<div class="top">
    <div class="container">
        <div class="row">
            <div class="col-md-6">
                <div class="flat-address">        
                    <ul>
                        <li class="address">
                            R.T. Briscoe Head Office - 18, Fatai Atere Way, Matori, Oshodi, Lagos
                        </li>
                    </ul>
                </div><!-- /.flat-address -->
            </div><!-- /.col-md-6 -->   
            <div class="col-md-6">
                <div class="top-navigator">        
                    <ul>
                        <li style="border-right: 1px solid #FFF; padding-right: 15px;"><a href="blog.php">Briscoe Blog</a></li>
                        <li><a href="portals.php">Customer Portal</a></li>
                    </ul>
                </div><!-- /.top-navigator -->
            </div><!-- /.col-md-6 -->              
        </div><!-- /.row -->
    </div><!-- /.container -->
</div><!-- /.top -->

<!-- Modal -->
<div class="modal fade" style="z-index: 1000000;" id="requestService" tabindex="-1" role="dialog" aria-labelledby="exampleModalCenterTitle" aria-hidden="true">
    <!-- Add .modal-dialog-centered to .modal-dialog to vertically center the modal -->
    <div class="modal-dialog modal-dialog-centered" role="document">
        <div class="modal-content">
            <div class="modal-header row" style="background-color: #383E77;">
                <h5 class="modal-title col-md-10" style="color: #FFF;" id="exampleModalLongTitle">Book A Service</h5>
                <button type="button" class="close col-md-2" data-dismiss="modal" aria-label="Close" style="color: #FFF;">
                    <span aria-hidden="true" style="color: #FFF;">&times;</span>
                </button>
            </div>
            <div class="modal-body">
                <form id="contactform" method="post" action="mailer/">
                    <div class="row">
                        <div class="col-md-6">
                            <input name="txtOrigin" type="hidden" value="book quote">
                            <p><input name="txtName" type="text" placeholder="Your Name" required></p><br>
                            <p><input id="email" name="txtEmail" type="email" placeholder="Your Email" required></p><br>
                            <p>
                                <select class="control-select" style="width: 100%;" name="txtUnit" required>
                                    <option>Our Vehicles</option>
                                    <option>Yaris</option>
                                    <option>Corolla</option>
                                    <option>Camry</option>
                                    <option>Avensis</option>
                                    <option>Rush</option>
                                    <option>Landcruiser</option>
                                    <option>Rav 4</option>
                                    <option>Prado</option>
                                    <option>Fortuner</option>
                                    <option>Hilux</option>
                                    <option>Hiace</option>
                                    <option>Coaster</option>
                                    <option>Dyna</option>
                                </select>
                            </p>
                        </div><!-- /.col-md-6 -->

                        <div class="col-md-6">
                            <p><input id="subject" name="txtSubject" type="text" placeholder="Subject" required></p><br>
                            <p><textarea name="comment" placeholder="txtMessage" required></textarea></p>
                        </div><!-- /.col-md-6 -->
                    </div><!-- /.row -->
                    <div class="row">
                        <div class="col-md-12 text-right">
                            <input type="submit" class="btn btn-primary" value="Book A Service">
                        </div>
                    </div>
                </form>
            </div>
        </div>
    </div>
</div>