{"id":17359,"date":"2021-06-01T15:58:40","date_gmt":"2021-06-01T13:58:40","guid":{"rendered":"https:\/\/www.coch.pl\/formularz-zlecenia\/"},"modified":"2024-07-07T23:47:09","modified_gmt":"2024-07-07T21:47:09","slug":"form-order","status":"publish","type":"page","link":"https:\/\/www.coch.pl\/en\/form-order\/","title":{"rendered":"Order form"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"17359\" class=\"elementor elementor-17359 elementor-12128\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2d4bd67 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2d4bd67\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fd9008c\" data-id=\"fd9008c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b7ad70d elementor-widget elementor-widget-spacer\" data-id=\"b7ad70d\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-2cc245f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2cc245f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-4614e6c\" data-id=\"4614e6c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2027ec3 elementor-widget elementor-widget-menu-anchor\" data-id=\"2027ec3\" data-element_type=\"widget\" data-widget_type=\"menu-anchor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-menu-anchor\" id=\"FORMULARZE\"><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35e21f3 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"35e21f3\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:0}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Order forms<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-1af415d\" data-id=\"1af415d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-85903bc elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"85903bc\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:160}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong><span style=\"color: #000000;\">If you choose the traditional form of the order, the documents should be sent to the address:<\/span>\u00a0<a href=\"laboratorium@coch.pl\">laboratorium<span id=\"eeb-824383-745122\"><\/span><\/a><a href=\"laboratorium@coch.pl\"><span id=\"eeb-824383-745122\">@coch.pl<\/span><\/a><\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9ca4e14 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9ca4e14\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bbb0633\" data-id=\"bbb0633\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d863642 elementor-widget elementor-widget-text-editor\" data-id=\"d863642\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><span style=\"color: #000000;\">If you have any problems \/ concerns, please contact us directly using the details in the <strong>Contact Us<\/strong> tab. <strong>After submitting the form, you will receive an e-mail confirmation with further instructions for shipping \/ delivery of the device to our headquarters.<\/strong><\/span><\/p><p><span style=\"color: #000000;\">You can also use the downloadable forms below:<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f05ea34 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f05ea34\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4bca502\" data-id=\"4bca502\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section data-ep-wrapper-link=\"{&quot;url&quot;:&quot;https:\\\/\\\/www.coch.pl\\\/wp-content\\\/uploads\\\/2024\\\/06\\\/Zlecenie_sprawdzenia_wykrywacza_nieszczelnosci.pdf&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;}\" style=\"cursor: pointer\" class=\"bdt-element-link elementor-section elementor-inner-section elementor-element elementor-element-83cea16 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"83cea16\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-b1f38a7\" data-id=\"b1f38a7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e4cc5c9 elementor-invisible elementor-widget elementor-widget-image\" data-id=\"e4cc5c9\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:160}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"400\" height=\"128\" src=\"https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf.png\" class=\"attachment-full size-full wp-image-35749\" alt=\"\" srcset=\"https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf.png 400w, https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf-300x96.png 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-e6a6523\" data-id=\"e6a6523\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c5c0fe5 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"c5c0fe5\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:240}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"> Traditional application - LEAK DETECTOR<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-bbf27f6\" data-id=\"bbf27f6\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-436396e elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"436396e\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:320}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>\u00a0Order to check the leak detector<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-5a13372\" data-id=\"5a13372\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8716609 elementor-align-right elementor-mobile-align-left elementor-invisible elementor-widget elementor-widget-button\" data-id=\"8716609\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:400}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"ti ti-arrow-top-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ceacbb6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ceacbb6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-20ef7d7\" data-id=\"20ef7d7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<section data-ep-wrapper-link=\"{&quot;url&quot;:&quot;https:\\\/\\\/www.coch.pl\\\/wp-content\\\/uploads\\\/2024\\\/06\\\/Zlecenie_sprawdzenia_wagi-i-manometru.pdf&quot;,&quot;is_external&quot;:&quot;&quot;,&quot;nofollow&quot;:&quot;&quot;,&quot;custom_attributes&quot;:&quot;&quot;}\" style=\"cursor: pointer\" class=\"bdt-element-link elementor-section elementor-inner-section elementor-element elementor-element-9b00996 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9b00996\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-bc28d69\" data-id=\"bc28d69\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-cf96386 elementor-invisible elementor-widget elementor-widget-image\" data-id=\"cf96386\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:160}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"400\" height=\"128\" src=\"https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf.png\" class=\"attachment-full size-full wp-image-35749\" alt=\"\" srcset=\"https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf.png 400w, https:\/\/www.coch.pl\/wp-content\/uploads\/2024\/06\/pdf-300x96.png 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-6521828\" data-id=\"6521828\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d2992e2 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"d2992e2\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:240}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"> Traditional application - refrigeration EQUIPMENT<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-a56b11b\" data-id=\"a56b11b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f9f7f43 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"f9f7f43\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:320}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>Order to check refrigeration scale and pressure gauge<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-25 elementor-inner-column elementor-element elementor-element-76fff87\" data-id=\"76fff87\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6179fa1 elementor-align-right elementor-mobile-align-left elementor-invisible elementor-widget elementor-widget-button\" data-id=\"6179fa1\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_delay&quot;:400}\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-size-sm\" role=\"button\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"ti ti-arrow-top-right\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-8996826 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"8996826\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-62e0d91\" data-id=\"62e0d91\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7df8cbb elementor-widget elementor-widget-heading\" data-id=\"7df8cbb\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">WNIOSEK ONLINE:<\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6afdf7 elementor-widget elementor-widget-arf-element-shortcode\" data-id=\"b6afdf7\" data-element_type=\"widget\" data-widget_type=\"arf-element-shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h5 class=\"title\"><\/h5><div class=\"arf_select\"><style type=\"text\/css\" id=\"112\" data-form-unique-id=\"55934\" ><\/style><div class=\"arf_form ar_main_div_112 arf_form_outer_wrapper \" id=\"arffrm_112_container\"><div id=\"arf_message_error\" class=\"frm_error_style\" style=\"display:none;\"><div class=\"msg-detail\"><div class=\"msg-description-success\">Form Submission is restricted<\/div><\/div><\/div><div id=\"arf_message_success_popup\" style=\"display:none;\"><div class=\"msg-detail\"><div class=\"msg-description-success\">Twoje zg\u0142oszenie zosta\u0142o pomy\u015blnie przes\u0142ane!<br>\nInformacje odno\u015bnie wysy\u0142ki urz\u0105dze\u0144 do kontroli zosta\u0142y przes\u0142ane na podany przez Pa\u0144stwa adres email.<br>\nDzi\u0119kujemy!<\/div><\/div><\/div><form enctype=\"multipart\/form-data\" method=\"post\" class=\"arfshowmainform  \" style=\"\" data-form-id=\"form_abi7ot\"  novalidate=\"\" data-id=\"55934\"  data-random-id=\"112_M35suqaamN\"  data-submission-key=\"S8ioVR0f\"  data-key-validate=\"false\"  data-popup-id=\"\"><input type='text' name='arf_filter_input' data-jqvalidate='false' data-random-key='112_M35suqaamN' value='' style='opacity:0 !important;display:none !important;visibility:hidden !important;' \/><input type='hidden' id='arf_ajax_url' value='https:\/\/www.coch.pl\/wp-admin\/admin-ajax.php' \/><input type=\"hidden\" data-jqvalidate=\"false\" class=\"kpress\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" class=\"stime\" value=\"1778769025\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"nonce_start_time\" class=\"nonce_start_time\" value=\"form_filter_st\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"nonce_keyboard_press\" class=\"nonce_keyboard_press\" value=\"form_filter_kp\" \/><input type=\"hidden\" data-jqvalidate=\"false\" data-id=\"arm_nonce_check\" name=\"arm_nonce_check\" value=\"156baae75f\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_redirect_url_to\" id=\"arf_redirect_url_to\" value=\"same_tab\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_browser_name\" data-id=\"arf_browser_name\" data-version=\"unknown\" value=\"Unknown\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arforms_nonce\" id=\"arforms_nonce\" value=\"d3e67f94bb\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfdecimal_separator\" data-id=\"arfdecimal_separator\" value=\".\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_key_112\" data-id=\"form_key_112\" value=\"abi7ot\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_success_message_show_time_112\" data-id=\"arf_success_message_show_time_112\" value=\"3\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_form_hide_after_submit_112\" data-id=\"arf_form_hide_after_submit_112\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"is_form_preview_112\" data-id=\"is_form_preview_112\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_validate_outside_112\" data-id=\"arf_validate_outside_112\" data-validate=\"0\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_validate_outside_112\" data-id=\"arf_is_validate_outside_112\" data-validate=\"0\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_resetform_aftersubmit_112\" data-id=\"arf_is_resetform_aftersubmit_112\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_is_resetform_outside_112\" data-id=\"arf_is_resetform_outside_112\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_form_enable_cookie_112\" data-id=\"arf_form_enable_cookie_112\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_tooltip_settings_112\" data-id=\"arf_tooltip_settings_112\" class=\"arf_front_tooltip_settings\" data-form-id=\"112\" data-color=\"#FFFFFF\" data-position=\"top\" data-width=\"\" data-bg-color=\"#000000\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfsuccessmsgposition_112\" data-id=\"arfsuccessmsgposition_112\"  value=\"top\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfpagebreakstyle_112\" data-id=\"arfpagebreakstyle_112\"  value=\"number\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfpagebreakaddtimer_112\" data-id=\"arfpagebreakaddtimer_112\" value=\"0\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_tooltip_error_112\" data-id=\"form_tooltip_error_112\" data-color=\"\" data-position=\"bottom\" value=\"advance\" \/><input type=\"text\" data-jqvalidate=\"false\" name=\"fake_text\" data-id=\"fake_text\" value=\"\" style=\"height:0 !important; margin:0 !important; opacity: 0 !important; filter:alpha(opacity=0); padding:0 !important; width:0 !important; float:left;\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfaction\" value=\"create\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_id\" data-id=\"form_id\" value=\"112\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_data_id\" data-id=\"form_data_id\" value=\"55934\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_key\" data-id=\"form_key\" value=\"abi7ot\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_ajax_url\" value=\"https:\/\/www.coch.pl\/wp-admin\/admin-ajax.php\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_display_type\" data-id=\"form_display_type\" value=\"0|https:\/\/www.coch.pl\/en\/form-order\/\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_submit_type\" data-id=\"form_submit_type\" value=\"1\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_http_referrer_url\" data-id=\"arf_http_referrer_url\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"entry_key\" value=\"\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arf_skip_captcha\" data-id=\"arf_skip_captcha\" value=\"0\" \/><input type='hidden' id='arf_pb_field_animation_style_front_112' name='arf_pb_field_animation_style_front_112' value='slideInLeft' \/><input type='hidden' id='arf_pb_field_animation_duration_front_112' name='arf_pb_field_animation_duration_front_112' value='' \/><input type='hidden' id='arf_pb_field_animation_delay_front_112' name='arf_pb_field_animation_delay_front_112' value='' \/><input type='hidden' id='arf_pb_field_animation_inherit_112' name='arf_pb_field_animation_inherit_112' value='0' \/><input type='hidden' id='arf_field_animation_style_front_112' name='arf_field_animation_style_front_112' value='' \/><input type='hidden' id='arf_field_animation_duration_front_112' name='arf_field_animation_duration_front_112' value='' \/><input type='hidden' id='arf_field_animation_delay_front_112' name='arf_field_animation_delay_front_112' value='' \/><input type=\"hidden\" id=\"arf_form_site_wide_112\" value=\"\" \/><div class=\"allfields\"  style=\"visibility:hidden;height:0;\"><div class=\"arf_fieldset arf_material_outline_form\" id=\"arf_fieldset_55934\"><div id=\"page_0\" class=\"page_break\"><input type=\"hidden\" id=\"arf_repeatable_field_counter_697\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_697\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top  ' style='display:block'; data-field-type='section' ><b>Typ urz\u0105dzenia do kontroli<\/b><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_695_55934_container\" class=\"arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_checkbox   top_container arfformfield  top_container arf_field_695\"  style='width: 100%'  data-field-type=\"checkbox\" data-parent_field=\"697\"><label data-type=\"checkbox\" for=\"field_ms2yek_55934\" class=\"arf_main_label arf_main_label_16px\">Wybierz typ urz\u0105dze\u0144 jakie chcesz przes\u0142a\u0107 do kontroli \/ wzorcowania:<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_checkbox controls  arf_material_checkbox arf_default_material \" style=\"padding-top:5px;\" ><div class=\"arf_checkbox_style  \" id=\"frm_checkbox_695-0\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[695][]\" data-type=\"checkbox\" id=\"field_695-0-55934\" value=\"Wykrywacz\/detektor nieszczelno\u015bci\"    class=\" arf_required \"data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"To pole nie mo\u017ce by\u0107 puste\" style=''  onChange='arf_cl_apply_v3(55934,[\"707\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_695-0-55934\" >Wykrywacz\/detektor nieszczelno\u015bci<\/label><\/div><div class=\"arf_checkbox_style  \" id=\"frm_checkbox_695-1\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[695][]\" data-type=\"checkbox\" id=\"field_695-1-55934\" value=\"Manometr ch\u0142odniczy\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(55934,[\"707\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_695-1-55934\" >Manometr ch\u0142odniczy<\/label><\/div><div class=\"arf_checkbox_style  \" id=\"frm_checkbox_695-2\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[695][]\" data-type=\"checkbox\" id=\"field_695-2-55934\" value=\"Termometr ch\u0142odniczy\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(55934,[\"707\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_695-2-55934\" >Termometr ch\u0142odniczy<\/label><\/div><div class=\"arf_checkbox_style  \" id=\"frm_checkbox_695-3\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[695][]\" data-type=\"checkbox\" id=\"field_695-3-55934\" value=\"Waga ch\u0142odnicza\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(55934,[\"707\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_695-3-55934\" >Waga ch\u0142odnicza<\/label><\/div><div class=\"arf_checkbox_style  \" id=\"frm_checkbox_695-4\"><div class='arf_checkbox_input_wrapper'><input type=\"checkbox\" name=\"item_meta[695][]\" data-type=\"checkbox\" id=\"field_695-4-55934\" value=\"Multimetr\"    class=\" arf_required \" style=''  onChange='arf_cl_apply_v3(55934,[\"707\"]);' \/><span><\/span><\/div><label data-type=\"checkbox\" for=\"field_695-4-55934\" >Multimetr<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_707_55934_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_707\" data-field-type=\"html\" data-parent_field=\"697\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p style=\"text-align:justify\"><span style=\"font-size:14px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Zgodnie\u00a0 z\u00a0 <a href=\"https:\/\/isap.sejm.gov.pl\/isap.nsf\/DocDetails.xsp?id=WDU20170002417\" target=\"_blank\" rel=\"noopener\">Rozporz\u0105dzeniem\u00a0 Ministra\u00a0 Rozwoju\u00a0 i\u00a0 Finans\u00f3w\u00a0 z\u00a0 dnia\u00a0 7\u00a0 grudnia\u00a0 2017\u00a0 r.\u00a0<\/a> w\u00a0 sprawie\u00a0 minimalnego\u00a0 wyposa\u017cenia technicznego, procedur oraz systemu dokumentowania czynno\u015bci przy prowadzeniu dzia\u0142alno\u015bci, polegaj\u0105cej na instalowaniu, konserwacji\u00a0 lub\u00a0 serwisowaniu,\u00a0 naprawie\u00a0 lub\u00a0 likwidacji\u00a0 urz\u0105dze\u0144,\u00a0 zawieraj\u0105cych\u00a0 fluorowane\u00a0 gazy\u00a0 cieplarniane,\u00a0 sprawdzenie wykrywaczy nieszczelno\u015bci nale\u017cy przeprowadza\u0107 raz na rok.<\/span><\/span><\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_708_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_708\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"697\"><div class=\"controls\"   ><div class=\"arf_material_outline_container  \"><textarea name=\"item_meta[708]\" id=\"field_kbnsl_55934\"  rows=\"3\"  class=\" arf_required \" placeholder=\"Prodecent \/ Typ \/ Numer seryjny\"  data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"  ><\/textarea><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"textarea\" for=\"field_kbnsl_55934\" class=\"arf_main_label arf_main_label_16px\">Wpisz dane urz\u0105dzenia\/urz\u0105dze\u0144:<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_698\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_698\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top  ' style='display:block'; data-field-type='section' ><b>Dane do faktury:<\/b><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_702_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_702\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"698\" ><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_only_leading_icon  \"><i class=\"arf_leading_icon far fa-building\"><\/i><input   type=\"text\" id=\"field_3pxyw3_55934\"  name=\"item_meta[702]\"  class=\" arf_required \" data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"   \/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"text\" for=\"field_3pxyw3_55934\" class=\"arf_main_label arf_main_label_16px\">Nazwa firmy<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_701_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_701\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"698\" ><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_only_leading_icon  \"><i class=\"arf_leading_icon far fa-building\"><\/i><input   type=\"text\" id=\"field_v5vnup_55934\"  name=\"item_meta[701]\"  class=\" arf_required \" data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"   \/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"text\" for=\"field_v5vnup_55934\" class=\"arf_main_label arf_main_label_16px\">Adres firmy<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_700_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_700\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"698\" ><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_only_leading_icon  \"><i class=\"arf_leading_icon far fa-building\"><\/i><input   type=\"text\" id=\"field_2d3gbj_55934\"  name=\"item_meta[700]\"  class=\" arf_required \" data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"   \/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"text\" for=\"field_2d3gbj_55934\" class=\"arf_main_label arf_main_label_16px\">Numer NIP<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_699\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_699\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top  ' style='display:block'; data-field-type='section' ><b>Dane kontaktowe:<\/b><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_709_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_text  top_container top_container arfformfield   arf_inline_field_value  arf_field_709\"  style='width: 100%' data-field-type=\"text\" data-parent_field=\"699\" ><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_only_leading_icon  \"><i class=\"arf_leading_icon far fa-address-card\"><\/i><input   type=\"text\" id=\"field_wxw7xi_55934\"  name=\"item_meta[709]\"  class=\" arf_required \" data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"   \/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"text\" for=\"field_wxw7xi_55934\" class=\"arf_main_label arf_main_label_16px\">Imi\u0119 i Nazwisko<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_705_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_email  top_container  arf_inline_field_value   top_container arfformfield  arf_field_705\"  style='width: 100%'  data-field-type=\"email\" data-parent_field=\"699\"><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_only_leading_icon  \"><i class=\"arf_leading_icon fas fa-mail-bulk\"><\/i><input type=\"text\" id=\"field_ozxep2_55934\" name=\"item_meta[705]\"  class=\" arf_required \" data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"  data-validation-regex-regex=\"[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\\.[A-Za-z]+\" data-validation-regex-message=\"Wprowadzony adres email jest nieprawid\u0142owy\"  \/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"email\" for=\"field_ozxep2_55934\" class=\"arf_main_label arf_main_label_16px\">Adres e-mail<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_704_55934_container\" class=\"arfformfield control-group arfmainformfield  arffieldrequired arf_field_type_phone  top_container  top_container arfformfield   arf_inline_field_value  arf_field_704\"  style='width: 100%'  data-field-type=\"phone\" data-parent_field=\"699\"><div class=\"controls\"   ><div class=\"arf_material_outline_container arf_material_outline_container_with_icons arf_phone_with_flag arf_only_leading_icon  \"><input type=\"text\" data-type=\"phone\"  id=\"field_z08kni_55934\"name=\"item_meta[704]\" class=\" arf_required  arf_phone_utils \" data-defaultCountryCode=\"af\"  data-do-validation=\"true\" data-invalid-format-message=\"Numer telefonu jest nieprawid\u0142owy\"data-validation-required-message=\"To pole nie mo\u017ce by\u0107 puste\"\/><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"phone\" for=\"field_z08kni_55934\" class=\"arf_main_label arf_main_label_16px arf_phone_label_cls \">Numer telefonu<span class=\"arfcheckrequiredfield\">*<\/span><\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><input type='hidden' data-jqvalidate='false' id='field_z08kni_country_list' value='[\"af\",\"ax\",\"al\",\"dz\",\"as\",\"ad\",\"ao\",\"ai\",\"ag\",\"ar\",\"am\",\"aw\",\"au\",\"at\",\"az\",\"bs\",\"bh\",\"bd\",\"bb\",\"by\",\"be\",\"bz\",\"bj\",\"bm\",\"bt\",\"bo\",\"ba\",\"bw\",\"br\",\"io\",\"vg\",\"bn\",\"bg\",\"bf\",\"bi\",\"kh\",\"cm\",\"ca\",\"cv\",\"bq\",\"ky\",\"cf\",\"td\",\"cl\",\"cn\",\"cx\",\"cc\",\"co\",\"km\",\"cd\",\"cg\",\"ck\",\"cr\",\"ci\",\"hr\",\"cu\",\"cw\",\"cy\",\"cz\",\"dk\",\"dj\",\"dm\",\"do\",\"ec\",\"eg\",\"sv\",\"gq\",\"er\",\"ee\",\"et\",\"fk\",\"fo\",\"fj\",\"fi\",\"fr\",\"gf\",\"pf\",\"ga\",\"gm\",\"ge\",\"de\",\"gh\",\"gi\",\"gr\",\"gl\",\"gd\",\"gp\",\"gu\",\"gt\",\"gg\",\"gn\",\"gw\",\"gy\",\"ht\",\"hn\",\"hk\",\"hu\",\"is\",\"in\",\"id\",\"ir\",\"iq\",\"ie\",\"im\",\"il\",\"it\",\"jm\",\"jp\",\"je\",\"jo\",\"kz\",\"ke\",\"ki\",\"xk\",\"kw\",\"kg\",\"la\",\"lv\",\"lb\",\"ls\",\"lr\",\"ly\",\"li\",\"lt\",\"lu\",\"mo\",\"mk\",\"mg\",\"mw\",\"my\",\"mv\",\"ml\",\"mt\",\"mh\",\"mq\",\"mr\",\"mu\",\"yt\",\"mx\",\"fm\",\"md\",\"mc\",\"mn\",\"me\",\"ms\",\"ma\",\"mz\",\"mm\",\"na\",\"nr\",\"np\",\"nl\",\"nc\",\"nz\",\"ni\",\"ne\",\"ng\",\"nu\",\"nf\",\"kp\",\"mp\",\"no\",\"om\",\"pk\",\"pw\",\"ps\",\"pa\",\"pg\",\"py\",\"pe\",\"ph\",\"pl\",\"pt\",\"pr\",\"qa\",\"re\",\"ro\",\"ru\",\"rw\",\"bl\",\"sh\",\"kn\",\"lc\",\"mf\",\"pm\",\"vc\",\"ws\",\"sm\",\"st\",\"sa\",\"sn\",\"rs\",\"sc\",\"sl\",\"sg\",\"sx\",\"sk\",\"si\",\"sb\",\"so\",\"za\",\"kr\",\"ss\",\"es\",\"lk\",\"sd\",\"sr\",\"sj\",\"sz\",\"se\",\"ch\",\"sy\",\"tw\",\"tj\",\"tz\",\"th\",\"tl\",\"tg\",\"tk\",\"to\",\"tt\",\"tn\",\"tr\",\"tm\",\"tc\",\"tv\",\"vi\",\"ug\",\"ua\",\"ae\",\"gb\",\"us\",\"uy\",\"uz\",\"vu\",\"va\",\"ve\",\"vn\",\"wf\",\"eh\",\"ye\",\"zm\",\"zw\"]' \/><input type='hidden' data-jqvalidate='false' name='item_meta[704_country_code]' id='field_z08kni_55934_country_code' \/><input type='hidden' data-jqvalidate='false' id='field_z08kni_55934_default_country' value='pl' \/><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><input type=\"hidden\" id=\"arf_repeatable_field_counter_696\" data-max_add=\"0\" value=\"1\" \/><div id=\"heading_696\" class=\"arf_heading_div\"><h2 class='arf_sec_heading_field pos_top  ' style='display:block'; data-field-type='section' ><b>Dane dodatkowe:<\/b><\/h2><div class=\"arf_field_description arf_heading_description\"><\/div><div id=\"arf_field_694_55934_container\" class=\"arfformfield control-group arfmainformfield  arf_vertical_radio  arffieldrequired arf_field_type_radio   top_container arfformfield  top_container arf_field_694\"  style='width: 100%'  data-field-type=\"radio\" data-parent_field=\"696\"><label data-type=\"radio\" for=\"field_vjcc71_55934\" class=\"arf_main_label arf_main_label_16px\">Jak odbierzesz urz\u0105dzenie?<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"setting_radio controls  arf_material_radio arf_default_material \" style=\"padding-top:5px;\" ><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[694]\" data-type=\"radio\" id=\"field_694-0-55934\" data-unique-id=\"55934\" value=\"Odbi\u00f3r osobisty\"   class=\" arf_required \" data-validation-minchecked-minchecked=\"1\" data-validation-minchecked-message=\"Pole nie mo\u017ce by\u0107 puste\" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_694-0-55934\" class=\"\">Odbi\u00f3r osobisty<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[694]\" data-type=\"radio\" id=\"field_694-1-55934\" data-unique-id=\"55934\" value=\"Wysy\u0142ka kurierem przez COCH\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_694-1-55934\" class=\"\">Wysy\u0142ka kurierem przez COCH<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[694]\" data-type=\"radio\" id=\"field_694-2-55934\" data-unique-id=\"55934\" value=\"W\u0142asny kurier\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_694-2-55934\" class=\"\">W\u0142asny kurier<\/label><\/div><div class=\"arf_radiobutton \"><div class='arf_radio_input_wrapper'><input type=\"radio\" name=\"item_meta[694]\" data-type=\"radio\" id=\"field_694-3-55934\" data-unique-id=\"55934\" value=\"Inne (sprecyzuj w uwagach)\"   class=\" arf_required \" style=\" \" \/><span><\/span><\/div><label data-type=\"radio\" for=\"field_694-3-55934\" class=\"\">Inne (sprecyzuj w uwagach)<\/label><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_706_55934_container\" class=\"arfformfield control-group arfmainformfield  arf_field_type_textarea  top_container top_container arfformfield   arf_inline_field_value  arf_field_706\"  style='width: 100%'  data-field-type=\"textarea\" data-parent_field=\"696\"><div class=\"controls\"   ><div class=\"arf_material_outline_container  \"><textarea name=\"item_meta[706]\" id=\"field_wfxedd_55934\"  rows=\"3\"  ><\/textarea><div class=\"arf_material_outliner\"><div class=\"arf_material_outliner_prefix\"><\/div><div class=\"arf_material_outliner_notch \"><label data-type=\"textarea\" for=\"field_wfxedd_55934\" class=\"arf_main_label arf_main_label_16px\">Uwagi do zlecenia<\/label><\/div><div class=\"arf_material_outliner_suffix\"><\/div><\/div><\/div><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_710_55934_container\" class=\"arfformfield arf_display_to_confirmation_summary control-group arfmainformfield  arf_field_type_html  top_container  top_container arfformfield  arf_field_710\" data-field-type=\"html\" data-parent_field=\"696\" style='width: 100%'><div class=\"arf_htmlfield_control\"><p style=\"text-align:justify\"><span style=\"font-size:14px\"><span style=\"font-family:Arial,Helvetica,sans-serif\">Dostarczenie uzupe\u0142nionego (wraz z podpisami) zlecenia wraz z w\/w przyrz\u0105dami jest jednoznaczne z akceptacj\u0105 warunk\u00f3w zam\u00f3wienia i zawarciem umowy na wykonanie us\u0142ugi.<\/span><\/span><\/p><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_703_55934_container\" class=\"arfformfield control-group arfmainformfield   arffieldrequired arf_field_type_arf_switch  top_container  top_container arfformfield  arf_field_703\"  style='width: 100%' data-field-type=\"arf_switch\" data-parent_field=\"696\"><label data-type=\"arf_switch\" for=\"field_tbqrsd_55934\" class=\"arf_main_label arf_main_label_16px\">Wyra\u017cam zgod\u0119 na przetwarzanie moich danych osobowych przez COCH na potrzeby realizacji zam\u00f3wienia.<span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"arf_input_field_switch_wrapper controls \" ><label class=\"arf_js_field_switch_label\" for=\"switch_field_tbqrsd-55934\"><span>Nie&nbsp;<\/span><\/label><span class=\"arf_js_field_switch_wrapper\"><input type=\"checkbox\" data-type=\"arf_switch_input\"  id=\"switch_field_tbqrsd-55934\" name=\"switch_item_meta[703]\" class=\"js-field_switch arf_hide_opacity arf_field_switch_input arf_switch_input\"  value=\"Nie\" data-leftval=\"Nie\" data-rightval=\"Tak\"   data-validation-required-message=\"To pole nie mo\u017ce by\u0107 niewype\u0142nione\"\/ ><span class=\"arf_js_field_switch\"><\/span><input type=\"hidden\" data-type=\"arf_switch\" id=\"field_tbqrsd-55934\" name=\"item_meta[703]\" value=\"Nie\" class=\"arf_hidden_field_switch\"\/ ><\/span> <label class=\"arf_js_field_switch_label\" for=\"switch_field_tbqrsd-55934\"><span>&nbsp;Tak<\/span><\/label><\/div><\/div><div style=\"clear:both;\"><\/div><div id=\"arf_field_711_55934_container\" class=\"arfformfield control-group arfmainformfield   arffieldrequired arf_field_type_arf_switch  top_container  top_container arfformfield  arf_field_711\"  style='width: 100%' data-field-type=\"arf_switch\" data-parent_field=\"696\"><label data-type=\"arf_switch\" for=\"field_3yz306_55934\" class=\"arf_main_label arf_main_label_16px\">Zapozna\u0142em si\u0119 i akceptuj\u0119 <a href=\"https:\/\/www.coch.pl\/rodo\/\">Polityk\u0119 Prywatno\u015bci COCH.<\/a><span class=\"arfcheckrequiredfield\">*<\/span><\/label><div class=\"arf_input_field_switch_wrapper controls \" ><label class=\"arf_js_field_switch_label\" for=\"switch_field_3yz306-55934\"><span>Nie&nbsp;<\/span><\/label><span class=\"arf_js_field_switch_wrapper\"><input type=\"checkbox\" data-type=\"arf_switch_input\"  id=\"switch_field_3yz306-55934\" name=\"switch_item_meta[711]\" class=\"js-field_switch arf_hide_opacity arf_field_switch_input arf_switch_input\"  value=\"Nie\" data-leftval=\"Nie\" data-rightval=\"Tak\"   data-validation-required-message=\"To pole nie mo\u017ce by\u0107 niewype\u0142nione\"\/ ><span class=\"arf_js_field_switch\"><\/span><input type=\"hidden\" data-type=\"arf_switch\" id=\"field_3yz306-55934\" name=\"item_meta[711]\" value=\"Nie\" class=\"arf_hidden_field_switch\"\/ ><\/span> <label class=\"arf_js_field_switch_label\" for=\"switch_field_3yz306-55934\"><span>&nbsp;Tak<\/span><\/label><\/div><\/div><div style=\"clear:both;\"><\/div><\/div><div style=\"clear:both;\"><\/div><div style=\"clear:both;height:1px;\">&nbsp;<\/div><\/div><!-- page_break && page_0--><div class=\"arfsubmitbutton top_container\" ><div class=\"arf_submit_div  top_container\"><input type=\"hidden\" data-jqvalidate=\"false\" value=\"1\" name=\"is_submit_form_112\" data-id=\"is_submit_form_112\" \/><input type=\"hidden\" data-jqvalidate=\"false\" value=\"0\" data-val=\"0\" data-max=\"0\" name=\"submit_form_112\" data-id=\"submit_form_112\" \/><button class=\"arf_submit_btn  arf_submit_btn_border   btn-info arfstyle-button  unknown\"  id=\"arf_submit_btn_55934\" name=\"arf_submit_btn_55934\" data-style=\"zoom-in\"  ><span class=\"arfsubmitloader\"><\/span><span class=\"arfstyle-label\">Wy\u015blij zam\u00f3wienie<\/span><\/button><\/div><\/div><div style=\"clear:both\"><\/div><\/div><!-- arf_fieldset --><input type=\"hidden\" id=\"arf_recaptcha_v3_public_key\" value=\"6LfPnicaAAAAAIXzjpB4xHvTwVsJtZp_gdETJtq6\" \/><input type=\"hidden\" id=\"arf_recaptcha_v3_private_key\" value=\"6LfPnicaAAAAAPpopvYlgRA32k-BgJR_b5S6wlR9\" \/><input type=\"hidden\" id=\"arf_recaptcha_v3_theme\" value=\"light\" \/><input type=\"hidden\" id=\"arf_recaptcha_v3_lang\" value=\"pl\" \/><input type=\"hidden\" name=\"arf_captcha_55934\" id=\"arf_captcha_55934\" class=\"arf_required\" value=\"\" \/><script type=\"text\/javascript\">window.addEventListener(\"DOMContentLoaded\", function() { (function($) {\n                                jQuery(document).ready(function (){\n                            if( !window[\"arf_recaptcha_v3\"] ){\n                                window[\"arf_recaptcha_v3\"] = {};\n                            }\n                            \n                            window[\"arf_recaptcha_v3\"][\"arf_captcha_55934\"] = {\n                                size : \"normal\"\n                            };\n                            \n                            }); })(jQuery); });<\/script><\/div><!-- allfields --><\/form><script type='text\/javascript' data-cfasync='false'>if(!window['arf_conditional_logic']){window['arf_conditional_logic'] = new Array();}window['arf_conditional_logic'][55934] = {\"logic\":{\"707\":{\"fields\":[{\"actionType\":\"show\",\"logicType\":\"all\",\"field_key\":\"gd8xq\",\"value\":\"\",\"default_value\":\"\",\"field_type\":\"html\",\"page_no\":0,\"rules\":[{\"fieldId\":\"695\",\"operator\":\"is\",\"value\":\"Wykrywacz\\\/detektor nieszczelno\u015bci\",\"fieldType\":\"checkbox\",\"fieldKey\":\"ms2yek\"}]}]}},\"dependents\":{\"707\":[707]},\"defaults\":[]};if(!window['arf_pages_fields']){window['arf_pages_fields'] = new Array();}window['arf_pages_fields'][55934] = [{\"field_id\":\"697\",\"field_key\":\"o7s24p\",\"default_value\":\"\",\"field_type\":\"section\",\"page_no\":0,\"heading_id\":\"697\",\"repeater_id\":0},{\"field_id\":\"698\",\"field_key\":\"jpzxiq\",\"default_value\":\"\",\"field_type\":\"section\",\"page_no\":0,\"heading_id\":\"698\",\"repeater_id\":0},{\"field_id\":\"699\",\"field_key\":\"q6b2nd\",\"default_value\":\"\",\"field_type\":\"section\",\"page_no\":0,\"heading_id\":\"699\",\"repeater_id\":0},{\"field_id\":\"696\",\"field_key\":\"8u6p4w\",\"default_value\":\"\",\"field_type\":\"section\",\"page_no\":0,\"heading_id\":\"696\",\"repeater_id\":0}];<\/script><\/div><!--arf_form_outer_wrapper --><div class=\"brand-div\"><\/div><div class=\"\"><input type=\"hidden\" data-jqvalidate=\"false\" name=\"form_id\" data-id=\"form_id\" value=\"112\" \/><input type=\"hidden\" data-jqvalidate=\"false\" name=\"arfmainformurl\" data-id=\"arfmainformurl\" value=\"https:\/\/www.coch.pl\/wp-content\/plugins\/arforms\" \/><\/div><\/div>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Order forms If you choose the traditional form of the order, the documents should be sent to the address:\u00a0laboratorium@coch.pl If you have [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-17359","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/pages\/17359","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/comments?post=17359"}],"version-history":[{"count":0,"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/pages\/17359\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.coch.pl\/en\/wp-json\/wp\/v2\/media?parent=17359"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}