{"id":8993,"date":"2023-04-21T12:39:07","date_gmt":"2023-04-21T10:39:07","guid":{"rendered":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/"},"modified":"2024-12-16T12:30:45","modified_gmt":"2024-12-16T10:30:45","slug":"declaration-du-sinistre","status":"publish","type":"page","link":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr","title":{"rendered":"D\u00c9CLARATION DU SINISTRE"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"8993\" class=\"elementor elementor-8993 elementor-3539\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d70cb83 elementor-section-full_width elementor-section-height-min-height elementor-section-height-default elementor-section-items-middle\" data-id=\"d70cb83\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;background_motion_fx_motion_fx_scrolling&quot;:&quot;yes&quot;,&quot;background_motion_fx_translateY_effect&quot;:&quot;yes&quot;,&quot;background_motion_fx_translateY_direction&quot;:&quot;negative&quot;,&quot;background_motion_fx_translateY_speed&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:4,&quot;sizes&quot;:[]},&quot;background_motion_fx_translateY_affectedRange&quot;:{&quot;unit&quot;:&quot;%&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:{&quot;start&quot;:0,&quot;end&quot;:100}},&quot;background_motion_fx_devices&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;]}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6fedc89\" data-id=\"6fedc89\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bcf806b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bcf806b\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-8d02bcc\" data-id=\"8d02bcc\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2b8bad5 elementor-widget elementor-widget-heading\" data-id=\"2b8bad5\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">D\u00c9CLARATION DU SINISTRE\n\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ecdd02 elementor-widget elementor-widget-heading\" data-id=\"3ecdd02\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Remplissez ce formulaire et nous prendrons contact avec vous.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-e9f96d8\" data-id=\"e9f96d8\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ebe0b90 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ebe0b90\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-dc76175\" data-id=\"dc76175\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-71994ee elementor-widget elementor-widget-breadcrumbs\" data-id=\"71994ee\" data-element_type=\"widget\" data-widget_type=\"breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/dunach.com\/index_beta.php\">Inici<\/a><\/span><\/span><\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18d90fe elementor-widget elementor-widget-shortcode\" data-id=\"18d90fe\" data-element_type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-8981 forminator-design--default  forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-8981\" data-uid=\"6ab490252b78a\"><br\/><\/div><form\n\t\t\t\tid=\"forminator-module-8981\"\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-8981 forminator-design--default  forminator_ajax\"\n\t\t\t\tmethod=\"post\"\n\t\t\t\tdata-forminator-render=\"0\"\n\t\t\t\tdata-form-id=\"8981\"\n\t\t\t\tenctype=\"multipart\/form-data\" data-color-option=\"default\" data-design=\"default\" data-grid=\"open\" style=\"display: none;\"\n\t\t\t\tdata-uid=\"6ab490252b78a\"\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div role=\"tablist\" class=\"forminator-pagination-steps\" aria-label=\"Pagination\"><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-8981--page-0\"\n\t\t\t\tclass=\"forminator-pagination forminator-pagination-start\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-8981--page-0-label\"\n\t\t\t\tdata-step=\"0\"\n\t\t\t\tdata-label=\"CONTACTE\"\n\t\t\t\tdata-actual-label=\"DONN\u00c9ES\"\n\t\t\t\tdata-name=\"page-break-1\"\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6ab490252b78a\" id=\"forminator-field-text-1_6ab490252b78a-label\" class=\"forminator-label\">NOM ET PR\u00c9NOM: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"\" id=\"forminator-field-text-1_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-17\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-17_6ab490252b78a\" id=\"forminator-field-text-17_6ab490252b78a-label\" class=\"forminator-label\">NIF\/CIF\/NIE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-17\" value=\"\" placeholder=\"\" id=\"forminator-field-text-17_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"12\" \/><span id=\"forminator-field-text-17_6ab490252b78a-description\" class=\"forminator-description\"><span data-limit=\"12\" data-type=\"characters\">0 \/ 12<\/span><\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6ab490252b78a\" id=\"forminator-field-text-2_6ab490252b78a-label\" class=\"forminator-label\">ADRESSE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"\" id=\"forminator-field-text-2_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-3\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-3_6ab490252b78a\" id=\"forminator-field-text-3_6ab490252b78a-label\" class=\"forminator-label\">CODE POSTAL: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-3\" value=\"\" placeholder=\"\" id=\"forminator-field-text-3_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"5\" \/><span id=\"forminator-field-text-3_6ab490252b78a-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6ab490252b78a\" id=\"forminator-field-text-4_6ab490252b78a-label\" class=\"forminator-label\">LOCALIT\u00c9:<\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"\" id=\"forminator-field-text-4_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6ab490252b78a\" id=\"forminator-field-phone-1_6ab490252b78a-label\" class=\"forminator-label\">T\u00c9L\u00c9PHONE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-1_6ab490252b78a\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6ab490252b78a\" id=\"forminator-field-email-1_6ab490252b78a-label\" class=\"forminator-label\">E-MAIL: <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"\" id=\"forminator-field-email-1_6ab490252b78a\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-8981--page-1\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-8981--page-1-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"1\"\n\t\t\t\tdata-label=\"DONN\u00c9ES\"\n\t\t\t\tdata-actual-label=\"SINISTRE\"\n\t\t\t\tdata-name=\"page-break-2\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"radio-8\" class=\"forminator-field-radio forminator-col forminator-col-12  races\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-8-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-8-6ab490252b78a-label\" class=\"forminator-label\">GENRE D&#039;ASSURANCE:<\/span><label id=\"forminator-field-radio-8-label-1\" for=\"forminator-field-radio-8-1-6ab490252b78a\" class=\"forminator-radio\" title=\"Bateaux plaisance\"><input type=\"radio\" name=\"radio-8\" value=\"one\" id=\"forminator-field-radio-8-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Bateaux plaisance<\/span><\/label><label id=\"forminator-field-radio-8-label-2\" for=\"forminator-field-radio-8-2-6ab490252b78a\" class=\"forminator-radio\" title=\"Habitation\"><input type=\"radio\" name=\"radio-8\" value=\"two\" id=\"forminator-field-radio-8-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Habitation<\/span><\/label><label id=\"forminator-field-radio-8-label-3\" for=\"forminator-field-radio-8-3-6ab490252b78a\" class=\"forminator-radio\" title=\"Enterprises\"><input type=\"radio\" name=\"radio-8\" value=\"Enterprises\" id=\"forminator-field-radio-8-3-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Enterprises<\/span><\/label><label id=\"forminator-field-radio-8-label-4\" for=\"forminator-field-radio-8-4-6ab490252b78a\" class=\"forminator-radio\" title=\"Personnes\"><input type=\"radio\" name=\"radio-8\" value=\"Personnes\" id=\"forminator-field-radio-8-4-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Personnes<\/span><\/label><label id=\"forminator-field-radio-8-label-5\" for=\"forminator-field-radio-8-5-6ab490252b78a\" class=\"forminator-radio\" title=\"V\u00e9hicules\"><input type=\"radio\" name=\"radio-8\" value=\"V\u00e9hicules\" id=\"forminator-field-radio-8-5-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">V\u00e9hicules<\/span><\/label><label id=\"forminator-field-radio-8-label-6\" for=\"forminator-field-radio-8-6-6ab490252b78a\" class=\"forminator-radio\" title=\"Responsabilit\u00e9 civile\"><input type=\"radio\" name=\"radio-8\" value=\"Responsabilit\u00e9-civile\" id=\"forminator-field-radio-8-6-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-8-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Responsabilit\u00e9 civile<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-7\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-7_6ab490252b78a\" id=\"forminator-field-text-7_6ab490252b78a-label\" class=\"forminator-label\">DATE DU SINISTRE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-7\" value=\"\" placeholder=\"\" id=\"forminator-field-text-7_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"10\" aria-describedby=\"forminator-field-text-7_6ab490252b78a-description\" \/><span id=\"forminator-field-text-7_6ab490252b78a-description\" class=\"forminator-description\">DD\/MM\/AAAA<span data-limit=\"10\" data-type=\"characters\">0 \/ 10<\/span><\/span><\/div><\/div><div id=\"text-8\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-8_6ab490252b78a\" id=\"forminator-field-text-8_6ab490252b78a-label\" class=\"forminator-label\">HEURE: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-8\" value=\"\" placeholder=\"\" id=\"forminator-field-text-8_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" maxlength=\"5\" \/><span id=\"forminator-field-text-8_6ab490252b78a-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-9\" class=\"forminator-field-text forminator-col forminator-col-4 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-9_6ab490252b78a\" id=\"forminator-field-text-9_6ab490252b78a-label\" class=\"forminator-label\">LIEU: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-9\" value=\"\" placeholder=\"\" id=\"forminator-field-text-9_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-5\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-5_6ab490252b78a\" id=\"forminator-field-text-5_6ab490252b78a-label\" class=\"forminator-label\">ASSUREUR:<\/label><input type=\"text\" name=\"text-5\" value=\"\" placeholder=\"\" id=\"forminator-field-text-5_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-6\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-6_6ab490252b78a\" id=\"forminator-field-text-6_6ab490252b78a-label\" class=\"forminator-label\">N\u00ba DE POLICE:<\/label><input type=\"text\" name=\"text-6\" value=\"\" placeholder=\"\" id=\"forminator-field-text-6_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-9\" class=\"forminator-field-radio forminator-col forminator-col-12  races\"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-9-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-9-6ab490252b78a-label\" class=\"forminator-label\">Cause :<\/span><label id=\"forminator-field-radio-9-label-1\" for=\"forminator-field-radio-9-1-6ab490252b78a\" class=\"forminator-radio\" title=\"INCENDIE\"><input type=\"radio\" name=\"radio-9\" value=\"one\" id=\"forminator-field-radio-9-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-1\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">INCENDIE<\/span><\/label><label id=\"forminator-field-radio-9-label-2\" for=\"forminator-field-radio-9-2-6ab490252b78a\" class=\"forminator-radio\" title=\"D\u00c9G\u00c2TS DES EAUX\"><input type=\"radio\" name=\"radio-9\" value=\"two\" id=\"forminator-field-radio-9-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-2\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">D\u00c9G\u00c2TS DES EAUX<\/span><\/label><label id=\"forminator-field-radio-9-label-3\" for=\"forminator-field-radio-9-3-6ab490252b78a\" class=\"forminator-radio\" title=\"VANDALISME\"><input type=\"radio\" name=\"radio-9\" value=\"VANDALISME\" id=\"forminator-field-radio-9-3-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-3\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">VANDALISME<\/span><\/label><label id=\"forminator-field-radio-9-label-4\" for=\"forminator-field-radio-9-4-6ab490252b78a\" class=\"forminator-radio\" title=\"VOL\"><input type=\"radio\" name=\"radio-9\" value=\"VOL\" id=\"forminator-field-radio-9-4-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-4\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">VOL<\/span><\/label><label id=\"forminator-field-radio-9-label-5\" for=\"forminator-field-radio-9-5-6ab490252b78a\" class=\"forminator-radio\" title=\"Dommages \u00e9lectriques\"><input type=\"radio\" name=\"radio-9\" value=\"Dommages \u00e9lectriques\" id=\"forminator-field-radio-9-5-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-5\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Dommages \u00e9lectriques<\/span><\/label><label id=\"forminator-field-radio-9-label-6\" for=\"forminator-field-radio-9-6-6ab490252b78a\" class=\"forminator-radio\" title=\"Bris de vitres\"><input type=\"radio\" name=\"radio-9\" value=\"Bris de vitres\" id=\"forminator-field-radio-9-6-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-6\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Bris de vitres<\/span><\/label><label id=\"forminator-field-radio-9-label-7\" for=\"forminator-field-radio-9-7-6ab490252b78a\" class=\"forminator-radio\" title=\"Ph\u00e9nom\u00e8nes atmosph\u00e9riques\"><input type=\"radio\" name=\"radio-9\" value=\"Ph\u00e9nom\u00e8nes atmosph\u00e9riques\" id=\"forminator-field-radio-9-7-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-7\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Ph\u00e9nom\u00e8nes atmosph\u00e9riques<\/span><\/label><label id=\"forminator-field-radio-9-label-8\" for=\"forminator-field-radio-9-8-6ab490252b78a\" class=\"forminator-radio\" title=\"RESPONSABILIT\u00c9 CIVILE\"><input type=\"radio\" name=\"radio-9\" value=\"RESPONSABILIT\u00c9-CIVILE\" id=\"forminator-field-radio-9-8-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-8\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">RESPONSABILIT\u00c9 CIVILE<\/span><\/label><label id=\"forminator-field-radio-9-label-9\" for=\"forminator-field-radio-9-9-6ab490252b78a\" class=\"forminator-radio\" title=\"COLLISION\"><input type=\"radio\" name=\"radio-9\" value=\"COLLISION\" id=\"forminator-field-radio-9-9-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-9\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">COLLISION<\/span><\/label><label id=\"forminator-field-radio-9-label-10\" for=\"forminator-field-radio-9-10-6ab490252b78a\" class=\"forminator-radio\" title=\"AUTRES CAUSES\"><input type=\"radio\" name=\"radio-9\" value=\"AUTRES-CAUSES\" id=\"forminator-field-radio-9-10-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-9-label-10\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">AUTRES CAUSES<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-1\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-1_6ab490252b78a\" id=\"forminator-field-textarea-1_6ab490252b78a-label\" class=\"forminator-label\">DESCRIPTION AUTRES CAUSES:<\/label><textarea name=\"textarea-1\" placeholder=\"\" id=\"forminator-field-textarea-1_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-2\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Liste des \u00e9l\u00e9ments affect\u00e9s :<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Ajouter \\u00e9l\\u00e9ment&quot;,&quot;remove_text&quot;:&quot;Effacer \\u00e9l\\u00e9ment&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-18\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-18_6ab490252b78a\" id=\"forminator-field-text-18_6ab490252b78a-label\" class=\"forminator-label\">Appareil affect\u00e9 :<\/label><input type=\"text\" name=\"text-18\" value=\"\" placeholder=\"\" id=\"forminator-field-text-18_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"number-1\" class=\"forminator-field-number forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-number-1_6ab490252b78a\" id=\"forminator-field-number-1_6ab490252b78a-label\" class=\"forminator-label\">\u00c2ge :<\/label><input name=\"number-1\" value=\"\" placeholder=\"\" id=\"forminator-field-number-1_6ab490252b78a\" class=\"forminator-input forminator-number--field\" inputmode=\"decimal\" data-required=\"\" data-decimals=\"0\" aria-required=\"false\" data-inputmask=\"&#039;groupSeparator&#039;: &#039;&#039;, &#039;radixPoint&#039;: &#039;&#039;, &#039;digits&#039;: &#039;0&#039;\" data-hidden-behavior=\"zero\" type=\"number\" step=\"any\" min=\"1800\" max=\"2200\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Ajouter \u00e9l\u00e9ment\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Effacer \u00e9l\u00e9ment\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-1\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-1_6ab490252b78a\" id=\"forminator-field-upload-1_6ab490252b78a-label\" class=\"forminator-label\">Joindre une copie de la plainte d\u00e9pos\u00e9e aupr\u00e8s des autorit\u00e9s : <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-file-upload \" data-element=\"upload-1_6ab490252b78a\"><input type=\"file\" name=\"upload-1\" id=\"forminator-field-upload-1_6ab490252b78a\" class=\"forminator-input-file-required do-validate\" accept=\".avif,.heif,.heics,.heifs,.wav,.jpg,.jpeg,.jpe,.gif,.png,.bmp,.tiff,.tif,.heic,.webp,.doc,.docx,.odt,.pages,.pdf,image\/avif,image\/heif,image\/heic-sequence,image\/heif-sequence,audio\/wav,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/tiff,image\/heic,image\/webp,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.apple.pages,application\/pdf\" tabindex=\"-1\"><button id=\"forminator-field-upload-1_6ab490252b78a_button\" class=\"forminator-button forminator-button-upload\" data-id=\"forminator-field-upload-1_6ab490252b78a\">Escolliu fitxer<\/button><span data-empty-text=\"Cap fitxer escollit\">Cap fitxer escollit<\/span><button class=\"forminator-button-delete\" style=\"display: none;\"><i class=\"forminator-icon-close\" aria-hidden=\"true\"><\/i><span class=\"forminator-screen-reader-only\">Delete uploaded file<\/span><\/button><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-10\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-10_6ab490252b78a\" id=\"forminator-field-text-10_6ab490252b78a-label\" class=\"forminator-label\">Conducteur\/Pilot<\/label><input type=\"text\" name=\"text-10\" value=\"\" placeholder=\"\" id=\"forminator-field-text-10_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-10_6ab490252b78a-description\" \/><span id=\"forminator-field-text-10_6ab490252b78a-description\" class=\"forminator-description\">(pr\u00e9nom et nom)<\/span><\/div><\/div><div id=\"phone-2\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-2_6ab490252b78a\" id=\"forminator-field-phone-2_6ab490252b78a-label\" class=\"forminator-label\">T\u00e9l\u00e9phone<\/label><input type=\"text\" name=\"phone-2\" value=\"\" placeholder=\"\" id=\"forminator-field-phone-2_6ab490252b78a\" class=\"forminator-input forminator-field--phone\" data-required=\"\" aria-required=\"false\" autocomplete=\"off\" data-national_mode=\"disabled\" data-country=\"es\" data-validation=\"international\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-11\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-11_6ab490252b78a\" id=\"forminator-field-text-11_6ab490252b78a-label\" class=\"forminator-label\">Date de naissance<\/label><input type=\"text\" name=\"text-11\" value=\"\" placeholder=\"\" id=\"forminator-field-text-11_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><div id=\"text-12\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-12_6ab490252b78a\" id=\"forminator-field-text-12_6ab490252b78a-label\" class=\"forminator-label\">Date du permis<\/label><input type=\"text\" name=\"text-12\" value=\"\" placeholder=\"\" id=\"forminator-field-text-12_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-2\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-2_6ab490252b78a\" id=\"forminator-field-textarea-2_6ab490252b78a-label\" class=\"forminator-label\">Version et circonstances des faits : <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-2\" placeholder=\"\" id=\"forminator-field-textarea-2_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-3\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-3_6ab490252b78a\" id=\"forminator-field-textarea-3_6ab490252b78a-label\" class=\"forminator-label\">CLASSE DE DOMMAGES (MAT\u00c9RIELS ET CORPORELS) OBSERV\u00c9S CAUS\u00c9S\/SUBIS et \u00c9VALUATION approximative des biens : <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-3\" placeholder=\"\" id=\"forminator-field-textarea-3_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-6\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-6-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-6-6ab490252b78a-label\" class=\"forminator-label\">Le responsable est-il un tiers ?: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-6-label-1\" for=\"forminator-field-radio-6-1-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Oui\"><input type=\"radio\" name=\"radio-6\" value=\"one\" id=\"forminator-field-radio-6-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-6-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Oui<\/span><\/label><label id=\"forminator-field-radio-6-label-2\" for=\"forminator-field-radio-6-2-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Non\"><input type=\"radio\" name=\"radio-6\" value=\"two\" id=\"forminator-field-radio-6-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-6-label-2\" data-calculation=\"0\" checked=\"checked\" \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Non<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-4\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-4_6ab490252b78a\" id=\"forminator-field-textarea-4_6ab490252b78a-label\" class=\"forminator-label\">Coordonn\u00e9es du tiers responsable: <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-4\" placeholder=\"\" id=\"forminator-field-textarea-4_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-4_6ab490252b78a-description\" ><\/textarea><span id=\"forminator-field-textarea-4_6ab490252b78a-description\" class=\"forminator-description\">DONN\u00c9ES DU CONTRAIRE (IMMATRICULATION, ADRESSE, ETC.), DONN\u00c9S ASSURANCE DE L'ADVERSE, DESCRIPTION DE DOMMAGES DE L'ADVERSE, DONN\u00c9ES CONDUCTEUR\/PILOT<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-7\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-7-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-7-6ab490252b78a-label\" class=\"forminator-label\">Avez-vous caus\u00e9 des dommages \u00e0 un tiers ?: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-7-label-1\" for=\"forminator-field-radio-7-1-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Oui\"><input type=\"radio\" name=\"radio-7\" value=\"one\" id=\"forminator-field-radio-7-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-7-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Oui<\/span><\/label><label id=\"forminator-field-radio-7-label-2\" for=\"forminator-field-radio-7-2-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Non\"><input type=\"radio\" name=\"radio-7\" value=\"two\" id=\"forminator-field-radio-7-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-7-label-2\" data-calculation=\"0\" checked=\"checked\" \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Non<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-8\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-8_6ab490252b78a\" id=\"forminator-field-textarea-8_6ab490252b78a-label\" class=\"forminator-label\">Coordonn\u00e9es du tiers l\u00e9s\u00e9 : <span class=\"forminator-required\">*<\/span><\/label><textarea name=\"textarea-8\" placeholder=\"\" id=\"forminator-field-textarea-8_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-19\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-19_6ab490252b78a\" id=\"forminator-field-text-19_6ab490252b78a-label\" class=\"forminator-label\">lien de parent\u00e9 avec l&#039;assur\u00e9 et \u00e2ge approximatif :<\/label><input type=\"text\" name=\"text-19\" value=\"\" placeholder=\"\" id=\"forminator-field-text-19_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-2\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-2-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-2-6ab490252b78a-label\" class=\"forminator-label\">BLESS\u00c9S: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-2-label-1\" for=\"forminator-field-radio-2-1-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Oui\"><input type=\"radio\" name=\"radio-2\" value=\"one\" id=\"forminator-field-radio-2-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-2-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Oui<\/span><\/label><label id=\"forminator-field-radio-2-label-2\" for=\"forminator-field-radio-2-2-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Non\"><input type=\"radio\" name=\"radio-2\" value=\"two\" id=\"forminator-field-radio-2-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-2-label-2\" data-calculation=\"0\" checked=\"checked\" \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Non<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">DONN\u00c9ES BLESS\u00c9S:<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Ajouter bless\\u00e9&quot;,&quot;remove_text&quot;:&quot;Effacer bless\\u00e9&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-13\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-13_6ab490252b78a\" id=\"forminator-field-text-13_6ab490252b78a-label\" class=\"forminator-label\">Pr\u00e9nom et nom:<\/label><input type=\"text\" name=\"text-13\" value=\"\" placeholder=\"\" id=\"forminator-field-text-13_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-14\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-14_6ab490252b78a\" id=\"forminator-field-text-14_6ab490252b78a-label\" class=\"forminator-label\">Adresse:<\/label><input type=\"text\" name=\"text-14\" value=\"\" placeholder=\"\" id=\"forminator-field-text-14_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-15\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-15_6ab490252b78a\" id=\"forminator-field-text-15_6ab490252b78a-label\" class=\"forminator-label\">Code Postal:<\/label><input type=\"text\" name=\"text-15\" value=\"\" placeholder=\"\" id=\"forminator-field-text-15_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"5\" \/><span id=\"forminator-field-text-15_6ab490252b78a-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-16\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-16_6ab490252b78a\" id=\"forminator-field-text-16_6ab490252b78a-label\" class=\"forminator-label\">Ville:<\/label><input type=\"text\" name=\"text-16\" value=\"\" placeholder=\"\" id=\"forminator-field-text-16_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Ajouter bless\u00e9\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Effacer bless\u00e9\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-5\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-5_6ab490252b78a\" id=\"forminator-field-textarea-5_6ab490252b78a-label\" class=\"forminator-label\">GENRE DE L\u00c9SION:<\/label><textarea name=\"textarea-5\" placeholder=\"\" id=\"forminator-field-textarea-5_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-20\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-20_6ab490252b78a\" id=\"forminator-field-text-20_6ab490252b78a-label\" class=\"forminator-label\">Assistance m\u00e9dicale qui est intervenue :<\/label><input type=\"text\" name=\"text-20\" value=\"\" placeholder=\"\" id=\"forminator-field-text-20_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-21_6ab490252b78a\" id=\"forminator-field-text-21_6ab490252b78a-label\" class=\"forminator-label\">Moyen utilis\u00e9 pour le transport de la personne bless\u00e9e :<\/label><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-22_6ab490252b78a\" id=\"forminator-field-text-22_6ab490252b78a-label\" class=\"forminator-label\">Centre m\u00e9dical vers lequel il a \u00e9t\u00e9 transf\u00e9r\u00e9 :<\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-3\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-3-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-3-6ab490252b78a-label\" class=\"forminator-label\">T\u00c9MOINS: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-3-label-1\" for=\"forminator-field-radio-3-1-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Oui\"><input type=\"radio\" name=\"radio-3\" value=\"one\" id=\"forminator-field-radio-3-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-3-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Oui<\/span><\/label><label id=\"forminator-field-radio-3-label-2\" for=\"forminator-field-radio-3-2-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Non\"><input type=\"radio\" name=\"radio-3\" value=\"two\" id=\"forminator-field-radio-3-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-3-label-2\" data-calculation=\"0\" checked=\"checked\" \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Non<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-3\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">DONN\u00c9ES DE T\u00c9MOINS :<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:1,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Ajouter temoin&quot;,&quot;remove_text&quot;:&quot;Effacer temoin&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"text-23\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-23_6ab490252b78a\" id=\"forminator-field-text-23_6ab490252b78a-label\" class=\"forminator-label\">NOM ET PR\u00c9NOM:<\/label><input type=\"text\" name=\"text-23\" value=\"\" placeholder=\"\" id=\"forminator-field-text-23_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-24\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-24_6ab490252b78a\" id=\"forminator-field-text-24_6ab490252b78a-label\" class=\"forminator-label\">ADRESSE:<\/label><input type=\"text\" name=\"text-24\" value=\"\" placeholder=\"\" id=\"forminator-field-text-24_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-25\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-25_6ab490252b78a\" id=\"forminator-field-text-25_6ab490252b78a-label\" class=\"forminator-label\">Code Postal:<\/label><input type=\"text\" name=\"text-25\" value=\"\" placeholder=\"\" id=\"forminator-field-text-25_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" maxlength=\"5\" \/><span id=\"forminator-field-text-25_6ab490252b78a-description\" class=\"forminator-description\"><span data-limit=\"5\" data-type=\"characters\">0 \/ 5<\/span><\/span><\/div><\/div><div id=\"text-26\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-26_6ab490252b78a\" id=\"forminator-field-text-26_6ab490252b78a-label\" class=\"forminator-label\">Ville:<\/label><input type=\"text\" name=\"text-26\" value=\"\" placeholder=\"\" id=\"forminator-field-text-26_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Ajouter temoin\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Effacer temoin\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"radio-4\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-4-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-4-6ab490252b78a-label\" class=\"forminator-label\">EST-CE QUE L&#039;AUTORIT\u00c9 A INTERVENU: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-4-label-1\" for=\"forminator-field-radio-4-1-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Oui\"><input type=\"radio\" name=\"radio-4\" value=\"one\" id=\"forminator-field-radio-4-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-4-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Oui<\/span><\/label><label id=\"forminator-field-radio-4-label-2\" for=\"forminator-field-radio-4-2-6ab490252b78a\" class=\"forminator-radio forminator-radio-inline\" title=\"Non\"><input type=\"radio\" name=\"radio-4\" value=\"two\" id=\"forminator-field-radio-4-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-4-label-2\" data-calculation=\"0\" checked=\"checked\" \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">Non<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-7\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-7_6ab490252b78a\" id=\"forminator-field-textarea-7_6ab490252b78a-label\" class=\"forminator-label\">AUTORIT\u00c9 QUI A INTERVENU:<\/label><textarea name=\"textarea-7\" placeholder=\"\" id=\"forminator-field-textarea-7_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" ><\/textarea><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-27\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-27_6ab490252b78a\" id=\"forminator-field-text-27_6ab490252b78a-label\" class=\"forminator-label\">Lieu de r\u00e9paration :<\/label><input type=\"text\" name=\"text-27\" value=\"\" placeholder=\"\" id=\"forminator-field-text-27_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-28\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-28_6ab490252b78a\" id=\"forminator-field-text-28_6ab490252b78a-label\" class=\"forminator-label\">Personne de contact pour l&#039;\u00e9valuation d&#039;expertise :<\/label><input type=\"text\" name=\"text-28\" value=\"\" placeholder=\"\" id=\"forminator-field-text-28_6ab490252b78a\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"upload-2\" class=\"forminator-field-upload forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-upload-2_6ab490252b78a\" id=\"forminator-field-upload-2_6ab490252b78a-label\" class=\"forminator-label\">Fourniture de documents :<\/label><div class=\"forminator-multi-upload \" data-element=\"upload-2_6ab490252b78a\" aria-describedby=\"forminator-field-upload-2_6ab490252b78a-description\"><input type=\"file\" name=\"upload-2[]\" id=\"forminator-field-upload-2_6ab490252b78a\" class=\"forminator-input-file forminator-field-upload-2_6ab490252b78a-8981\" multiple=\"multiple\" data-method=\"ajax\" accept=\".avif,.heif,.heics,.heifs,.wav,.jpg,.jpeg,.jpe,.gif,.png,.bmp,.heic,.webp,.doc,.docx,.odt,.pages,.pdf,image\/avif,image\/heif,image\/heic-sequence,image\/heif-sequence,audio\/wav,image\/jpeg,image\/gif,image\/png,image\/bmp,image\/heic,image\/webp,application\/msword,application\/vnd.openxmlformats-officedocument.wordprocessingml.document,application\/vnd.oasis.opendocument.text,application\/vnd.apple.pages,application\/pdf\" data-size=\"8388608\" data-size-message=\"Maximum file size allowed is 8 MB. \" data-filetype=\"avif|heif|heics|heifs|wav|jpg|jpeg|jpe|gif|png|bmp|heic|webp|doc|docx|odt|pages|pdf\" data-filetype-message=\"file extension is not allowed.\"><div class=\"forminator-multi-upload-message\" aria-hidden=\"true\"><span class=\"forminator-icon-upload\" aria-hidden=\"true\"><\/span><p>Arrosegar i llan\u00e7ar (o) <a class=\"forminator-upload-file--forminator-field-upload-2_6ab490252b78a\" href=\"#\" onclick=\"return false;\">Escolliu fitxers<\/a><\/p><\/div><\/div><span id=\"forminator-field-upload-2_6ab490252b78a-description\" class=\"forminator-description\">(FEUILLE DE PLAINTE, D\u00c9CLARATION AMICALE D'ACCIDENT, D\u00c9CLARATION DE T\u00c9MOINS, ETC.)<\/span><ul class=\"forminator-uploaded-files upload-container-upload-2_6ab490252b78a\"><\/ul><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"textarea-9\" class=\"forminator-field-textarea forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-textarea-9_6ab490252b78a\" id=\"forminator-field-textarea-9_6ab490252b78a-label\" class=\"forminator-label\">OBSERVATIONS :<\/label><textarea name=\"textarea-9\" placeholder=\"\" id=\"forminator-field-textarea-9_6ab490252b78a\" class=\"forminator-textarea\" style=\"--forminator-textarea-min-height:140px;\" aria-describedby=\"forminator-field-textarea-9_6ab490252b78a-description\" ><\/textarea><span id=\"forminator-field-textarea-9_6ab490252b78a-description\" class=\"forminator-description\">EXPOSEZ CE QUE VOUS CONSID\u00c9REZ PERTINENT POUR LE CAS.<\/span><\/div><\/div><\/div><\/div><\/div><div\n\t\t\t\ttabindex=\"-1\"\n\t\t\t\trole=\"tabpanel\"\n\t\t\t\tid=\"forminator-custom-form-8981--page-2\"\n\t\t\t\tclass=\"forminator-pagination\"\n\t\t\t\taria-labelledby=\"forminator-custom-form-8981--page-2-label\"\n\t\t\t\taria-hidden=\"true\"\n\t\t\t\tdata-step=\"2\"\n\t\t\t\tdata-label=\"SINISTRE\"\n\t\t\t\tdata-actual-label=\"CONTACTE\"\n\t\t\t\tdata-name=\"\"\n\t\t\t\thidden\n\t\t\t><div class=\"forminator-pagination--content\"><div class=\"forminator-row\"><div id=\"radio-5\" class=\"forminator-field-radio forminator-col forminator-col-12 \"><div role=\"radiogroup\" class=\"forminator-field\" aria-labelledby=\"forminator-radiogroup-radio-5-6ab490252b78a-label\"><span id=\"forminator-radiogroup-radio-5-6ab490252b78a-label\" class=\"forminator-label\">SI VOUS AVEZ DE QUESTIONS COMPL\u00c9MENTAIRES, CONTACTEZ NOUS PAR: <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-radio-5-label-1\" for=\"forminator-field-radio-5-1-6ab490252b78a\" class=\"forminator-radio\" title=\"E-MAIL\"><input type=\"radio\" name=\"radio-5\" value=\"one\" id=\"forminator-field-radio-5-1-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-5-label-1\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">E-MAIL<\/span><\/label><label id=\"forminator-field-radio-5-label-2\" for=\"forminator-field-radio-5-2-6ab490252b78a\" class=\"forminator-radio\" title=\"T\u00c9L\u00c9PHONE\"><input type=\"radio\" name=\"radio-5\" value=\"two\" id=\"forminator-field-radio-5-2-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-5-label-2\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">T\u00c9L\u00c9PHONE<\/span><\/label><label id=\"forminator-field-radio-5-label-3\" for=\"forminator-field-radio-5-3-6ab490252b78a\" class=\"forminator-radio\" title=\"COURRIER\"><input type=\"radio\" name=\"radio-5\" value=\"CORREU-POSTAL\" id=\"forminator-field-radio-5-3-6ab490252b78a\" aria-labelledby=\"forminator-field-radio-5-label-3\" data-calculation=\"0\"  \/><span class=\"forminator-radio-bullet\" aria-hidden=\"true\"><\/span><span class=\"forminator-radio-label\">COURRIER<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"consent-1\" class=\"forminator-field-consent forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-consent-1_6ab490252b78a\" id=\"forminator-field-consent-1_6ab490252b78a-label\" class=\"forminator-label\">Je Consents <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-checkbox__wrapper\"><label id=\"forminator-field-consent-1_6ab490252b78a__label\" class=\"forminator-checkbox forminator-consent\"><input type=\"checkbox\" name=\"consent-1\" id=\"forminator-field-consent-1_6ab490252b78a\" value=\"checked\" aria-labelledby=\"forminator-field-consent-1_6ab490252b78a-label\" aria-describedby=\"forminator-field-consent-1_6ab490252b78a__description\" data-required=\"true\" aria-required=\"true\" \/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><\/label><div id=\"forminator-field-consent-1_6ab490252b78a__description\" class=\"forminator-checkbox__label forminator-consent__label\"><p>JE CONFIRME QUE J\u2019ACCEPTE LA\u00a0<a href=\"#link-popup\">POLITIQUE DE CONFIDENTIALIT\u00c9<\/a>\u00a0DE CE SITE AFIN QUE VOUS PUISSIEZ R\u00c9PONDRE \u00c0 MA DEMANDE.<\/p><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-hidden\"><div id=\"hidden-1\" class=\"forminator-field-hidden  forminator-col-12 \"><input type=\"hidden\" id=\"hidden-1_6ab490252b78a\" name=\"hidden-1\" value=\"\" \/><\/div><\/div><div class=\"forminator-row forminator-hidden\"><div id=\"hidden-2\" class=\"forminator-field-hidden  forminator-col-12 \"><input type=\"hidden\" id=\"hidden-2_6ab490252b78a\" name=\"hidden-2\" value=\"\" \/><\/div><\/div><\/div><button class=\"forminator-button forminator-pagination-submit\" style=\"display: none;\" disabled>Envoyer formulaire<\/button><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"54a571b450\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index_beta.php\/wp-json\/wp\/v2\/pages\/8993\" \/><input type=\"hidden\" name=\"form_id\" value=\"8981\"><input type=\"hidden\" name=\"page_id\" value=\"8993\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"forminator-multifile-hidden\" class=\"forminator-multifile-hidden\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f2776c6 elementor-widget elementor-widget-html\" data-id=\"f2776c6\" data-element_type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script type=\"text\/javascript\">\r\nwindow.addEventListener(\"load\", function() {\r\nconst cobertura = document.getElementsByName(\"text-1\");;\r\nconst nif = document.getElementsByName(\"text-17\");\r\nconst addr = document.getElementsByName(\"text-2\");\r\nconst cp = document.getElementsByName(\"text-3\");\r\nconst pobl = document.getElementsByName(\"text-4\");\r\nconst phon = document.getElementsByName(\"phone-1\");\r\nconst ema = document.getElementsByName(\"email-1\");\r\n\r\n\/\/ alternative is to use \"change\" - explained below\r\ncobertura[0].addEventListener(\"keyup\", buttonState);\r\n\r\nfunction buttonState() {\r\n    if (cobertura[0].value.toLowerCase() === \"broker\") {\r\n        nif[0].value = \"12345678A\";\r\n        addr[0].value = \"C\/ Nou, 123\";\r\n        cp[0].value = 17487;\r\n        pobl[0].value =\"Empuriabrava\";\r\n        phon[0].value = \"+34972450430\";\r\n        ema[0].value = \"broker@dunach.com\";\r\n    }}});\r\n<\/script>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-b00e29f\" data-id=\"b00e29f\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d2658ba elementor-widget elementor-widget-template\" data-id=\"d2658ba\" data-element_type=\"widget\" data-settings=\"{&quot;sticky&quot;:&quot;top&quot;,&quot;sticky_offset&quot;:330,&quot;sticky_effects_offset&quot;:200,&quot;sticky_parent&quot;:&quot;yes&quot;,&quot;sticky_on&quot;:[&quot;desktop&quot;,&quot;tablet&quot;,&quot;mobile&quot;],&quot;sticky_anchor_link_offset&quot;:0}\" data-widget_type=\"template.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-template\">\n\t\t\t\t\t<div data-elementor-type=\"section\" data-elementor-id=\"1965\" class=\"elementor elementor-1965\" data-elementor-post-type=\"elementor_library\">\n\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b7952de franja-lateral-contacte elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b7952de\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-9e7b5e4\" data-id=\"9e7b5e4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-68ab834 elementor-widget elementor-widget-spacer\" data-id=\"68ab834\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c897f95 elementor-align-center elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"c897f95\" data-element_type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-comments\"><\/i>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">voleu contactar-nos?<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-471adda elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"471adda\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-17957a5\" data-id=\"17957a5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-079f24a elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"079f24a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\">Oficina Empuriabrava \/ <br>Castell\u00f3 d'Emp\u00faries<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1758c20 elementor-widget elementor-widget-spacer\" data-id=\"1758c20\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-735138c elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"735138c\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"tel:972450430\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">972 45 04 30<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cb1510d elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"cb1510d\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"mailto:broker@dunach.com\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-envelope\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">broker@dunach.com<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc2fd95 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"cc2fd95\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"https:\/\/www.google.com\/maps\/dir\/\/Du\u00f1ach+S.A.+Corredoria+d&#039;Assegurances,+Carrer+de+Sant+Mor\u00ed,+14,+Bajo,+17487+Empuriabrava,+Girona\/@42.241695,3.0877434,13z\/data=!3m1!4b1!4m8!4m7!1m0!1m5!1m1!1s0x12ba61b0ce87c3e5:0xf5316c2e78113760!2m2!1d3.1228485!2d42.2417004\" target=\"_blank\" rel=\"nofollow\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-map-marker-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Com arribar<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-405aaab elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"405aaab\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4210322\" data-id=\"4210322\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-089ca2b elementor-widget__width-auto elementor-widget elementor-widget-heading\" data-id=\"089ca2b\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-heading-title elementor-size-default\">Oficina roses<\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae99ddc elementor-widget elementor-widget-spacer\" data-id=\"ae99ddc\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-68abc79 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"68abc79\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"tel:972257322\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-phone-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">972 25 73 22<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-39bac28 elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"39bac28\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"mailto:broker@dunach.com\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-envelope\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">broker@dunach.com<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-313117e elementor-widget__width-auto elementor-widget elementor-widget-button\" data-id=\"313117e\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-xs\" href=\"https:\/\/www.google.com\/maps\/dir\/\/Du\u00f1ach+S.A.+Corredoria+d&#039;Assegurances,+Av.+de+Rhode,+89,+17480+Roses,+Girona\/@42.2531743,3.1129588,13z\/data=!4m8!4m7!1m0!1m5!1m1!1s0x12ba6153d851d44d:0x660b32b34718eaae!2m2!1d3.1731079!2d42.2646588\" target=\"_blank\" rel=\"nofollow\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"fas fa-map-marker-alt\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Com arribar<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>D\u00c9CLARATION DU SINISTRE Remplissez ce formulaire et nous prendrons contact avec vous.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-8993","page","type-page","status-publish"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>D\u00c9CLARATION DU SINISTRE - Dunach<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"D\u00c9CLARATION DU SINISTRE - Dunach\" \/>\n<meta property=\"og:description\" content=\"D\u00c9CLARATION DU SINISTRE Remplissez ce formulaire et nous prendrons contact avec vous.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr\" \/>\n<meta property=\"og:site_name\" content=\"Dunach\" \/>\n<meta property=\"article:modified_time\" content=\"2024-12-16T10:30:45+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Temps estimat de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"1 minut\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr\",\"url\":\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr\",\"name\":\"D\u00c9CLARATION DU SINISTRE - Dunach\",\"isPartOf\":{\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#website\"},\"datePublished\":\"2023-04-21T10:39:07+00:00\",\"dateModified\":\"2024-12-16T10:30:45+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr#breadcrumb\"},\"inLanguage\":\"ca\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Inici\",\"item\":\"https:\/\/dunach.com\/index_beta.php\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"D\u00c9CLARATION DU SINISTRE\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#website\",\"url\":\"https:\/\/dunach.com\/index_beta.php\/\",\"name\":\"Dunach\",\"description\":\"Correduria d&#039;assegurances\",\"publisher\":{\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/dunach.com\/index_beta.php\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"ca\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#organization\",\"name\":\"Dunach\",\"url\":\"https:\/\/dunach.com\/index_beta.php\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"ca\",\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/dunach.com\/wp-content\/uploads\/2020\/09\/dunach-logo.png\",\"contentUrl\":\"https:\/\/dunach.com\/wp-content\/uploads\/2020\/09\/dunach-logo.png\",\"width\":498,\"height\":110,\"caption\":\"Dunach\"},\"image\":{\"@id\":\"https:\/\/dunach.com\/index_beta.php\/#\/schema\/logo\/image\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"D\u00c9CLARATION DU SINISTRE - Dunach","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/","og_locale":"ca_ES","og_type":"article","og_title":"D\u00c9CLARATION DU SINISTRE - Dunach","og_description":"D\u00c9CLARATION DU SINISTRE Remplissez ce formulaire et nous prendrons contact avec vous.","og_url":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr","og_site_name":"Dunach","article_modified_time":"2024-12-16T10:30:45+00:00","twitter_card":"summary_large_image","twitter_misc":{"Temps estimat de lectura":"1 minut"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr","url":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr","name":"D\u00c9CLARATION DU SINISTRE - Dunach","isPartOf":{"@id":"https:\/\/dunach.com\/index_beta.php\/#website"},"datePublished":"2023-04-21T10:39:07+00:00","dateModified":"2024-12-16T10:30:45+00:00","breadcrumb":{"@id":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr#breadcrumb"},"inLanguage":"ca","potentialAction":[{"@type":"ReadAction","target":["https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/dunach.com\/index_beta.php\/declaration-du-sinistre\/?lang=fr#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Inici","item":"https:\/\/dunach.com\/index_beta.php"},{"@type":"ListItem","position":2,"name":"D\u00c9CLARATION DU SINISTRE"}]},{"@type":"WebSite","@id":"https:\/\/dunach.com\/index_beta.php\/#website","url":"https:\/\/dunach.com\/index_beta.php\/","name":"Dunach","description":"Correduria d&#039;assegurances","publisher":{"@id":"https:\/\/dunach.com\/index_beta.php\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/dunach.com\/index_beta.php\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"ca"},{"@type":"Organization","@id":"https:\/\/dunach.com\/index_beta.php\/#organization","name":"Dunach","url":"https:\/\/dunach.com\/index_beta.php\/","logo":{"@type":"ImageObject","inLanguage":"ca","@id":"https:\/\/dunach.com\/index_beta.php\/#\/schema\/logo\/image\/","url":"https:\/\/dunach.com\/wp-content\/uploads\/2020\/09\/dunach-logo.png","contentUrl":"https:\/\/dunach.com\/wp-content\/uploads\/2020\/09\/dunach-logo.png","width":498,"height":110,"caption":"Dunach"},"image":{"@id":"https:\/\/dunach.com\/index_beta.php\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/pages\/8993","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/comments?post=8993"}],"version-history":[{"count":3,"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/pages\/8993\/revisions"}],"predecessor-version":[{"id":19660,"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/pages\/8993\/revisions\/19660"}],"wp:attachment":[{"href":"https:\/\/dunach.com\/index_beta.php\/wp-json\/wp\/v2\/media?parent=8993"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}