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DESCRIPTIF&nbsp;ENTREE

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td style="width: 20%;">MURS</td>
			<td style="width: 15%; text-align: justify;">BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
			<td style="text-align: justify;">SOLS</td>
			<td style="text-align: justify;">BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
			<td>PLAFONDS</td>
			<td style="text-align: justify;">BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
		</tr>
		<tr>
			<td style="width: 20%;">Peinture</td>
			<td style="width: 15%; text-align: justify;">{% radio_tag name=&quot;8101a28c&quot; data_label=&quot;&eacute;tat des murs&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Carrelage</td>
			<td>{% radio_tag name=&quot;b4c1e769&quot; data_label=&quot;&eacute;tat des sols&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Peinture</td>
			<td>{% radio_tag name=&quot;1ba06ef2&quot; data_label=&quot;&eacute;tat des plafonds&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">Cr&eacute;pi</td>
			<td style="width: 15%;">{% radio_tag name=&quot;0e7f76b0&quot; data_label=&quot;&eacute;tat des murs&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Parquet stratifi&eacute;</td>
			<td>{% radio_tag name=&quot;8199f055&quot; data_label=&quot;&eacute;tat des sols&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Cr&eacute;pi</td>
			<td>{% radio_tag name=&quot;57795a6e&quot; data_label=&quot;&eacute;tat des plafonds&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">Tapisserie</td>
			<td style="width: 15%;">{% radio_tag name=&quot;50b01994&quot; data_label=&quot;&eacute;tat des murs&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Plinthe</td>
			<td>{% radio_tag name=&quot;0c08bf9e&quot; data_label=&quot;&eacute;tat des sols&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>{% textinput_tag name=&quot;0171a5f0&quot; data_label=&quot;autre type de plafonds&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>{% radio_tag name=&quot;06d57265&quot; data_label=&quot;&eacute;tat des plafonds&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">{% textinput_tag name=&quot;52b75b6d&quot; data_label=&quot;autre type de murs&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 15%;">{% radio_tag name=&quot;585551e9&quot; data_label=&quot;&eacute;tat des murs&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>{% textinput_tag name=&quot;75c47f70&quot; data_label=&quot;autre type de sols&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>{% radio_tag name=&quot;01e2ffb4&quot; data_label=&quot;&eacute;tat des sols&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 20%;">&nbsp;</td>
			<td style="width: 15%;">&nbsp;</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td style="width: 20%;">HUISSERIES</td>
			<td style="width: 15%;">BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
			<td>ELECTRICITE</td>
			<td>BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
			<td>DIVERS</td>
			<td>BE&nbsp; EM&nbsp; &nbsp;D&nbsp; &nbsp;HS</td>
		</tr>
		<tr>
			<td style="width: 20%;">Porte</td>
			<td style="width: 15%;">{% radio_tag name=&quot;4143a9ed&quot; data_label=&quot;&eacute;tat des huisseries&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Prises</td>
			<td>{% radio_tag name=&quot;2693f87a&quot; data_label=&quot;&eacute;tat de l&#39;&eacute;lectricit&eacute;&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Volets - stores</td>
			<td>{% radio_tag name=&quot;e45a3690&quot; data_label=&quot;&eacute;tat de divers&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">Fen&ecirc;tre</td>
			<td style="width: 15%;">{% radio_tag name=&quot;e3f68371&quot; data_label=&quot;&eacute;tat des huisseries&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Interrupteurs</td>
			<td>{% radio_tag name=&quot;4e1d40fa&quot; data_label=&quot;&eacute;tat des &eacute;lectricit&eacute;&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>{% textinput_tag name=&quot;50e6227f&quot; data_label=&quot;autre divers&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>{% radio_tag name=&quot;2f309a56&quot; data_label=&quot;&eacute;tat de divers&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">Serrures</td>
			<td style="width: 15%;">{% radio_tag name=&quot;aecda95e&quot; data_label=&quot;&eacute;tat des huisseries&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>Eclairage</td>
			<td>{% radio_tag name=&quot;de610124&quot; data_label=&quot;&eacute;tat des &eacute;lectricit&eacute;&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>{% textinput_tag name=&quot;f21396e0&quot; data_label=&quot;autre divers&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>{% radio_tag name=&quot;481e2fcb&quot; data_label=&quot;&eacute;tat de divers&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
		</tr>
		<tr>
			<td style="width: 20%;">{% textinput_tag name=&quot;c18299bb&quot; data_label=&quot;autre huisserie 2&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td style="width: 15%;">{% radio_tag name=&quot;d75dad8c&quot; data_label=&quot;&eacute;tat des huisseries&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>{% textinput_tag name=&quot;c6dcc547&quot; data_label=&quot;autre &eacute;lectricit&eacute;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
			<td>{% radio_tag name=&quot;47f6290b&quot; data_label=&quot;&eacute;tat des &eacute;lectricit&eacute;&quot; data_choices=&quot;|Bon &eacute;tat;|Etat moyen;|D&eacute;grad&eacute;;|Hors d&#39;usage;&quot; %}</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
	<tbody>
		<tr>
			<td>Observations :</td>
		</tr>
		<tr>
			<td>{% textarea_tag name=&quot;3c603ac5&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Observations entr&eacute;e&quot; data_help=&quot;Observations entr&eacute;e&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</td>
		</tr>
	</tbody>
</table>

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