{"id":5215,"date":"2022-10-03T11:40:08","date_gmt":"2022-10-03T09:40:08","guid":{"rendered":"http:\/\/select-assur.com\/?page_id=5215"},"modified":"2022-10-24T18:16:44","modified_gmt":"2022-10-24T16:16:44","slug":"formulaire-assurance-maritime","status":"publish","type":"page","link":"https:\/\/select-assur.com\/formulaire-assurance-maritime\/","title":{"rendered":"Formulaire Assurance Maritime"},"content":{"rendered":"\t\t<div data-custom_css-type=\"wp-page\" data-custom_css-id=\"5215\" class=\"custom_css custom_css-5215\">\n\t\t\t\t\t\t\t        <section class=\"custom_css-section custom_css-top-section custom_css-element custom_css-element-be19fd8 custom_css-section-boxed custom_css-section-height-default custom_css-section-height-default ct-header-fixed-none ct-row-max-none\" data-id=\"be19fd8\" data-element_type=\"section\">\n            \n                        <div class=\"custom_css-container custom_css-column-gap-default \">\n                    <div class=\"custom_css-column custom_css-col-100 custom_css-top-column custom_css-element custom_css-element-464c13b\" data-id=\"464c13b\" data-element_type=\"column\">\n            <div class=\"custom_css-widget-wrap custom_css-element-populated\">\n                        \t\t<div class=\"custom_css-element custom_css-element-79abd79 custom_css-widget custom_css-widget-shortcode\" data-id=\"79abd79\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"custom_css-widget-container\">\n\t\t\t\t\t<div class=\"custom_css-shortcode\"><div class='fluentform fluentform_wrapper_7'><form data-form_id=\"7\" id=\"fluentform_7\" class=\"frm-fluent-form fluent_form_7 ff-el-form-top ff_form_instance_7_1 ff-form-loading ff-form-has-steps ff_has_v3_recptcha\" data-form_instance=\"ff_form_instance_7_1\" method=\"POST\" data-recptcha_key=\"6Lc4KhIsAAAAAG0v28JTBkOOnC5YJJ-iu5pLEL-_\" ><fieldset style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;\n                                 box-shadow: none!important;outline: none!important;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;\">Assurance Maritime<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='5215' \/><input type=\"hidden\" id=\"_fluentform_7_fluentformnonce\" name=\"_fluentform_7_fluentformnonce\" value=\"88afb416cc\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/php_api\/wp\/v2\/pages\/5215\" \/><div class='ff-step-container' class=\"Assurance maritime\" data-name=\"step_start-7_2\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"no\" data-enable_step_page_resume=\"no\" ><div class='ff-step-header'><div class='ff-el-progress-status'><\/div>\n            <div class='ff-el-progress'>\n                <div class='ff-el-progress-bar'><span><\/span><\/div>\n            <\/div>\n            <ul style='display: none' class='ff-el-progress-title'>\n                <li>Votre bien et usage<\/li><li>Vous<\/li>\n            <\/ul><\/div><span class='ff_step_start'><\/span><div class='ff-step-body'><div class=\"Assurance maritime fluentform-step active\" data-name=\"step_start-7_2\" data-disable_auto_focus=\"no\" data-enable_auto_slider=\"no\" data-enable_step_data_persistency=\"no\" data-enable_step_page_resume=\"no\" ><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown_5' aria-label=\"Que souhaitez-vous assurer ?\">Que souhaitez-vous assurer ?<\/label> <\/div><div class='ff-el-input--content'><select name=\"dropdown_5\" id=\"ff_7_dropdown_5\" class=\"ff-el-form-control\" data-name=\"dropdown_5\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"\"><\/option><option value=\"Un bateau \u00e0 moteur\"  >Un bateau \u00e0 moteur<\/option><option value=\"Un voilier\"  >Un voilier<\/option><option value=\"Un jet\"  >Un jet<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text' aria-label=\"Quel est le constructeur\">Quel est le constructeur<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" data-name=\"input_text\" id=\"ff_7_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text_1' aria-label=\"Quel est le mod\u00e8le ?\">Quel est le mod\u00e8le ?<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" data-name=\"input_text_1\" id=\"ff_7_input_text_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_numeric-field' aria-label=\"Quelle est l&#039;ann\u00e9e de construction ?\">Quelle est l'ann\u00e9e de construction ?<\/label> <\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field\" id=\"ff_7_numeric-field\" class=\"ff-el-form-control\" data-name=\"numeric-field\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_numeric-field_1' aria-label=\"Quelle valeur totale souhaitez-vous assurer ?\">Quelle valeur totale souhaitez-vous assurer ?<\/label> <\/div><div class='ff-el-input--content'><div class=\"ff_input-group\"><input type=\"number\" name=\"numeric-field_1\" id=\"ff_7_numeric-field_1\" class=\"ff-el-form-control\" data-name=\"numeric-field_1\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><div class=\"ff_input-group-append\"><span class=\"ff_input-group-text\">\u20ac<\/span><\/div><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Combien y a-t-il de moteurs sur votre bateau ?\">Combien y a-t-il de moteurs sur votre bateau ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_93f74033af0a414981b3d338eb2730e1><input type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"1\"  id='input_radio_93f74033af0a414981b3d338eb2730e1' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_afbc095c15226021c4b8370f9fc72b47><input type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"2\"  id='input_radio_afbc095c15226021c4b8370f9fc72b47' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_03ac69624104b5ab51a0d98b9cb15073><input type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"3\"  id='input_radio_03ac69624104b5ab51a0d98b9cb15073' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_df8a017f45d0102e46e560af7084875f><input type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"4\"  id='input_radio_df8a017f45d0102e46e560af7084875f' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Souhaitez vous assurer une remorque ?\">Souhaitez vous assurer une remorque ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_10_ff72d6f9d3d6d1e00b1c36dedc42b6f5><input type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_10_ff72d6f9d3d6d1e00b1c36dedc42b6f5' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_10_1fabe9ea84663dd8df1ffc041cc790b5><input type=\"radio\" name=\"input_radio_10\" data-name=\"input_radio_10\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_10_1fabe9ea84663dd8df1ffc041cc790b5' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_numeric-field_4' aria-label=\"Quelle est la valeur de votre remorque ?\">Quelle est la valeur de votre remorque ?<\/label> <\/div><div class='ff-el-input--content'><div class=\"ff_input-group\"><input type=\"number\" name=\"numeric-field_4\" id=\"ff_7_numeric-field_4\" class=\"ff-el-form-control\" data-name=\"numeric-field_4\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><div class=\"ff_input-group-append\"><span class=\"ff_input-group-text\">\u20ac<\/span><\/div><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Utilisez-vous votre jet uniquement pour vos loisirs ?\">Utilisez-vous votre jet uniquement pour vos loisirs ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_11_7c0eb43f4a7e6ce9f666d945eb4e0012><input type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_11_7c0eb43f4a7e6ce9f666d945eb4e0012' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_11_da99c417e1030f6c7ac106ea4854f1d7><input type=\"radio\" name=\"input_radio_11\" data-name=\"input_radio_11\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_11_da99c417e1030f6c7ac106ea4854f1d7' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Quelles activit\u00e9s pratiquez-vous ? \">Quelles activit\u00e9s pratiquez-vous ? <\/label> <div class=\"ff-el-tooltip\" data-content=\"Plusieurs r\u00e9ponses possibles\"><svg width=\"16\" height=\"16\" viewBox=\"0 0 25 25\"><path d=\"m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z\" transform=\"scale(0.046875 0.046875)\"><\/path><\/svg><\/div><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_1_d082732a23cc0d7f8b9fb4be639fb1e3><input type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Location\"  id='checkbox_1_d082732a23cc0d7f8b9fb4be639fb1e3' aria-label='Location' aria-invalid='false' aria-required=true> <span>Location<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_1_ea9e1b04cada557d9372d82b7920b7bf><input type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"P\u00eache r\u00e9cr\u00e9ative\"  id='checkbox_1_ea9e1b04cada557d9372d82b7920b7bf' aria-label='P\u00eache r\u00e9cr\u00e9ative' aria-invalid='false' aria-required=true> <span>P\u00eache r\u00e9cr\u00e9ative<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_1_a625a168a2952dc5b2b5a022b6ab6929><input type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Autres activit\u00e9s\"  id='checkbox_1_a625a168a2952dc5b2b5a022b6ab6929' aria-label='Autres activit\u00e9s' aria-invalid='false' aria-required=true> <span>Autres activit\u00e9s<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_1_5f839b4c28fb1f87fdb82a90b32ab829><input type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Aucune\"  id='checkbox_1_5f839b4c28fb1f87fdb82a90b32ab829' aria-label='Aucune' aria-invalid='false' aria-required=true> <span>Aucune<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text_2' aria-label=\"Quelle est la marque du moteur ?\">Quelle est la marque du moteur ?<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" data-name=\"input_text_2\" id=\"ff_7_input_text_2\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Quel carburant utilisez vous ?\">Quel carburant utilisez vous ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_1_aadd01b13ac9081f1b4e9760be978be0><input type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Essence\"  id='input_radio_1_aadd01b13ac9081f1b4e9760be978be0' aria-label='Essence' aria-invalid='false' aria-required=true> <span>Essence<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_1_a21b05fedda8c0c2484bbccba688fb5c><input type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Diesel\"  id='input_radio_1_a21b05fedda8c0c2484bbccba688fb5c' aria-label='Diesel' aria-invalid='false' aria-required=true> <span>Diesel<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_1_194fd441022d693e14e4f09ff46df1f9><input type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"\u00c9lectricit\u00e9\"  id='input_radio_1_194fd441022d693e14e4f09ff46df1f9' aria-label='\u00c9lectricit\u00e9' aria-invalid='false' aria-required=true> <span>\u00c9lectricit\u00e9<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_numeric-field_2' aria-label=\"Quelle est la puissance r\u00e9elle par moteur (en CV) ?\">Quelle est la puissance r\u00e9elle par moteur (en CV) ?<\/label> <\/div><div class='ff-el-input--content'><div class=\"ff_input-group\"><input type=\"number\" name=\"numeric-field_2\" id=\"ff_7_numeric-field_2\" class=\"ff-el-form-control\" data-name=\"numeric-field_2\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><div class=\"ff_input-group-append\"><span class=\"ff_input-group-text\">CV<\/span><\/div><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_numeric-field_3' aria-label=\"Quelle est l&#039;ann\u00e9e de construction du moteur ?\">Quelle est l'ann\u00e9e de construction du moteur ?<\/label> <\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_3\" id=\"ff_7_numeric-field_3\" class=\"ff-el-form-control\" data-name=\"numeric-field_3\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Quel est le nombre d&#039;heures moteur ?\">Quel est le nombre d'heures moteur ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_2_c7f93c7781145a34e8ffcdbaca9953ee><input type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Moins de 1 500 h\"  id='input_radio_2_c7f93c7781145a34e8ffcdbaca9953ee' aria-label='Moins de 1 500 h' aria-invalid='false' aria-required=true> <span>Moins de 1 500 h<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_2_799e5bb2a33cc9968fffdce9e43233f3><input type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Plus de 1 500 h\"  id='input_radio_2_799e5bb2a33cc9968fffdce9e43233f3' aria-label='Plus de 1 500 h' aria-invalid='false' aria-required=true> <span>Plus de 1 500 h<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Quel est l&#039;usage de votre bateau ?\">Quel est l'usage de votre bateau ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_3_55ac9b00698c2ae9ab5827abe6495c23><input type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Priv\u00e9\"  id='input_radio_3_55ac9b00698c2ae9ab5827abe6495c23' aria-label='Priv\u00e9' aria-invalid='false' aria-required=true> <span>Priv\u00e9<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_3_dbe2edca815707fb56aa7c28db193187><input type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Professionnel\"  id='input_radio_3_dbe2edca815707fb56aa7c28db193187' aria-label='Professionnel' aria-invalid='false' aria-required=true> <span>Professionnel<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Utilisez vous votre bateau comme habitation principale ?\">Utilisez vous votre bateau comme habitation principale ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_4_707a027727d9c4b5e55d4f7698c63a41><input type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_4_707a027727d9c4b5e55d4f7698c63a41' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_4_d19ce1b3c06306a08e97ff62f8c1870e><input type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_4_d19ce1b3c06306a08e97ff62f8c1870e' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Souhaitez vous pratiquer la location avec votre bateau ?\">Souhaitez vous pratiquer la location avec votre bateau ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_5_59d0f7049f6e6c158f9bcb198cf3d745><input type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_5_59d0f7049f6e6c158f9bcb198cf3d745' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_5_af08c27303ef6a0b63fa281edc655780><input type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_5_af08c27303ef6a0b63fa281edc655780' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"\u00c0 quelle fr\u00e9quence pratiquez vous la location ?\">\u00c0 quelle fr\u00e9quence pratiquez vous la location ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_6_973336560867db9defd395d0cc00f21d><input type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Occasionnellement\"  id='input_radio_6_973336560867db9defd395d0cc00f21d' aria-label='Occasionnellement' aria-invalid='false' aria-required=true> <span>Occasionnellement<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_6_238a43e8714a92225d7e532b98389f3b><input type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Exclusivement\"  id='input_radio_6_238a43e8714a92225d7e532b98389f3b' aria-label='Exclusivement' aria-invalid='false' aria-required=true> <span>Exclusivement<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"La location se fera-t-elle sans skipper ?\">La location se fera-t-elle sans skipper ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_7_b3b950b898059c1c32bad8fbc9fa723b><input type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_7_b3b950b898059c1c32bad8fbc9fa723b' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_7_0b8b02d3aa1f1b050b0b2c38d08e357b><input type=\"radio\" name=\"input_radio_7\" data-name=\"input_radio_7\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_7_0b8b02d3aa1f1b050b0b2c38d08e357b' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"La location se fera-t-elle avec skipper ?\">La location se fera-t-elle avec skipper ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_8_cdd0e775109e1c70b25b8d94ec871e34><input type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_8_cdd0e775109e1c70b25b8d94ec871e34' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_8_d445b46b4f3a1762246222474ee0a1ad><input type=\"radio\" name=\"input_radio_8\" data-name=\"input_radio_8\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_8_d445b46b4f3a1762246222474ee0a1ad' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"La location se fera-t-elle \u00e0 quai ?\">La location se fera-t-elle \u00e0 quai ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_9_94fa18c3d7dd5ffc8a7fd28459a34a8b><input type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_9_94fa18c3d7dd5ffc8a7fd28459a34a8b' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_9_9c22c659dbe3d82807014e452c9e772b><input type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_9_9c22c659dbe3d82807014e452c9e772b' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Par quel moyen louez vous votre bateau ?\">Par quel moyen louez vous votre bateau ?<\/label> <div class=\"ff-el-tooltip\" data-content=\"Plusieurs r\u00e9ponses possibles\"><svg width=\"16\" height=\"16\" viewBox=\"0 0 25 25\"><path d=\"m329 393l0-46c0-2-1-4-2-6-2-2-4-3-7-3l-27 0 0-146c0-3-1-5-3-7-2-1-4-2-7-2l-91 0c-3 0-5 1-7 2-1 2-2 4-2 7l0 46c0 2 1 5 2 6 2 2 4 3 7 3l27 0 0 91-27 0c-3 0-5 1-7 3-1 2-2 4-2 6l0 46c0 3 1 5 2 7 2 1 4 2 7 2l128 0c3 0 5-1 7-2 1-2 2-4 2-7z m-36-256l0-46c0-2-1-4-3-6-2-2-4-3-7-3l-54 0c-3 0-5 1-7 3-2 2-3 4-3 6l0 46c0 3 1 5 3 7 2 1 4 2 7 2l54 0c3 0 5-1 7-2 2-2 3-4 3-7z m182 119c0 40-9 77-29 110-20 34-46 60-80 80-33 20-70 29-110 29-40 0-77-9-110-29-34-20-60-46-80-80-20-33-29-70-29-110 0-40 9-77 29-110 20-34 46-60 80-80 33-20 70-29 110-29 40 0 77 9 110 29 34 20 60 46 80 80 20 33 29 70 29 110z\" transform=\"scale(0.046875 0.046875)\"><\/path><\/svg><\/div><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_165becb5866f9927737b699b98f52015><input type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"De particulier \u00e0 particulier (inciuant les plateformes de location entre particuliers)\"  id='checkbox_165becb5866f9927737b699b98f52015' aria-label='De particulier \u00e0 particulier (inciuant les plateformes de location entre particuliers)' aria-invalid='false' aria-required=true> <span>De particulier \u00e0 particulier (inciuant les plateformes de location entre particuliers)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=checkbox_d3f2fd3dc6bd26f0cb1d23be9efd1ea8><input type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Par un gestionnaire de location professionnel\"  id='checkbox_d3f2fd3dc6bd26f0cb1d23be9efd1ea8' aria-label='Par un gestionnaire de location professionnel' aria-invalid='false' aria-required=true> <span>Par un gestionnaire de location professionnel<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text_3' aria-label=\"Pourriez vous indiquer le nom de la plateforme ou de la soci\u00e9t\u00e9 de location ?\">Pourriez vous indiquer le nom de la plateforme ou de la soci\u00e9t\u00e9 de location ?<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_3\" class=\"ff-el-form-control\" data-name=\"input_text_3\" id=\"ff_7_input_text_3\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_country-list' aria-label=\"Quel est le pays de la zone de navigation ?\">Quel est le pays de la zone de navigation ?<\/label> <\/div><div class='ff-el-input--content'><select name=\"country-list\" id=\"ff_7_country-list\" class=\"ff-el-form-control\" placeholder=\"S\u00e9lectionnez un pays\" data-name=\"country-list\" aria-invalid='false' aria-required=true><option value=''>S\u00e9lectionnez un pays<\/option><option value='AF' >Afghanistan<\/option><option value='ZA' >Afrique du Sud<\/option><option value='AL' >Albanie<\/option><option value='DZ' >Alg\u00e9rie<\/option><option value='DE' >Allemagne<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorre<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctique<\/option><option value='AG' >Antigua-et-Barbuda<\/option><option value='SA' >Arabie Saoudite<\/option><option value='AR' >Argentine<\/option><option value='AM' >Arm\u00e9nie<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australie<\/option><option value='AT' >Autriche<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbades<\/option><option value='PW' >Belau<\/option><option value='BE' >Belgique<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermudes<\/option><option value='BT' >Bhutan<\/option><option value='BY' >Bi\u00e9lorussie<\/option><option value='BO' >Bolivie<\/option><option value='BA' >Bosnie-Herz\u00e9govine<\/option><option value='BW' >Botswana<\/option><option value='BN' >Brunei<\/option><option value='BR' >Br\u00e9sil<\/option><option value='BG' >Bulgarie<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodge<\/option><option value='CM' >Cameroun<\/option><option value='CA' >Canada<\/option><option value='CV' >Cap Vert<\/option><option value='CL' >Chili<\/option><option value='CN' >Chine<\/option><option value='CX' >Christmas Island<\/option><option value='CY' >Chypre<\/option><option value='CO' >Colombie<\/option><option value='KM' >Comores<\/option><option value='CG' >Congo (Brazzaville)<\/option><option value='CD' >Congo (Kinshasa)<\/option><option value='KP' >Cor\u00e9e du Nord<\/option><option value='KR' >Cor\u00e9e du Sud<\/option><option value='CR' >Costa Rica<\/option><option value='HR' >Croatie<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CI' >C\u00f4te-d\u2019Ivoire<\/option><option value='DK' >Danemark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominique<\/option><option value='ER' >Erythr\u00e9e<\/option><option value='ES' >Espagne<\/option><option value='EE' >Estonie<\/option><option value='US' >Etats-Unis (USA)<\/option><option value='FJ' >Fidji<\/option><option value='FI' >Finlande<\/option><option value='FR' selected>France<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambie<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GD' >Grenade<\/option><option value='GL' >Groenland<\/option><option value='GR' >Gr\u00e8ce<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernesey<\/option><option value='GN' >Guin\u00e9e<\/option><option value='GQ' >Guin\u00e9e \u00e9quatoriale<\/option><option value='GW' >Guin\u00e9e-Bissau<\/option><option value='GY' >Guyane<\/option><option value='GF' >Guyane Fran\u00e7aise<\/option><option value='GE' >G\u00e9orgie<\/option><option value='GS' >G\u00e9orgie du Sud \/ \u00eeles Sandwich<\/option><option value='HT' >Ha\u00efti<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongrie<\/option><option value='IN' >Inde<\/option><option value='ID' >Indon\u00e9sie<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Irlande<\/option><option value='IS' >Islande<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Italie<\/option><option value='JM' >Jama\u00efque<\/option><option value='JP' >Japon<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordanie<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='XK' >Kosovo<\/option><option value='KW' >Kowe\u00eft<\/option><option value='KG' >Kyrgyzstan<\/option><option value='RE' >La R\u00e9union<\/option><option value='LA' >Laos<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Lettonie<\/option><option value='LB' >Liban<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libye<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lituanie<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao S.A.R., Chine<\/option><option value='MK' >Mac\u00e9doine<\/option><option value='MG' >Madagascar<\/option><option value='MY' >Malaisie<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malte<\/option><option value='MA' >Maroc<\/option><option value='MQ' >Martinique<\/option><option value='MU' >Maurice<\/option><option value='MR' >Mauritanie<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexique<\/option><option value='FM' >Micron\u00e9sie<\/option><option value='MD' >Moldavie<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolie<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibie<\/option><option value='NR' >Nauru<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norv\u00e8ge<\/option><option value='NC' >Nouvelle-Cal\u00e9donie<\/option><option value='NZ' >Nouvelle-Z\u00e9lande<\/option><option value='NP' >N\u00e9pal<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PA' >Panama<\/option><option value='PG' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='PY' >Paraguay<\/option><option value='NL' >Pays-Bas<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Pologne<\/option><option value='PF' >Polyn\u00e9sie Fran\u00e7aise<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='PE' >P\u00e9rou<\/option><option value='QA' >Qatar<\/option><option value='RO' >Roumanie<\/option><option value='GB' >Royaume-Uni (UK)<\/option><option value='RU' >Russie<\/option><option value='RW' >Rwanda<\/option><option value='CF' >R\u00e9publique Centrafricaine<\/option><option value='DO' >R\u00e9publique Dominicaine<\/option><option value='CZ' >R\u00e9publique Tch\u00e8que<\/option><option value='BQ' >Saba, Saint-Eustache et Bonaire<\/option><option value='EH' >Sahara occidental<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='PM' >Saint Pierre et Miquelon<\/option><option value='KN' >Saint-Kitts-et-Nevis<\/option><option value='MF' >Saint-Martin (partie fran\u00e7aise)<\/option><option value='SX' >Saint-Martin (partie n\u00e9erlandaise)<\/option><option value='VC' >Saint-Vincent-et-les-Grenadines<\/option><option value='SH' >Sainte-H\u00e9l\u00e8ne<\/option><option value='LC' >Sainte-Lucie<\/option><option value='SV' >Salvador<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tom\u00e9-et-Principe<\/option><option value='RS' >Serbie<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapour<\/option><option value='SK' >Slovaquie<\/option><option value='SI' >Slov\u00e9nie<\/option><option value='SO' >Somalie<\/option><option value='SD' >Soudan<\/option><option value='SS' >Soudan du Sud<\/option><option value='LK' >Sri Lanka<\/option><option value='CH' >Suisse<\/option><option value='SR' >Suriname<\/option><option value='SE' >Su\u00e8de<\/option><option value='SJ' >Svalbard et Jan Mayen<\/option><option value='SZ' >Swaziland<\/option><option value='SY' >Syrie<\/option><option value='SN' >S\u00e9n\u00e9gal<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzanie<\/option><option value='TD' >Tchad<\/option><option value='TF' >Terres Australes Fran\u00e7aises<\/option><option value='PS' >Territoire Palestinien<\/option><option value='IO' >Territoire britannique de l&rsquo;oc\u00e9an Indien<\/option><option value='TH' >Thailande<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinit\u00e9-et-Tobago<\/option><option value='TN' >Tunisie<\/option><option value='TM' >Turkm\u00e9nistan<\/option><option value='TR' >Turquie<\/option><option value='TV' >Tuvalu<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='UY' >Uruguay<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VA' >Vatican<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis et Futuna<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambie<\/option><option value='ZW' >Zimbabwe<\/option><option value='EG' >\u00c9gypte<\/option><option value='AE' >\u00c9mirats Arabes Unis<\/option><option value='EC' >\u00c9quateur<\/option><option value='ET' >\u00c9thiopie<\/option><option value='BV' >\u00cele Bouvet<\/option><option value='NF' >\u00cele Norfolk<\/option><option value='IM' >\u00cele de Man<\/option><option value='AX' >\u00celes Aland<\/option><option value='KY' >\u00celes Ca\u00efmans<\/option><option value='CC' >\u00celes Cocos<\/option><option value='CK' >\u00celes Cook<\/option><option value='FK' >\u00celes Falkland<\/option><option value='FO' >\u00celes F\u00e9ro\u00e9<\/option><option value='HM' >\u00celes Heard-et-MacDonald<\/option><option value='MH' >\u00celes Marshall<\/option><option value='UM' >\u00celes Mineures \u00e9loign\u00e9es des \u00c9tats-Unis<\/option><option value='SB' >\u00celes Salomon<\/option><option value='TC' >\u00celes Turques et Ca\u00efques<\/option><option value='VI' >\u00celes Vierges am\u00e9ricaines (US)<\/option><option value='VG' >\u00celes Vierges britanniques<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown_6' aria-label=\"Quelle est la r\u00e9gion de la zone de navigation ?\">Quelle est la r\u00e9gion de la zone de navigation ?<\/label> <\/div><div class='ff-el-input--content'><select name=\"dropdown_6\" id=\"ff_7_dropdown_6\" class=\"ff-el-form-control\" data-name=\"dropdown_6\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"\"><\/option><option value=\"M\u00e9diterran\u00e9e\"  >M\u00e9diterran\u00e9e<\/option><option value=\"Manche, Mer du Nord\"  >Manche, Mer du Nord<\/option><option value=\"Bretagne\"  >Bretagne<\/option><option value=\"Atlantique\"  >Atlantique<\/option><option value=\"Corse\"  >Corse<\/option><option value=\"Eaux int\u00e9rieures\"  >Eaux int\u00e9rieures<\/option><\/select><\/div><\/div><div class='ff-el-group  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Le bien est-il immatricul\u00e9 en France ?\">Le bien est-il immatricul\u00e9 en France ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_12_f4db01ea59f68fc9a09ba2ae90adf216><input type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_12_f4db01ea59f68fc9a09ba2ae90adf216' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_12_482323b5d331c24fe06d573396eda8d0><input type=\"radio\" name=\"input_radio_12\" data-name=\"input_radio_12\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_12_482323b5d331c24fe06d573396eda8d0' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Etiez vous assur\u00e9 pour ce bien ou le pr\u00e9c\u00e9dent au cours des 12 derniers mois ?\">Etiez vous assur\u00e9 pour ce bien ou le pr\u00e9c\u00e9dent au cours des 12 derniers mois ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_13_a9e6069367c1506572eb8b04cdd9021b><input type=\"radio\" name=\"input_radio_13\" data-name=\"input_radio_13\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_13_a9e6069367c1506572eb8b04cdd9021b' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_13_bb4e4dbf1aa5b4412f98f9407b4fac6f><input type=\"radio\" name=\"input_radio_13\" data-name=\"input_radio_13\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_13_bb4e4dbf1aa5b4412f98f9407b4fac6f' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown_7' aria-label=\"Depuis combien d&#039;ann\u00e9es cons\u00e9cutives \u00e9tiez vous assur\u00e9 ?\">Depuis combien d'ann\u00e9es cons\u00e9cutives \u00e9tiez vous assur\u00e9 ?<\/label> <\/div><div class='ff-el-input--content'><select name=\"dropdown_7\" id=\"ff_7_dropdown_7\" class=\"ff-el-form-control\" data-name=\"dropdown_7\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"\"><\/option><option value=\"Moins de 1 an\"  >Moins de 1 an<\/option><option value=\"Plus de 1 an\"  >Plus de 1 an<\/option><option value=\"Plus de 2 ans\"  >Plus de 2 ans<\/option><option value=\"Plus de 3 ans\"  >Plus de 3 ans<\/option><option value=\"Plus de 4 ans\"  >Plus de 4 ans<\/option><option value=\"Plus de 5 ans\"  >Plus de 5 ans<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Sur cette p\u00e9riode, combien avez-vous eu de sinistres ?\">Sur cette p\u00e9riode, combien avez-vous eu de sinistres ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_ec25306da882e6905a1df66d62ec1a22><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"0\"  id='input_radio_14_ec25306da882e6905a1df66d62ec1a22' aria-label='0' aria-invalid='false' aria-required=true> <span>0<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_1bd3e9e3ece28d2fdabaf061f79dc895><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"1\"  id='input_radio_14_1bd3e9e3ece28d2fdabaf061f79dc895' aria-label='1' aria-invalid='false' aria-required=true> <span>1<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_75c19dfc3b04b585df435d2127cbc255><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"2\"  id='input_radio_14_75c19dfc3b04b585df435d2127cbc255' aria-label='2' aria-invalid='false' aria-required=true> <span>2<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_7b4a985d1d25283f561d016b6dda3f39><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"3\"  id='input_radio_14_7b4a985d1d25283f561d016b6dda3f39' aria-label='3' aria-invalid='false' aria-required=true> <span>3<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_c5a70fc9a49e1cf250e84d0f8cfd913b><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"4\"  id='input_radio_14_c5a70fc9a49e1cf250e84d0f8cfd913b' aria-label='4' aria-invalid='false' aria-required=true> <span>4<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_f96c71a9286a8ef0f3444fa66ac5973a><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"5\"  id='input_radio_14_f96c71a9286a8ef0f3444fa66ac5973a' aria-label='5' aria-invalid='false' aria-required=true> <span>5<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_14_47f09984f791064e982a6e73b29aae70><input type=\"radio\" name=\"input_radio_14\" data-name=\"input_radio_14\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"6\"  id='input_radio_14_47f09984f791064e982a6e73b29aae70' aria-label='6' aria-invalid='false' aria-required=true> <span>6<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group  ff_list_buttons'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label  aria-label=\"Avez-vous \u00e9t\u00e9 titulaire d&#039;un contrat d&#039;assurance plaisance et\/ou remorque ayant fait l&#039;objet de r\u00e9siliation pour sinistre ou pour non-paiement de prime pendant les 24 derniers mois ?\">Avez-vous \u00e9t\u00e9 titulaire d'un contrat d'assurance plaisance et\/ou remorque ayant fait l'objet de r\u00e9siliation pour sinistre ou pour non-paiement de prime pendant les 24 derniers mois ?<\/label> <\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_15_b5889a3ae290946905ba85844d6108c1><input type=\"radio\" name=\"input_radio_15\" data-name=\"input_radio_15\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_15_b5889a3ae290946905ba85844d6108c1' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_radio_15_37d6b69b9e92119e010c5a8fe857ad05><input type=\"radio\" name=\"input_radio_15\" data-name=\"input_radio_15\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_15_37d6b69b9e92119e010c5a8fe857ad05' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class='step-nav ff_step_nav_last'><button  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Pr\u00e9c\u00e9dent<\/button><button  type='button' data-action='next' class='ff-float-right ff-btn ff-btn-next ff-btn-secondary'>Suivant<\/button><\/div><\/div><div class=\" fluentform-step\" data-name=\"form_step-7_1\" ><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown_3' aria-label=\"Civilit\u00e9\">Civilit\u00e9<\/label> <\/div><div class='ff-el-input--content'><select name=\"dropdown_3\" id=\"ff_7_dropdown_3\" class=\"ff-el-form-control\" data-name=\"dropdown_3\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"Madame\"  >Madame<\/option><option value=\"Ma\u00eetre\"  >Ma\u00eetre<\/option><option value=\"Monsieur\"  >Monsieur<\/option><\/select><\/div><\/div><div data-type=\"name-element\" data-name=\"names_1\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_names_1_first_name_' aria-label=\"Nom\">Nom<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[first_name]\" id=\"ff_7_names_1_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_names_1_last_name_' aria-label=\"Pr\u00e9nom\">Pr\u00e9nom<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[last_name]\" id=\"ff_7_names_1_last_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_dropdown_4' aria-label=\"Situation matrimoniale\">Situation matrimoniale<\/label> <\/div><div class='ff-el-input--content'><select name=\"dropdown_4\" id=\"ff_7_dropdown_4\" class=\"ff-el-form-control\" data-name=\"dropdown_4\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=true><option value=\"Mari\u00e9(e)\"  >Mari\u00e9(e)<\/option><option value=\"Pacs\u00e9(e)\"  >Pacs\u00e9(e)<\/option><option value=\"Divorc\u00e9(e)\"  >Divorc\u00e9(e)<\/option><option value=\"S\u00e9par\u00e9(e)\"  >S\u00e9par\u00e9(e)<\/option><option value=\"Concubin(e)\"  >Concubin(e)<\/option><option value=\"C\u00e9libataire\"  >C\u00e9libataire<\/option><option value=\"Veuf(ve)\"  >Veuf(ve)<\/option><option value=\"Autres\"  >Autres<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_input_text_4' aria-label=\"Date de naissance\">Date de naissance<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_4\" value=\"09\/04\/2026\" class=\"ff-el-form-control\" maxlength=\"10\" data-name=\"input_text_4\" id=\"ff_7_input_text_4\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_phone_1' aria-label=\"T\u00e9l\u00e9phone portable\">T\u00e9l\u00e9phone portable<\/label> <\/div><div class='ff-el-input--content'><input name=\"phone_1\" class=\"ff-el-form-control ff-el-phone\" type=\"tel\" placeholder=\"Num\u00e9ro de portable\" data-name=\"phone_1\" id=\"ff_7_phone_1\" inputmode=\"tel\" ><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_7_email' aria-label=\"E-mail\">E-mail<\/label> <\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_7_email\" class=\"ff-el-form-control\" placeholder=\"Email Address\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_1\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_7_address_1_address_line_1_' aria-label=\"Adresse\">Adresse<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_7_address_1_address_line_1_\" class=\"ff-el-form-control\" placeholder=\"Adresse ligne 1\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_7_address_1_address_line_2_' aria-label=\"Compl\u00e9ment d&#039;adresse\">Compl\u00e9ment d'adresse<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_2]\" id=\"ff_7_address_1_address_line_2_\" class=\"ff-el-form-control\" data-key_name=\"address_line_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_7_address_1_zip_' aria-label=\"Code postal\">Code postal<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[zip]\" id=\"ff_7_address_1_zip_\" class=\"ff-el-form-control\" placeholder=\"Code Postal\" data-key_name=\"zip\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_7_address_1_city_' aria-label=\"Ville\">Ville<\/label> <\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_7_address_1_city_\" class=\"ff-el-form-control\" placeholder=\"Ville\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><\/div>        <div class=\"ff-step-t-container ff-inner_submit_container ff-column-container ff_columns_total_2\">\n            <div class=\"ff-t-cell ff-t-column-1\"><div class='step-nav ff_step_nav_last'><button  type='button' data-action='prev' class='ff-btn ff-btn-prev ff-btn-secondary'>Pr\u00e9c\u00e9dent<\/button><\/div><\/div>\n            <div class=\"ff-t-cell ff-t-column-2\"><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-lg ff_btn_style\" >Envoyer votre devis<\/button><\/div><\/div>\n        <\/div>\n        <\/div><\/div><\/div>\n        <\/fieldset><\/form><div id='fluentform_7_errors' class='ff-errors-in-stack ff_form_instance_7_1 ff-form-loading_errors ff_form_instance_7_1_errors'><\/div><\/div>        <script type=\"text\/javascript\">\n            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