{block name=forms_contact}
    <div id="contact">
        {$message}
        {if $show_form eq 'true'}
        <p class="alert alert-info">
            <i class="fa fa-info-circle"></i> {txt key=TEXT_CONTACT_INTRO}
        </p>
        {/if}

        {block name=forms_contact_include_content}
            {include file="xtCore/pages/content.html"}
        {/block}

        {if $show_form eq 'true'}
        {form class="form-horizontal" type=form name=login action='dynamic' link_params=getParams method=post conn=SSL role="form"}
        {form type=hidden name=action value=send}
        <fieldset>
            <legend>{txt key=TEXT_CONTACT_PAGE}</legend>
            <div class="form-group">
                <label class="col-sm-3" for="email_address">{txt key=TEXT_EMAIL}*</label>
                <div class="col-sm-9">{form id=email_address type=text name=email_address params='maxlength="40"' value=$email_address}</div>
            </div>
	        {if $show_title eq 1}
	        <div class="form-group">
		        <label for="default_address_customers_title" class="col-sm-3">{txt key=TEXT_CUSTOMERS_TITLE}</label>
		        <div class="col-sm-9">
			        {if $title_data|count}
			        {form params='id="default_address_customers_title"' type=select name='title' value=$title_data default=$title class="form-control"}
			        {else}
			        {form params='id="default_address_customers_title"' type=text   name='title' value=$title_data default=$title class="form-control"}
			        {/if}
		        </div>
	        </div>
	        {/if}
            <div class="form-group">
                <label class="col-sm-3" for="firstname">{txt key=TEXT_FIRSTNAME}*</label>
                <div class="col-sm-9">{form id=firstname type=text name=firstname params='maxlength="40"' value=$firstname}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="lastname">{txt key=TEXT_LASTNAME}*</label>
                <div class="col-sm-9">{form id=lastname type=text name=lastname params='maxlength="40"' value=$lastname}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="company">{txt key=TEXT_COMPANY}</label>
                <div class="col-sm-9">{form id=company type=text name=company params='maxlength="40"' value=$company}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="telefone">{txt key=TEXT_PHONE}</label>
                <div class="col-sm-9">{form id=telefone type=text name=telefone params='maxlength="32"' value=$telefone}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="mobile_phone">{txt key=TEXT_MOBILE_PHONE}</label>
                <div class="col-sm-9">{form id=mobile_phone type=text name=mobile_phone params='maxlength="32"' value=$mobile_phone}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="order_id">{txt key=TEXT_ORDER_NUMBER}</label>
                <div class="col-sm-9">{form id=order_id type=text name=order_id params='maxlength="40"' value=$order_id}</div>
            </div>
            <div class="form-group">
                <label class="col-sm-3" for="customer_message">{txt key=TEXT_MESSAGE}</label>
                <div class="col-sm-9">{form class="form-control" id=customer_message type=textarea name=customer_message params='cols="50" rows="15"' value=$customer_message}</div>
            </div>

            <div class="form-group">
                <label class="col-sm-3" for="customers_op_in"></label>
                <div class="col-sm-9">
                    <div class="checkbox">
                        <label> {form type=checkbox name=contact_opt_in value=1} {txt key=TEXT_CONTACT_OPT_IN} </label>
                    </div>
                </div>
            </div>

	        {if $logged_in == 'false' || $logged_in==false}
	        {if $recaptcha eq 'true' || $recaptcha==true}
	        <div class="row">
		        <div class="form-group pull-right">
			        <div class="col-sm-9 recaptcha-wrapper"></div>
		        </div>
	        </div>
	        {else}
            <div class="form-group">
                <label class="col-sm-3" for="captcha_code">{txt key=TEXT_CAPTCHA}*</label>
                <div class="col-sm-9">
                    <p id="captcha-img">
                        <img src="{$captcha_link}" alt="{txt key=TEXT_CAPTCHA}" class="img-responsive img-thumbnail" />
                    </p>
                    {form id=captcha_code type=text name=captcha params='maxlength="30"'}
                </div>
            </div>
            {/if}
            {/if}

            <div class="form-submit pull-right text-right">
                {if $show_privacy eq 1}
                {content cont_id=2 is_id='false'}
                {if $show_privacy_type eq 1}
                <div class="checkbox">
                    <label> {form type=checkbox name=privacy value=1} {txt key=TEXT_PRIVACY_TEXT_INFO} <a href="{$privacy_link}" target="_blank">{txt key=TEXT_PRIVACY_TEXT}</a>{txt key=TEXT_DOT}</label>
                </div>
                {else}
                <p>{txt key=TEXT_PRIVACY_TEXT_INFO} <a href="{$privacy_link}" target="_blank">{txt key=TEXT_PRIVACY_TEXT}</a>{txt key=TEXT_DOT}</p>
                {/if}
                {/if}
                <p>
                    <button type="submit" class="btn btn-primary"><span class="glyphicon glyphicon-envelope"></span> {txt key=BUTTON_SUBMIT}</button>
                </p>
            </div>

            <div class="clearfix visible-xs"></div>

            <p class="required pull-right-xs">{txt key=TEXT_MUST}</p>
            <div class="clearfix"></div>

        </fieldset>
        {form type=formend}
        {/if}
    </div>
{/block}