{"id":4339,"date":"2012-09-23T13:45:06","date_gmt":"2012-09-23T13:45:06","guid":{"rendered":"http:\/\/@WEBSITE_1@\/?page_id=4339"},"modified":"2018-09-28T12:11:38","modified_gmt":"2018-09-28T12:11:38","slug":"offerte-brandverzekering","status":"publish","type":"page","link":"https:\/\/www.zakenkantoorgoethals.be\/en\/offerte-brandverzekering\/","title":{"rendered":"Quotation Housing policy"},"content":{"rendered":"<p>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_21' ><div id='gf_21' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_21'  action=\"\/en\/wp-json\/wp\/v2\/pages\/4339#gf_21\" data-formid='21' novalidate>\n        <div id='gf_progressbar_wrapper_21' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>10<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_10' style='width:10%;'><span>10%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_21_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_21' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_69\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_69' class='gfield_label gform-field-label' for='input_21_69'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container'><input name='input_69' id='input_21_69' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_21_69'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_21_2\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Policyholder<\/h2><\/li><li id=\"field_21_3\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_3' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_21_3'>\n                            \n                            <span id='input_21_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_21_3_3' id='input_21_3_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_21_3_3' value=''   aria-required='true'     aria-labelledby=\"input_21_3_3_label gfield_label_21_3\"\/>\n                                                <\/span>\n                            \n                            <span id='input_21_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_21_3_6' id='input_21_3_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_21_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_21_4\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_21_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_21_4_1_container' >\n                                        <label for='input_21_4_1' id='input_21_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_21_4_1' value=''    aria-required='true'    aria-labelledby=\"input_21_4_1_label gfield_label_21_4\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_21_4_3_container' >\n                                    <label for='input_21_4_3' id='input_21_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_21_4_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_21_4_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_21_4_5_container' >\n                                    <label for='input_21_4_5' id='input_21_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_4.5' id='input_21_4_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_21_4_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_21_5\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_5' class='gfield_label gform-field-label' for='input_21_5'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_21_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_21_6\" class=\"gfield gfield--type-phone gfield--phone-format-international gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_6' class='gfield_label gform-field-label' for='input_21_6'><span class='gform-field-label__text'>Telephone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_21_6' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                         <button type='button' id='gform_next_button_21_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_2' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_7\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">General information<\/h2><\/li><li id=\"field_21_8\" class=\"gfield gfield--type-address field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_8' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Risk address<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_21_8' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_21_8_1_container' >\n                                        <label for='input_21_8_1' id='input_21_8_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_8.1' id='input_21_8_1' value=''    aria-required='false'    aria-describedby=\"gfield_description_21_8\" aria-labelledby=\"input_21_8_1_label gfield_label_21_8\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_21_8_3_container' >\n                                    <label for='input_21_8_3' id='input_21_8_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_8.3' id='input_21_8_3' value=''    aria-required='false'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_8.4' id='input_21_8_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_21_8_5_container' >\n                                    <label for='input_21_8_5' id='input_21_8_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_8.5' id='input_21_8_5' value=''    aria-required='false'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_8.6' id='input_21_8_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_21_8'><strong>(only if different from your home address)<\/strong><\/div><\/li><li id=\"field_21_15\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_15' class='gfield_label gform-field-label' for='input_21_15'><span class='gform-field-label__text'>Type van house<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_21_15' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Detached house' >Detached house<\/option><option value='Half-open house' >Half-open house<\/option><option value='Terraced house' >Terraced house<\/option><option value='Apartment - completely above ground floor' >Apartment - completely above ground floor<\/option><option value='Apartment - ground floor' >Apartment - ground floor<\/option><\/select><\/div><\/li><li id=\"field_21_16\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_16' class='gfield_label gform-field-label' for='input_21_16'><span class='gform-field-label__text'>Capacity<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_21_16' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Owner' >Owner<\/option><option value='Tenant' >Tenant<\/option><option value='Tenant (not responsible)' >Tenant (not responsible)<\/option><option value='Co-owner with syndic policy' >Co-owner with syndic policy<\/option><option value='Usufruct' >Usufruct<\/option><\/select><\/div><\/li><li id=\"field_21_17\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_17' class='gfield_label gform-field-label' for='input_21_17'><span class='gform-field-label__text'>Number of floors finished for habitation<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_17' id='input_21_17' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Only downstairs' >Only downstairs<\/option><option value='2 floors' >2 floors<\/option><option value='3 floors' >3 floors<\/option><option value='4 floors' >4 floors<\/option><option value='5 floors' >5 floors<\/option><option value='More than 5 floors' >More than 5 floors<\/option><\/select><\/div><\/li><li id=\"field_21_12\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_12' class='gfield_label gform-field-label' for='input_21_12'><span class='gform-field-label__text'>House to be built or still under construction?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_21_12' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><li id=\"field_21_18\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_18' class='gfield_label gform-field-label' for='input_21_18'><span class='gform-field-label__text'>Notary deed (Building under construction)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_18' id='input_21_18' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Not applicable' >Not applicable<\/option><option value='Act not yet past at the notary' >Act not yet past at the notary<\/option><option value='Act already past at the notary' >Act already past at the notary<\/option><\/select><\/div><\/li><li id=\"field_21_19\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_19' class='gfield_label gform-field-label' for='input_21_19'><span class='gform-field-label__text'>Purchase compromise signed less than 30 days ago (Purchase building)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_19' id='input_21_19' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Niet van toepassing' >Niet van toepassing<\/option><option value='Ja' >Ja<\/option><option value='Neen' >Neen<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_20' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_20' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_3' class='gform_page' data-js='page-field-id-20' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_3' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_23\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Please list your spaces<\/h2><\/li><li id=\"field_21_26\" class=\"gfield gfield--type-html gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h3>Your open living spaces<\/h3><\/li><li id=\"field_21_24\" class=\"gfield gfield--type-select field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_24' class='gfield_label gform-field-label' for='input_21_24'><span class='gform-field-label__text'>Number of open living spaces in your home<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_24' id='input_21_24' class='medium gfield_select'  aria-describedby=\"gfield_description_21_24\"   aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_21_24'>Open living spaces are rooms that are connected to each other without a door (!). (Eg dining room-sitting room or kitchen-living-desk count as 1 open living space if these are connected as one and in an open way).<\/div><\/li><li id=\"field_21_25\" class=\"gfield gfield--type-select field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_25' class='gfield_label gform-field-label' for='input_21_25'><span class='gform-field-label__text'>Area of your largest open living space (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_25' id='input_21_25' class='medium gfield_select'  aria-describedby=\"gfield_description_21_25\"   aria-invalid=\"false\" ><option value='&lt; 20m\u00b2' >&lt; 20m\u00b2<\/option><option value='20m\u00b2 - 25 m\u00b2' >20m\u00b2 - 25 m\u00b2<\/option><option value='25m\u00b2 - 30 m\u00b2' >25m\u00b2 - 30 m\u00b2<\/option><option value='30m\u00b2 - 35 m\u00b2' >30m\u00b2 - 35 m\u00b2<\/option><option value='35m\u00b2 - 40 m\u00b2' >35m\u00b2 - 40 m\u00b2<\/option><option value='40m\u00b2 - 45 m\u00b2' >40m\u00b2 - 45 m\u00b2<\/option><option value='45m\u00b2 - 50 m\u00b2' >45m\u00b2 - 50 m\u00b2<\/option><option value='50m\u00b2 - 55 m\u00b2' >50m\u00b2 - 55 m\u00b2<\/option><option value='55m\u00b2 - 60 m\u00b2' >55m\u00b2 - 60 m\u00b2<\/option><option value='60m\u00b2 - 65 m\u00b2' >60m\u00b2 - 65 m\u00b2<\/option><option value='65m\u00b2 - 70 m\u00b2' >65m\u00b2 - 70 m\u00b2<\/option><option value='70m\u00b2 - 75 m\u00b2' >70m\u00b2 - 75 m\u00b2<\/option><option value='75m\u00b2 - 80 m\u00b2' >75m\u00b2 - 80 m\u00b2<\/option><option value='80m\u00b2 - 85 m\u00b2' >80m\u00b2 - 85 m\u00b2<\/option><option value='85m\u00b2 - 90 m\u00b2' >85m\u00b2 - 90 m\u00b2<\/option><option value='90m\u00b2 - 95 m\u00b2' >90m\u00b2 - 95 m\u00b2<\/option><option value='95m\u00b2 - 100 m\u00b2' >95m\u00b2 - 100 m\u00b2<\/option><option value='&gt; 100 m\u00b2' >&gt; 100 m\u00b2<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_21_25'>If your kitchen-living-office is your largest open space, you need to count the <strong> area of all these spaces. <\/ Strong> (If your hall also forms part of this open living space, you should not include it)<\/div><\/li><li id=\"field_21_27\" class=\"gfield gfield--type-html gfield_html field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><\/br><\/br><h3>Your non-open living spaces<\/h3>\n<\/br>\n<\/br>\n<strong>Only spaces that are not part of the open living areas in your home and whose surface area is &gt; 4 m\u00b2<\/span><\/strong><\/li><li id=\"field_21_28\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_28' class='gfield_label gform-field-label' for='input_21_28'><span class='gform-field-label__text'>Separate kitchens<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_28' id='input_21_28' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><\/select><\/div><\/li><li id=\"field_21_29\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_29' class='gfield_label gform-field-label' for='input_21_29'><span class='gform-field-label__text'>Bath\/shower rooms<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_29' id='input_21_29' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><\/select><\/div><\/li><li id=\"field_21_30\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_30' class='gfield_label gform-field-label' for='input_21_30'><span class='gform-field-label__text'>Bedrooms<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_30' id='input_21_30' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><\/select><\/div><\/li><li id=\"field_21_31\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_31' class='gfield_label gform-field-label' for='input_21_31'><span class='gform-field-label__text'>Veranda&#039;s<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_31' id='input_21_31' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_32\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_32' class='gfield_label gform-field-label' for='input_21_32'><span class='gform-field-label__text'>Offices<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_32' id='input_21_32' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_33\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_33' class='gfield_label gform-field-label' for='input_21_33'><span class='gform-field-label__text'>Play-, hobbyrooms,...<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_33' id='input_21_33' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_34\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_34' class='gfield_label gform-field-label' for='input_21_34'><span class='gform-field-label__text'>Dressings<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_34' id='input_21_34' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_35\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_35' class='gfield_label gform-field-label' for='input_21_35'><span class='gform-field-label__text'>Washing places<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_35' id='input_21_35' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_68\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_68' class='gfield_label gform-field-label' for='input_21_68'><span class='gform-field-label__text'>Storage areas<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_68' id='input_21_68' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><\/select><\/div><\/li><li id=\"field_21_36\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_36' class='gfield_label gform-field-label' for='input_21_36'><span class='gform-field-label__text'>Swimming pool (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_36' id='input_21_36' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_21_37\" class=\"gfield gfield--type-textarea field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_37' class='gfield_label gform-field-label' for='input_21_37'><span class='gform-field-label__text'>Other non-listed finished areas<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_21_37' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_22' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_22' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_4' class='gform_page' data-js='page-field-id-22' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_4' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_38\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Parking spaces (Amount)<\/h2><div class='gsection_description' id='gfield_description_21_38'><strong>Also included if the space is no longer used effectively to store cars.<\/strong><\/div><\/li><li id=\"field_21_39\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_39' class='gfield_label gform-field-label' for='input_21_39'><span class='gform-field-label__text'>Parking spaces in \/ at home<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_21_39' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><\/select><\/div><\/li><li id=\"field_21_41\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_41' class='gfield_label gform-field-label' for='input_21_41'><span class='gform-field-label__text'>Parking spaces in carport<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_21_41' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><\/select><\/div><\/li><li id=\"field_21_42\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_42' class='gfield_label gform-field-label' for='input_21_42'><span class='gform-field-label__text'>Parking spaces in outbuilding<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_42' id='input_21_42' class='medium gfield_select'     aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_21' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_21' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_5' class='gform_page' data-js='page-field-id-21' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_5' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_44\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Outbuildings (in m\u00b2)<\/h2><\/li><li id=\"field_21_45\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_45' class='gfield_label gform-field-label' for='input_21_45'><span class='gform-field-label__text'>Garden shed (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_45' id='input_21_45' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_21_46\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_46' class='gfield_label gform-field-label' for='input_21_46'><span class='gform-field-label__text'>Dovecote (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_46' id='input_21_46' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_21_48\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_48' class='gfield_label gform-field-label' for='input_21_48'><span class='gform-field-label__text'>Stables (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_48' id='input_21_48' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_21_47\" class=\"gfield gfield--type-textarea field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_47' class='gfield_label gform-field-label' for='input_21_47'><span class='gform-field-label__text'>Other outbuildings (description + number of m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_47' id='input_21_47' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_43' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_43' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_6' class='gform_page' data-js='page-field-id-43' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_6' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_50\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Finish<\/h2><\/li><li id=\"field_21_51\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_21_51' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Finishing details of your house<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_21_51'><li class='gchoice gchoice_21_51_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.1' type='checkbox'  value='Closing on street side, higher than 1m (Bekaert wire, iron fence, ...)'  id='choice_21_51_1'    aria-labelledby=\"label_21_51_1 gfield_label_21_51\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_1' id='label_21_51_1' class='gform-field-label gform-field-label--type-inline'>Closing on street side, higher than 1m (Bekaert wire, iron fence, ...)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.2' type='checkbox'  value='Driveway closed by gate'  id='choice_21_51_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_2' id='label_21_51_2' class='gform-field-label gform-field-label--type-inline'>Driveway closed by gate<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.3' type='checkbox'  value='Worktop kitchen in natural stone, composite, stainless steel or ceramics'  id='choice_21_51_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_3' id='label_21_51_3' class='gform-field-label gform-field-label--type-inline'>Worktop kitchen in natural stone, composite, stainless steel or ceramics<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.4' type='checkbox'  value='Roof covering main building in reeds'  id='choice_21_51_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_4' id='label_21_51_4' class='gform-field-label gform-field-label--type-inline'>Roof covering main building in reeds<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.5' type='checkbox'  value='At least 2 facades entirely in natural stone'  id='choice_21_51_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_5' id='label_21_51_5' class='gform-field-label gform-field-label--type-inline'>At least 2 facades entirely in natural stone<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.6' type='checkbox'  value='Basement in the main building (do not indicate a crawl cellar)'  id='choice_21_51_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_6' id='label_21_51_6' class='gform-field-label gform-field-label--type-inline'>Basement in the main building (do not indicate a crawl cellar)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_51_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_51.7' type='checkbox'  value='Domotics'  id='choice_21_51_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_51_7' id='label_21_51_7' class='gform-field-label gform-field-label--type-inline'>Domotics<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_21_52\" class=\"gfield gfield--type-select field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_52' class='gfield_label gform-field-label' for='input_21_52'><span class='gform-field-label__text'>Number of built-in kitchen appliances<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_52' id='input_21_52' class='medium gfield_select'  aria-describedby=\"gfield_description_21_52\"   aria-invalid=\"false\" ><option value='&lt;= 6' >&lt;= 6<\/option><option value='&gt; 6' >&gt; 6<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_21_52'>Eg. Fridge (= no freestanding American fridge), gas cooker, electric cooker, hood, dishwasher, oven, steam oven, espresso machine<\/div><\/li><li id=\"field_21_53\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_21_53' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Floor covering somewhere in the house<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_21_53'><li class='gchoice gchoice_21_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='Solid parquet'  id='choice_21_53_1'    aria-labelledby=\"label_21_53_1 gfield_label_21_53\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_21_53_1' id='label_21_53_1' class='gform-field-label gform-field-label--type-inline'>Solid parquet<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_53_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.2' type='checkbox'  value='Natural stone'  id='choice_21_53_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_53_2' id='label_21_53_2' class='gform-field-label gform-field-label--type-inline'>Natural stone<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_53_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.3' type='checkbox'  value='Cast floor (without cellar)'  id='choice_21_53_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_53_3' id='label_21_53_3' class='gform-field-label gform-field-label--type-inline'>Cast floor (without cellar)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_21_54\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_54' class='gfield_label gform-field-label' for='input_21_54'><span class='gform-field-label__text'>Solar panels<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_21_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='None' >None<\/option><option value='Solar panels fixed to home (eg on roof)' >Solar panels fixed to home (eg on roof)<\/option><option value='Solar panels separate from home (eg on frame in garden)' >Solar panels separate from home (eg on frame in garden)<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_49' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_49' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_7' class='gform_page' data-js='page-field-id-49' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_7' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_55\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Others<\/h2><\/li><li id=\"field_21_57\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_21_57' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Optional guarantees<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_21_57'><li class='gchoice gchoice_21_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Fuel oil tank'  id='choice_21_57_1'    aria-labelledby=\"label_21_57_1 gfield_label_21_57\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_1' id='label_21_57_1' class='gform-field-label gform-field-label--type-inline'>Fuel oil tank<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.2' type='checkbox'  value='Ensure theft'  id='choice_21_57_2'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_2' id='label_21_57_2' class='gform-field-label gform-field-label--type-inline'>Ensure theft<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.3' type='checkbox'  value='Motor vehicles on location risk insurance against theft, hail, fire, water damage, ...'  id='choice_21_57_3'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_3' id='label_21_57_3' class='gform-field-label gform-field-label--type-inline'>Motor vehicles on location risk insurance against theft, hail, fire, water damage, ...<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.4' type='checkbox'  value='Supplying additional costs for construction standards'  id='choice_21_57_4'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_4' id='label_21_57_4' class='gform-field-label gform-field-label--type-inline'>Supplying additional costs for construction standards<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.5' type='checkbox'  value='Insurance for the builder (Accidents, Liability, ...)'  id='choice_21_57_5'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_5' id='label_21_57_5' class='gform-field-label gform-field-label--type-inline'>Insurance for the builder (Accidents, Liability, ...)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.6' type='checkbox'  value='Free profession exercised in the home'  id='choice_21_57_6'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_6' id='label_21_57_6' class='gform-field-label gform-field-label--type-inline'>Free profession exercised in the home<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.7' type='checkbox'  value='Insurance for your ornamental garden (Insurance for the more expensive ornamental gardens)'  id='choice_21_57_7'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_7' id='label_21_57_7' class='gform-field-label gform-field-label--type-inline'>Insurance for your ornamental garden (Insurance for the more expensive ornamental gardens)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_21_57_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.8' type='checkbox'  value='Insurance for your pool (&amp; your accessories in all-risk formula)'  id='choice_21_57_8'    \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_57_8' id='label_21_57_8' class='gform-field-label gform-field-label--type-inline'>Insurance for your pool (& your accessories in all-risk formula)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_56' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_56' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_8' class='gform_page' data-js='page-field-id-56' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_8' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_59\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Only for tenants of a building<\/h2><\/li><li id=\"field_21_60\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_60' class='gfield_label gform-field-label' for='input_21_60'><span class='gform-field-label__text'>Monthly rent?<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_60' id='input_21_60' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_21_61\" class=\"gfield gfield--type-number field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_61' class='gfield_label gform-field-label' for='input_21_61'><span class='gform-field-label__text'>Rented surface?  (m\u00b2)<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_61' id='input_21_61' type='text' step='any'   value='' class='small'      aria-invalid=\"false\" aria-describedby=\"gfield_description_21_61\" \/><\/div><div class='gfield_description' id='gfield_description_21_61'>Only privide area if it concerns an apartment. Garages, parking spaces and terraces do not have to be counted<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_58' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_58' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_9' class='gform_page' data-js='page-field-id-58' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_9' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_63\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Damage history concerning this property<\/h2><\/li><li id=\"field_21_64\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_64' class='gfield_label gform-field-label' for='input_21_64'><span class='gform-field-label__text'>Water damage in the last 3 years?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_64' id='input_21_64' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><li id=\"field_21_65\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_65' class='gfield_label gform-field-label' for='input_21_65'><span class='gform-field-label__text'>Damage caused by natural disasters last 10 years?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_65' id='input_21_65' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_21_62' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_21_62' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_21_10' class='gform_page' data-js='page-field-id-62' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_21_10' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_21_66\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Extra<\/h2><\/li><li id=\"field_21_67\" class=\"gfield gfield--type-textarea field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_21_67' class='gfield_label gform-field-label' for='input_21_67'><span class='gform-field-label__text'>Other remarks<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_67' id='input_21_67' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer left_label'><button type='submit' id='gform_previous_button_21' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_21' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Send<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_21' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_21' id='gform_theme_21' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_21' id='gform_style_settings_21' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_21' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='21' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='JCGWbwCTDY0kDc8eq2oxV4MUmye8OQD3KYpQsw9+Lf9NAQxLAPf\/E+QKMD1PzGL4PIw6oPX765nfLTpEEtqKH\/b3hpc5HO3qLS0a7bBXubcrZDw=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_21' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_21' id='gform_target_page_number_21' value='2' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_21' id='gform_source_page_number_21' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n             <\/div><\/div>\n                        <\/form>\n                        <\/div><\/p>","protected":false},"excerpt":{"rendered":"Step 1 of 10 10% LinkedInThis field is for validation purposes and should be left unchanged.PolicyholderName* First Last Address* Street Address City ZIP \/ Postal Code Email* Telephone* Volgende General informationRisk address Street Address City ZIP \/ Postal Code (only if different from your home address)Type van houseDetached houseHalf-open houseTerraced houseApartment - completely above ground floorApartment - ground floorCapacityOwnerTenantTenant (not...","protected":false},"author":12,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-4339","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/pages\/4339","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/comments?post=4339"}],"version-history":[{"count":1,"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/pages\/4339\/revisions"}],"predecessor-version":[{"id":6746,"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/pages\/4339\/revisions\/6746"}],"wp:attachment":[{"href":"https:\/\/www.zakenkantoorgoethals.be\/en\/wp-json\/wp\/v2\/media?parent=4339"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}