@extends('layouts.master') @section('title') Nouvel Employeur @stop @section('content')
@if ($errors) @foreach ($errors->all() as $error)
{!! $error !!}
@endforeach @endif

Nouvel Employeur

{!! Form::open(['employeur' => 'form', 'url' => '/tiers/employeurs', 'class' => 'form-horizontal']) !!}
{!! Form::label('nom', 'Nom') !!} {!! Form::text('nom', null, ['placeholder' => 'Nom', 'class' => 'form-control']) !!}
{!! Form::label('numrc', 'Numéro RC') !!} {!! Form::text('numrc', null, ['placeholder' => 'Numéro RC', 'class' => 'form-control']) !!}
{!! Form::label('statut', 'Statut') !!}
{!! Form::select( 'statut', App\Models\MyApp::STATUTS_ENTREPRISE, '', [ 'class' => 'selectpicker', ] ) !!}
{!! Form::label('date_deb', 'Début d\'activité') !!}
{!! Form::text('date_deb', '', ['placeholder' => 'Début d\'activité', 'class' => 'form-control']) !!}
{!! Form::label('date_fin', 'Fin d\'activité') !!}
{!! Form::text('date_fin', '', ['placeholder' => 'Fin d\'activité', 'class' => 'form-control']) !!}
{!! Form::label('verrou', 'Verrou') !!} {!! Form::checkbox('verrou', null, ['class' => 'form-control']) !!}
{!! Form::label('observation', 'Observations') !!} {!! Form::textarea('observation', null, ['placeholder' => 'Observations', 'class' => 'form-control', 'rows'=>'3']) !!}
{!! Form::label('adresse', 'Adresse') !!} {!! Form::textarea('adresse', null, ['placeholder' => 'Adresse', 'class' => 'form-control', 'rows'=>'2']) !!}
{!! Form::label('cp', 'Code Postal') !!} {!! Form::text('cp', null, ['placeholder' => 'Code Postal', 'class' => 'form-control']) !!}
{!! Form::label('district', 'District - Zone') !!}
{!! Form::select( 'district', App\Models\MyApp::DISTRICTS2, '', [ 'placeholder'=>'Choisissez un District/Zone','class' => 'selectpicker', ] ) !!}
{!! Form::label('ile', 'Ile') !!}
{!! Form::select( 'ile', App\Models\MyApp::ILES2, '', [ 'placeholder'=>'Choisissez une Ile','class' => 'selectpicker', ] ) !!}
Contact 1 / Responsable
{!! Form::label('responsable', 'Nom') !!} {!! Form::text('responsable', null, ['placeholder' => 'Nom Responsable', 'class' => 'form-control'] )!!}
{!! Form::label('email', 'Email') !!} {!! Form::email('email', null, ['placeholder' => 'Email', 'class' => 'form-control'] )!!}
{!! Form::label('tel', 'Téléphone') !!} {!! Form::text('tel', null, ['placeholder' => 'Téléphone', 'class' => 'form-control']) !!}
{!! Form::label('fax', 'Fax') !!} {!! Form::text('fax', null, ['placeholder' => 'Fax', 'class' => 'form-control']) !!}
Contact 2
{!! Form::label('contact_nom', 'Nom') !!} {!! Form::text('contact_nom', null, ['placeholder' => 'Nom Contact', 'class' => 'form-control'] )!!}
{!! Form::label('contact_email', 'Email') !!} {!! Form::email('contact_email', null, ['placeholder' => 'Email', 'class' => 'form-control'] )!!}
{!! Form::label('contact_tel', 'Téléphone') !!} {!! Form::text('contact_tel', null, ['placeholder' => 'Téléphone', 'class' => 'form-control']) !!}
{!! Form::label('banque', 'Banque') !!}
{!! Form::select( 'banque_id', DB::table('banques')->where('active','=','1')->orderby(db::raw("nom"))->pluck(db::raw("CONCAT(nom,' - ',ville)"), 'id')->toArray(), '', [ 'placeholder'=>'Choisissez une banque','class' => 'form-control' ] ) !!}
{!! Form::label('compte', 'Compte') !!} {!!Form::text('compte', null, ['placeholder' => 'COMPTE', 'class' => 'form-control']) !!}
{!! Form::label('iban', 'IBAN') !!} {!!Form::text('iban', null, ['placeholder' => 'IBAN', 'class' => 'form-control']) !!}
{!! Form::label('secteur', "Secteur d'activité") !!}
{!! Form::select('sec_id', DB::table('secteurs')->orderby(db::raw("nom"))->pluck(db::raw("nom"), 'id')->toArray(), '', [ 'placeholder'=>"Choisissez un secteur d'activité", 'class' => 'form-control' ] ) !!}
COTISATIONS
{!! Form::label('mode_cotis', 'Mode de cotisation') !!}
{!! Form::radio('mode_cotis','1','' )." Trimestrielles " !!} {!! Form::radio('mode_cotis','2','' )." Mensuelles " !!}

{!! Form::label('der_cotis', 'Dernière cotisation') !!}
{!! Form::text('der_cotis', null, ['class' => 'form-control']) !!}
CFP
{!! Form::label('der_mois', 'Mois concerné') !!}
{!! Form::text('der_mois', '', ['placeholder' => 'Mois concerné', 'class' => 'form-control']) !!}
{!! Form::label('soldei', 'Solde antérieur') !!}
{!! Form::text('soldei', null, ['class' => 'form-control']) !!}
CFP
{!! Form::label('date_med', 'Dernière mise en demeure') !!}
{!! Form::text('date_med', '', ['placeholder' => 'Dernière MED', 'class' => 'form-control']) !!}
{!! Form::label('date_maj', 'Dernière mise à jour') !!}
{!! Form::text('date_maj', '', ['placeholder' => 'Dernière MAJ', 'class' => 'form-control']) !!}

CONTENTIEUX
{!! Form::label('nom_cont', 'Libellé') !!} {!! Form::text('nom_cont', null, ['placeholder' => 'Libellé du contentieux', 'class' => 'form-control']) !!}
{!! Form::label('date_cont', 'Date du contentieux') !!}
{!! Form::text('date_cont', '', ['placeholder' => 'Dernière MAJ', 'class' => 'form-control']) !!}
{!! Form::submit('Enregistrer', ['class' => 'btn btn-primary']) !!}
{!! Form::close() !!}
@stop