<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div id="login-overlay" class="modal-dialog" style="width:800px; background-color:#ebd3f7"> <div class="modal-content"> <div class="modal-header"> <h4 class="modal-title text-right" id="myModalLabel">Company Name {or logo}</h4> </div> <div class="modal-body" > <div class="row"> <div class="col-xs-5"> <div class="well"> <form id="loginForm" method="POST" action="/login/" novalidate="novalidate"> <div class="form-group"> <label for="product" class="control-label">Product</label> <select class="form-control" id="product" name="product"> <option value="ONESOURCE">OneSource</option> <option value="CLAIMSOURCE">ClaimSource</option> <option value="ECARENEXT">eCare Next</option> </select> </div> <div class="form-group"> <label for="username" class="control-label">Username</label> <input type="text" class="form-control" id="username" name="username" value="" required="" title="Please enter you username" placeholder="example@gmail.com"> <span class="help-block"></span> </div> <div class="form-group"> <label for="password" class="control-label">Password</label> <input type="password" class="form-control" id="password" name="password" value="" required="" title="Please enter your password"> <span class="help-block"></span> </div> <div id="loginErrorMsg" class="alert alert-error hide">Wrong username og password</div> <button type="submit" class="btn btn-success btn-block">Login</button> <a href="/forgot/" class="btn btn-default btn-block">Help to login</a> </form> </div> </div> <div class="col-xs-7"> <h1>Lorem Ipsum</h1> <h4>"Neque porro quisquam est qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit..."</h4> <h5>"There is no one who loves pain itself, who seeks after it and wants to have it, simply because it is pain..."</h5> <hr /> <div id="Content"> <div class="boxed"> <!-- If you want to use Lorem Ipsum within another program please contact us for details on our API rather than parse the HTML below, we have XML and JSON available. --> <div id="lipsum"> <p> Lorem ipsum dolor sit amet, consectetur adipiscing elit. Pellentesque sodales a justo fermentum vehicula. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Maecenas sit amet lorem mollis enim tempus tincidunt. Sed mollis egestas turpis, id dapibus ligula tristique id. Donec eget imperdiet diam, quis lobortis enim. Fusce ultrices tincidunt auctor. Nam sed tellus tincidunt, bibendum dui id, congue enim. Etiam sollicitudin semper tincidunt. Aliquam mollis massa orci, ut scelerisque nibh consectetur eu. Nunc eu purus in lorem aliquam convallis id quis massa. Donec id diam at quam luctus vehicula. </p> </div> <div id="generated">Generated 1 paragraph, 93 words, 635 bytes of <a href="http://www.lipsum.com/" title="Lorem Ipsum">Lorem Ipsum</a></div> </div> <div id="bannerL"> <div id="div-gpt-ad-1474537762122-2"> <script type="text/javascript">googletag.cmd.push(function() { googletag.display("div-gpt-ad-1474537762122-2"); });</script> </div> </div> <div id="bannerR"> <div id="div-gpt-ad-1474537762122-3"> <script type="text/javascript">googletag.cmd.push(function() { googletag.display("div-gpt-ad-1474537762122-3"); });</script> </div> </div> </div> </div> </div> </div> </div> </div>