-icon"></i>
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control" id="selectGetMoney">
<option selected>Нет</option>
<option>Да</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<label for="selectGetPay" class="control-label m-b-8">Оплата доставки</label>
<div class="inner-addon left-addon">
<i class="fas fa-id-card fa-fw custom-icon"></i>
<i class="fas fa-caret-down custom-arrow-down"></i>
<select class="form-control" id="selectGetPay">
<option selected>Отправитель наличными</option>
<option>Получатель наличными</option>
</select>
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<label for="inputPromokod" class="control-label m-b-8">Промокод</label>
<div class="inner-addon left-addon">
<i class="fas fa-star fa-fw custom-icon"></i>
<input type="text" class="form-control" id="inputPromokod" placeholder="Промокод (если есть)">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<label for="inputFirma" class="control-label m-b-8">Организация</label>
<div class="inner-addon left-addon">
<i class="fas fa-money-bill-wave fa-fw custom-icon"></i>
<input type="text" class="form-control" id="inputFirma" placeholder="ООО «Ромашка» ">
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<label for="inputOrderNum" class="control-label m-b-8">Номер заказа</label>
<div class="inner-addon left-addon">
<i class="fas fa-check-circle fa-fw custom-icon"></i>
<input type="text" class="form-control" id="inputOrderNum" placeholder="Внутренний номер">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5">
<label for="inputSurcharge" class="control-label m-b-8">
Доплата от заказчика
<i class="fas fa-question-circle fa-fw custom-color-grey"></i>
</label>
<div class="inner-addon left-addon">
<i class="fas fa-user-plus fa-fw custom-icon"></i>
<input type="text" class="form-control" id="inputSurcharge" placeholder="Не обязательно">
</div>
</div>
<div class="col-sm-6 col-md-4 p-r-7_5 p-l-7_5">
<label for="inputPhone" class="control-label m-b-8">Ваш мобильный телефон</label>
<div class="inner-addon left-addon">
<i class="fas fa-mobile fa-fw custom-icon"></i>
<input type="tel" class="form-control" id="inputPhone" placeholder="+7 (___) ___-__-__ *">
</div>
</div>
<div class="col-sm-6 col-md-4 p-l-7_5">
<label for="inputEmail" class="control-label m-b-8">Ваша электронная почта</label>
<div class="inner-addon left-addon">
<i class="fas fa-envelope fa-fw custom-icon"></i>
<input type="email" class="form-control" id="inputEmail" placeholder="[email protected]">
</div>
</div>
<div class="col-sm-12 m-t-20">
<div class="p-b-43 w-100 do-flex do-align-center w-654-f-d-c">
<div class="custom-form-group-summary do-flex do-wrap">
<div>Цена доставки:</div>
<div>289 рублей
<button type="button"
class="custom-btn-summary"
data-toggle="popover"
data-trigger="focus"
data-placement="right">
<i class="fas fa-info-circle fa-fw custom-color-green m-t-3"></i>
</button>
</div>
</div>
<button type="submit" class="btn custom-form-btn m-l-16 w-654-m-t-10">Оформить заказ</button>
<p class="custom-form-msg w-50 w-654-w-100 m-l-16 w-654-m-t-10">Нажимая на кнопку «Оформить заказ», Вы соглашаетесь на обработку
персональных данных в соответствии с пользовательским соглашением</p>
</div>
</div>
</div>
</form>
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</div>
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