Linux SRV-16 6.18.44-paas #1 SMP PREEMPT_DYNAMIC Thu Aug 13 10:08:12 UTC 2026 x86_64
/proc/212/root/srv/data/trash/vhost_www.taxisvsl.fr_1718269442/htdocs/pages/
//proc/212/root/srv/data/trash/vhost_www.taxisvsl.fr_1718269442/htdocs/pages/devis.php
 <?php
	//start_block('title','keywords','description')
	start_block('','','');
?>
<?php include "functions/devis.php" ?>
<section class="slider1 img4 ">
	<div class="container">
		<h1>Devis </h1>
	</div>
</section>
<section class="devis">
<div class="container">
	<div id="devis">
		<?=$devisMessage?>

		<div class="row">
			<div class="col-sm-12">
				<form role="form" method="post" action="<?=$routes['devis']?>#formD" enctype="multipart/form-data">
					<div class="row">
						<div class="col-sm-10 col-sm-offset-1">
							<fieldset>
								<div class="row">
									<div class="col-sm-6">
										<div class="form-group has-feedback <?=$data['lastname']['status']?>">
											<label>Nom</label>
											<input type="text" class="form-control " id="lastname" name="lastname" value="<?=$data['lastname']['value']?>" placeholder="Nom">
											<?php if($form_is_submitted)echo"<span class='fa ".(($data['lastname']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
										</div>
									</div>
									<div class="col-sm-6">
										<div class="form-group has-feedback <?=$data['firstname']['status']?>">
											<label>Prénom</label>
											<input type="text" class="form-control " id="firstname" name="firstname" value="<?=$data['firstname']['value']?>" placeholder="Prénom">
											<?php if($form_is_submitted)echo"<span class='fa ".(($data['firstname']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
										</div>
									</div>
								</div>
								<div class="form-group has-feedback <?=$data['phone']['status']?>">
									<label>Téléphone</label>
									<input type="text" class="form-control " id="phone" name="phone" value="<?=$data['phone']['value']?>" placeholder="06 00 00 00 00">
									<?php if($form_is_submitted)echo"<span class='fa ".(($data['phone']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
								</div>
								<div class="form-group has-feedback <?=$data['email']['status']?>">
										<label>Email</label>
									<input type="text" class="form-control " id="email" name="email" value="<?=$data['email']['value']?>" placeholder="text@exemple.fr">
									<?php if($form_is_submitted)echo"<span class='fa ".(($data['email']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
								</div>
								
								<?php /* PSEUDO utilisé pour bloquer les robots, ne pas afficher. Si le robot rempli ce champs, il est redirigé sur la page success sans envoyer le mail */ ?>
								<div class="form-group has-feedback pseudoForm">
									<label for="pseudoForm">Pseudo</label>
									<input type="text" class="form-control " id="pseudoForm" name="pseudo" value="">
								</div>
								<hr>
								<div class="form-group has-feedback <?=$data['address']['status']?>">
										<label>Adresse de départ</label>
									<input type="text" class="form-control " id="address" name="address" value="<?=$data['address']['value']?>" placeholder="">
									<?php if($form_is_submitted)echo"<span class='fa ".(($data['address']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
								</div>
								<div class="row">
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['date1']['status']?>">
											<label for="date1Form">Date (aller)</label>
											<div class="input-group bootstrap-datepicker">
												<input type="text" class="form-control " id="date1Form" name="date1" placeholder="<?=date("d/m/Y")?>" value="<?=$data['date1']['value']?>">
												<span class="input-group-addon"><span class="fa fa-calendar fa-fw"></span></span>
											</div>
										</div>
									</div>
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['hour1']['status']?>">
											<?=form_label($data['hour1']['label'],'hour1')?>
											<?=form_select('hour1',$data['hour1']['value'],array("---","0h","1h","2h","3h","4h","5h","6h","7h","8h","9h","10h","11h","12h","13h","14h","15h","16h","17h","18h","19h","20h","21h","22h","23h"),array('class'=>'form-control'))?>
										</div>
									</div>
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['minute1']['status']?>">
											<?=form_label($data['minute1']['label'],'minute1')?>
											<?=form_select('minute1',$data['minute1']['value'],array("---","00","15","30","45"),array('class'=>'form-control'))?>
										</div>
									</div>
									
								</div>
								<hr>
								<div class="form-group has-feedback <?=$data['address2']['status']?>">
										<label>Adresse de départ</label>
									<input type="text" class="form-control " id="address2" name="address2" value="<?=$data['address2']['value']?>" placeholder="">
									<?php if($form_is_submitted)echo"<span class='fa ".(($data['address2']['status']=="has-success")?"fa-check":"fa-times" )." form-control-feedback'></span>" ?>
								</div>
								<div class="row">
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['date2']['status']?>">
											<label for="date2Form">Date (aller)</label>
											<div class="input-group bootstrap-datepicker">
												<input type="text" class="form-control " id="date2Form" name="date2" placeholder="<?=date("d/m/Y")?>" value="<?=$data['date2']['value']?>">
												<span class="input-group-addon"><span class="fa fa-calendar fa-fw"></span></span>
											</div>
										</div>
									</div>
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['hour2']['status']?>">
											<?=form_label($data['hour2']['label'],'hour2')?>
											<?=form_select('hour2',$data['hour2']['value'],array("---","0h","1h","2h","3h","4h","5h","6h","7h","8h","9h","10h","11h","12h","13h","14h","15h","16h","17h","18h","19h","20h","21h","22h","23h"),array('class'=>'form-control'))?>
										</div>
									</div>
									<div class="col-sm-4">
										<div class="form-group has-feedback <?=$data['minute2']['status']?>">
											<?=form_label($data['minute2']['label'],'minute2')?>
											<?=form_select('minute2',$data['minute2']['value'],array("---","00","15","30","45"),array('class'=>'form-control'))?>
										</div>
									</div>
									
								</div>
								<div class="form-group has-feedback <?=($form_is_submitted)?'has-success':''?>">
									<label>Trajet</label>
									<div class="checkbox" style="margin-top: 0;">
										<input type="checkbox" id="tarjet" name="checkbox1" value="1" checked>
										<?=$data['checkbox1']['label']?>
									</div>
									<div class="checkbox" style="margin-top: 0;">
										<input type="checkbox" id="tarjet" name="checkbox2" value="1">
										<?=$data['checkbox2']['label']?>

									</div>
								</div>
								<div class="form-group has-feedback <?=$data['select1']['status']?>">
									<?=form_label($data['select1']['label'],'select1')?>
									<?=form_select('select1',$data['select1']['value'],array("1","2","3","4","5","6"),array('class'=>'form-control'))?>
								</div>
											
								<div class="form-group has-feedback <?=$messageClass?>">
									<label for="messageForm">Informations complémentaires <i>(facultatif)</i></label>
									<textarea id="messageForm" name="message" class="form-control" rows="6"><?=$message?></textarea>
								</div>
								
							</fieldset>
							
						</div>
					</div>

					
					<br>
					<div class="text-center">
						<button type="submit" name="devis" class="button">Envoyer</button>
					</div>
				</form>
			</div>
		</div>
	</div>
</div>
</section>
<?php end_block(); ?>