<div class="wrap">
  <div class="row-fluid col12">
    <form action="">
      <div class="col6">
        <p><strong>Choose Service</strong></p>
        <input checked type="checkbox" name="vehicle" value="Bike">Web Development<br>
        <input type="checkbox" name="vehicle" value="Car">Google AdWords<br>
        <input type="checkbox" name="vehicle" value="Car">Facebook Ads<br>
      </div>
      <div class="col6 slider">
        <p>
          <label for="amount"><strong>Choose Your Budget</strong></label>
          <input type="text" id="amount" readonly>
        </p>
        <div id="slider-range"></div>
      </div>
      <div class="row-fluid col12 input-field">
        <div class="input-group col6">
          <input type="text" name="first_name" placeholder="Your name*" required>
        </div>
        <div class="input-group col6">
          <input type="text" name="email" placeholder="Email adress*" required>
        </div>
        <div class="row-fluid">
          <div class="input-group col6">
            <input type="text" name="telephone" placeholder="Phone*" required>
          </div>
          <div class="input-group col6">
            <input type="text" name="website" placeholder="Your website (optional)">
          </div>
        </div>
        <div class="input-group col12">
          <textarea name="comments"></textarea>
        </div>
        <input type="submit" value="Submit">
    </form>
    </div>
  </div>
</div>
</div>

<div class="triangle"></div>

*,
*:before,
*:after {
  box-sizing: border-box;
}

body {
  display: flex;
  height: 100vh;
  justify-content: center;
  align-items: center;
  font-size: 16px;
  font-family: 'Lato';
  background-color: #f8f8f8;
  color: #555;
}

.wrap {
  position: relative;
  margin: 0 auto;
  width: 600px;
  height: auto;
  background-color: #fff;
  padding: 40px;
  border: 1px solid #d9d9d9;
  border-radius: 3px;
}

.row-fluid [class*="col"]:first-child {
  margin-left: 0;
}

.col12 {
  width: 100%;
  float: left;
}

.col6 {
  width: 48%;
  float: left;
  margin-left: 2%;
}

.col6.slider p {
  margin-bottom: 40px;
}

.input-field {
  margin-top: 40px;
}

.input-group {
  margin-bottom: 10px;
  position: relative;
  border-collapse: separate;
}

.input-field input,
textarea {
  height: 38px;
  padding: 6px 12px;
  font-size: 14px;
  line-height: 1.4;
  color: #555;
  width: 100%;
  background-color: #fff;
  background-image: none;
  border: 1px solid #ccc;
  border-radius: 4px;
  box-shadow: inset 0 1px 1px rgba(0, 0, 0, .075);
}

textarea {
  min-height: 60px;
  width: calc(100% - 10px);
}

input[type="checkbox"] {
  margin-bottom: 8px;
  margin-right: 10px;
  transform: scale(1.2);
}

input[type="submit"] {
  background-color: #FF712C;
  border-color: #Fc712C;
  color: #fff;
  font-weight: bold;
}


/* Slider */

.ui-widget.ui-widget-content {
  border: 1px solid #f1f1f1;
  background: linear-gradient(#e8e8e8, white);
}

.ui-slider-horizontal {
  height: 10px;
}

.ui-slider {
  position: relative;
  text-align: left;
}

.ui-slider-horizontal .ui-slider-range {
  top: 0;
  height: 100%;
}

.ui-slider-horizontal .ui-slider-handle {
  top: -5px;
  margin-left: -10px;
}

.ui-state-default,
.ui-widget-content .ui-state-default {
  border: 1px solid #c5c5c5;
  background: #695D46;
  font-weight: normal;
  color: #454545;
}

.ui-slider .ui-slider-range {
  position: absolute;
  z-index: 1;
  display: block;
  border: 0;
  background-position: 0 0;
}

.ui-slider .ui-slider-handle {
  position: absolute;
  z-index: 2;
  width: 20px;
  height: 20px;
  border-radius: 50%;
  cursor: pointer;
  -ms-touch-action: none;
  touch-action: none;
  outline: 0;
}

.ui-widget-header {
  border: 1px solid #dddddd;
  background: #FFC107;
  color: #333333;
  font-weight: bold;
}

input#amount {
  position: absolute;
  top: -32px;
  left: calc(50% - 65px);
  width: 130px;
  text-align: center;
  border: 0;
  color: #f6931f;
  font-weight: normal;
  color: #fff;
  border-radius: 2px;
  background-color: #ff712c;
}

.triangle {
  position: absolute;
  top: -8px;
  left: calc(50% - 5px);
  width: 0;
  height: 0;
  border-style: solid;
  border-width: 5px 5px 0 5px;
  border-color: #ff712c transparent transparent transparent;
}

@media screen and (max-width: 600px) {
  .col6 {
    width: 100%;
    margin: 4px 0;
  }
  textarea {
    width: 100%;
    margin-top: 4px;
  }
}

document.addEventListener('DOMContentLoaded',
  function(event) {
    $("#slider-range").slider({
      range: true,
      min: 0,
      max: 10000,
      values: [350, 4000],
      step: 50,
      slide: function(event, ui) {
        var max = $("#slider-range").slider('option', 'max');
        $("#amount").val("$" + ui.values[0] + " - " + "$" + ui.values[1]);
        if (ui.values[1] == max) $('#amount').val($('#amount').val() + '+');
      }
    });
    $("#amount").val("$" + $("#slider-range").slider("values", 0) + " - " + "$" + $("#slider-range").slider("values", 1));
    $(".ui-widget-header").append($("input#amount, .triangle"));
  })
copyright('');