24 lines
1.1 KiB
PHP
Executable File
24 lines
1.1 KiB
PHP
Executable File
<form id="formData">
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<legend id="titre_formData">Ajouter des données</legend>
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<table class="table table-responsive table-condensed">
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<tbody>
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<tr>
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<td width="10%" align="center" class="required">Garant</td>
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<td width="30%" >
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<SELECT class="form-control" id="codeGcAssureur" NAME="codeGcAssureur" onChange="tauxCommissionGarant()" required AUTOCOMPLETE="OFF" autofocus>
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<?php liste_options($garants,""); ?>
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</SELECT>
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</td>
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<td width="10%" align="center">Sinistre/Prime Minimal</td>
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<td width="10%" ><INPUT class="form-control" TYPE="number" step="0.01" id="spMin" NAME="spMin" ></td>
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<td width="10%" align="center">Sinistre/Prime Maximal</td>
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<td width="10%" ><INPUT class="form-control" TYPE="number" step="0.01" id="spMax" NAME="spMax" ></td>
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<td width="10%" align="center">Taux Ajustement</td>
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<td width="10%" ><INPUT class="form-control" TYPE="number" step="0.01" id="tauxAjustement" NAME="tauxAjustement"></td>
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</tr>
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</tbody>
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</table>
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</form>
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