Linux SRV-16 6.18.44-paas #1 SMP PREEMPT_DYNAMIC Thu Aug 13 10:08:12 UTC 2026 x86_64
/srv/data/trash/vhost_www.sanimoderne.fr_1511970463/htdocs/old/pages/db/
/srv/data/trash/vhost_www.sanimoderne.fr_1511970463/htdocs/old/pages/db/devis.php
 <?php
	//start_block('title','keywords','description')
	start_block('','','');
?>
<?php include "functions/devis.php" ?>
<section class="one devis">
	<div class="container">
		

<div id="devis">
	<h2 ><span>Devis</span></h2>

	<?php if ($form_has_errors): ?>
		<div class='alert alert-danger alert-dismissable'>
		  <button type='button' class='close' data-dismiss='alert' aria-hidden='true'>&times;</button>
		  <strong>Erreur!</strong> Nous n'avons pas reçu votre demande, merci de vérifier que les champs obligatoires du formulaire sont correctement remplis.
		</div>
	<?php endif ?>

	<div class="row">
		<div class="col-sm-12">
			<?=form_open($routes['devis'],array('enctype'=>'multipart/form-data'))?>
				<div class="row">
					<div class="col-sm-12">
						<fieldset>
					
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['lastname']['status']?>">
										<?=form_label($data['lastname']['label'],'lastname')?>
										<?=form_text('lastname',$data['lastname']['value'],array('class'=>'form-control','placeholder'=>'NOM'))?>
										<?=form_feedback($form_is_submitted,$data['lastname']['status'])?>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['phone']['status']?>">
										<?=form_label($data['phone']['label'],'phone')?>
										<?=form_text('phone',$data['phone']['value'],array('class'=>'form-control','placeholder'=>'06 00 00 00 00'))?>
										<?=form_feedback($form_is_submitted,$data['phone']['status'])?>
									</div>
								</div>
							
							</div>
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['email']['status']?>">
								<?=form_label($data['email']['label'],'email')?>
								<?=form_text('email',$data['email']['value'],array('class'=>'form-control','placeholder'=>'text@exemple.fr'))?>
								<?=form_feedback($form_is_submitted,$data['email']['status'])?>
							</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['zipcode']['status']?>">
										<?=form_label($data['zipcode']['label'],'zipcode')?>
										<?=form_text('zipcode',$data['zipcode']['value'],array('class'=>'form-control','placeholder'=>'75001'))?>
										<?=form_feedback($form_is_submitted,$data['zipcode']['status'])?>
									</div>
								</div>
							</div>
							<h4>Votre besoin </h4>
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['select1']['status']?>">
										<?=form_label($data['select1']['label'],'select1')?>
										<?=form_select('select1',$data['select1']['value'],array("---","Cuisine ","Salle de bain ","WC","Cave","Jardin"),array('class'=>'form-control'))?>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['select2']['status']?>">
										<?=form_label($data['select2']['label'],'select2')?>
										<?=form_select('select2',$data['select2']['value'],array("---","Je ne sais pas ","Dégorgement","Fuite","Siphon","Robinetterie ","Entretien ","Création et installation "),array('class'=>'form-control'))?>
									</div>
								</div>
							</div>
							<h4>Votre intervention </h4>
							<div class="row">
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['date1']['status']?>">
										<?=form_label($data['date1']['label'],'date1')?>
										<div class="input-group bootstrap-datepicker">
											<?=form_text('date1',$data['date1']['value'],array('class'=>'form-control','placeholder'=>date("d/m/Y")))?>
											<span class="input-group-addon"><span class="fa fa-calendar fa-fw"></span></span>
										</div>
									</div>
								</div>
								<div class="col-sm-6">
									<div class="form-group has-feedback <?=$data['select3']['status']?>">
								<?=form_label($data['select3']['label'],'select3')?>
								<?=form_select('select3',$data['select3']['value'],array("Peu m’importe ","06h00 – 08h00 ","08h00 – 10h00","10h00 – 12h00 ","12h00 – 14h00 ","14h00 - 16h00 ","16h00 – 18h00 ","18h00 – 20h00 ","20h00 – 22h00 "),array('class'=>'form-control'))?>
							</div>
								</div>
							</div>
							
														
						
						</fieldset>
						
					</div>
					
				</div>
				<div class="form-group has-feedback <?=$data['message']['status']?>">
					<?=form_label($data['message']['label'],'message')?>
					<?=form_textarea('message',$data['message']['value'],array('class'=>'form-control','rows'=>'6'))?>
				</div>
				<br>
				<div class="text-center">
					<button type="submit" name="devis" class="button">Envoyer</button>
				</div>
			<?=form_close()?>
		</div>
	</div>
</div>
	</div>
</section>
<?php end_block(); ?>