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@tiagorigoletto
Created March 25, 2014 19:10
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<!doctype html>
<html lang="en">
<head>
<meta charset="UTF-8">
<title>Document</title>
<link href="assets/css/dist/css/bootstrap.min.css" rel="stylesheet" type="text/css">
<link href="assets/css/dist/css/bootstrap-theme.min.css" rel="stylesheet" type="text/css">
<link href="assets/css/stylesheet.css" rel="stylesheet" type="text/css">
<script src="assets/js/jquery-1.10.2.min.js" type="text/javascript"></script>
<script src="assets/css/dist/js/bootstrap.min.js" type="text/javascript"></script>
<style>
.file {
background-color: #eee;
padding: 15px;
}
.file .progress {
margin-bottom: 0;
}
</style>
</head>
<body>
<div id="site">
<!-- Navbar -->
<div class="navbar navbar-default navbar-static-top" role="navigation">
<div class="container">
<div class="navbar-header">
<a href="index.html" class="navbar-brand">DNE</a>
</div>
<div class="navbar-collapse collapse">
<ul class="nav navbar-nav navbar-right">
<li>
<button type="button" class="btn btn-popover" data-container="body" data-toggle="popover" data-placement="bottom" data-content="Vivamus sagittis lacus vel augue laoreet rutrum faucibus.">
<span class="glyphicon glyphicon-globe"></span>
<span class="badge pull-right">42</span>
</button>
<div class="popover bottom globe">
<div class="arrow"></div>
<h3 class="popover-title">Notificações</h3>
<div class="popover-content">
<div class="row">
<div class="col-sm-2 text-center">
<a href="#"><span class="glyphicon glyphicon-ok"></span></a>
</div>
<div class="col-sm-10 text-left">
<p>Mathias Evangelista teve seu DNE entregue</p>
</div>
</div>
<div class="row">
<div class="col-sm-2 text-center">
<a href="#"><span class="glyphicon glyphicon-warning-sign"></span></a>
</div>
<div class="col-sm-10 text-left">
<p>Eric Stallone teve a validação de documentos negada</p>
</div>
</div>
<div class="row">
<div class="col-sm-2 text-center">
<a href="#"><span class="glyphicon glyphicon-ok"></span></a>
</div>
<div class="col-sm-10 text-left">
<p>Não foi possível entregar o DNE de Falcão Fernandes</p>
</div>
</div>
</div>
</div>
<!-- <a href="#" class="dropdown-toggle" data-toggle="dropdown">
<span class="glyphicon glyphicon-globe"></span>
</a>
<ul class="dropdown-menu" role="menu">
<li></li>
<li><a href="#">
<span class="glyphicon glyphicon-warning-sign"></span> O DNE de Eric Stallone teve a validação de documentos negada</a>
</li>
</ul> -->
</li>
<li>
<a href="index.html">Início</a>
</li>
<li>
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Meu DNE <span class="caret"></span></a>
<ul class="dropdown-menu" role="menu">
<li><a href="#">Solicitar DNE</a></li>
<li><a href="#">Solicitar Segunda via</a></li>
<li><a href="#">Minhas Solicitações</a></li>
</ul>
</li>
<li>
<a href="#" class="dropdown-toggle" data-toggle="dropdown">Minha conta <span class="caret"></span></a>
<ul class="dropdown-menu" role="menu">
<li><a href="#">Alterar senha</a></li>
<li><a href="#">Sair</a></li>
</ul>
</li>
</ul>
</div>
</div>
</div>
<!-- # Navbar # -->
<div class="container">
<div class="row">
<h3>Solicitar inclusão de agente</h3>
<br />
<fieldset>
<legend>Dados gerais</legend>
<p class="help-block">Para realizar a solicitação, é necessário enviar uma cópia (ou foto) dos seguintes documentos: Cartão CPNJ, Contrato Social e Comprovante de endereço estabelecimento.</p>
<div class="row">
<div class="form-group col-sm-8">
<label for="nome" class="">CNPJ</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
<div class="form-group col-sm-4">
<label for="nome" class="">Telefone Comercial</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
</div>
<div class="row">
<div class="form-group col-sm-12">
<label for="nome" class="">Cartão CNPJ</label>
<div class="input-group">
<input disabled type="text" class="form-control">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Selecionar arquivo</button>
</span>
</div><!-- /input-group -->
</div>
</div>
<div class="row">
<div class="form-group col-sm-12">
<label for="nome" class="">Contrato social</label>
<div class="input-group">
<input disabled type="text" class="form-control">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Selecionar arquivo</button>
</span>
</div><!-- /input-group -->
</div>
</div>
<div class="row">
<div class="form-group col-sm-12">
<label for="nome" class="">Comprovante de endereço</label>
<div class="file">
<div class="row">
<div class="col-sm-8">
<a href="#">nome_do_arquivo.jpeg</a>
</div>
<div class="col-sm-4">
<div class="pull-right">
<a href="#">
<span class="glyphicon glyphicon-remove"></span>
</a>
</div>
<div class="pull-right col-sm-10">
<div class="progress progress-striped active">
<div class="progress-bar" role="progressbar" aria-valuenow="45" aria-valuemin="0" aria-valuemax="100" style="width: 100%">
<span class="sr-only">Carregando</span>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
<fieldset>
<legend>Endereço comercial</legend>
<div class="row">
<p>Componente de endereço</p>
</div>
</fieldset>
<fiedset>
<legend>Endereço de postagem</legend>
<div class="row">
<p>Componente de endereço</p>
</div>
</fiedset>
<fieldset>
<legend>Responsáveis legais</legend>
<p class="help-block">Você pode cadastrar até quatro responsáveis legais, sendo necessário o envio uma cópia (ou foto) do RG e CPF de cada um.</p>
<div class="row">
<div class="form-group col-sm-4">
<label for="nome" class="">Nome</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
<div class="form-group col-sm-4">
<label for="nome" class="">RG</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
<div class="form-group col-sm-4">
<label for="nome" class="">CPF</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
</div>
<div class="row">
<div class="form-group col-sm-4">
<label for="nome" class="">E-mail</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
<div class="form-group col-sm-4">
<label for="nome" class="">Telefone</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
<div class="form-group col-sm-4">
<label for="nome" class="">Celular</label>
<input type="text" class="form-control" id="nome" placeholder="CNPJ">
</div>
</div>
<div class="row">
<div class="form-group col-sm-12">
<div class="row">
<div class="form-group col-sm-12">
<label for="nome" class="">Cópia do RG</label>
<div class="input-group">
<input disabled type="text" class="form-control">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Selecionar arquivo</button>
</span>
</div><!-- /input-group -->
</div>
</div>
<div class="row">
<div class="form-group col-sm-12">
<label for="nome" class="">Cópia do CPF</label>
<div class="input-group">
<input disabled type="text" class="form-control">
<span class="input-group-btn">
<button class="btn btn-default" type="button">Selecionar arquivo</button>
</span>
</div><!-- /input-group -->
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-12">
<button class="btn btn-default">
<span class="glyphicon glyphicon-plus"></span>
Adicionar outro responsável legal
</button>
</div>
</div>
</fieldset>
<br />
<div class="row">
<div class="col-sm-12">
<button class="btn btn-primary pull-right">Enviar solicitação</button>
</div>
</div>
</div><!-- /.row -->
</div><!-- /.container -->
</div><!-- /.site -->
</body>
</html>
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