{"id":29422,"date":"2025-03-06T09:41:02","date_gmt":"2025-03-06T14:41:02","guid":{"rendered":"https:\/\/skippersplan.com\/declarer-une-reclamation\/"},"modified":"2025-03-06T09:41:02","modified_gmt":"2025-03-06T14:41:02","slug":"declarer-une-reclamation","status":"publish","type":"page","link":"https:\/\/skippersplan.com\/fr\/declarer-une-reclamation\/","title":{"rendered":"D\u00e9clarer une r\u00e9clamation"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"29422\" class=\"elementor elementor-29422 elementor-15\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6878ee5c e-flex e-con-boxed e-con e-parent\" data-id=\"6878ee5c\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-22cbc86f elementor-widget elementor-widget-spacer\" data-id=\"22cbc86f\" data-element_type=\"widget\" data-e-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-4a337f00 elementor-widget elementor-widget-heading\" data-id=\"4a337f00\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<p class=\"elementor-heading-title elementor-size-default\">Rapport de r\u00e9clamation d'embarcation<\/p>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc2e310 elementor-widget elementor-widget-shortcode\" data-id=\"cc2e310\" data-element_type=\"widget\" data-e-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\"><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 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d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\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_1' ><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/fr\/wp-json\/wp\/v2\/pages\/29422' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_1_3\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><\/li><li id=\"field_1_5\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom<\/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_1_5'>\n                            \n                            <span id='input_1_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_1_5_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_5_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_1_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_1_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_1_5_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_1_6\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_6'><span class='gform-field-label__text'>Num\u00e9ro de police<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_1_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_7'><span class='gform-field-label__text'>Meilleur num\u00e9ro pour vous joindre - En journ\u00e9e<\/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_7' id='input_1_7' type='tel' value='' class='large'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_1_8\" class=\"gfield gfield--type-phone gfield--phone-format-standard field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_8'><span class='gform-field-label__text'>Meilleur num\u00e9ro pour vous joindre - Soir<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_1_8' type='tel' value='' class='large'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_1_9\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Votre adresse<\/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_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_1_9' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_1_9_1_container' >\n                                        <input type='text' name='input_9.1' id='input_1_9_1' value=''    aria-required='true'    \/>\n                                        <label for='input_1_9_1' id='input_1_9_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_1_9_2_container' >\n                                        <input type='text' name='input_9.2' id='input_1_9_2' value=''     aria-required='false'   \/>\n                                        <label for='input_1_9_2' id='input_1_9_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_1_9_3_container' >\n                                    <input type='text' name='input_9.3' id='input_1_9_3' value=''    aria-required='true'    \/>\n                                    <label for='input_1_9_3' id='input_1_9_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_1_9_4_container' >\n                                        <input type='text' name='input_9.4' id='input_1_9_4' value=''      aria-required='true'    \/>\n                                        <label for='input_1_9_4' id='input_1_9_4_label' class='gform-field-label gform-field-label--type-sub '>\u00c9tat\/Province\/R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_1_9_5_container' >\n                                    <input type='text' name='input_9.5' id='input_1_9_5' value=''    aria-required='true'    \/>\n                                    <label for='input_1_9_5' id='input_1_9_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_1_9_6_container' >\n                                        <select name='input_9.6' id='input_1_9_6'   aria-required='true'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='ZA' >Afrique du Sud<\/option><option value='AL' >Albanie<\/option><option value='DZ' >Alg\u00e9rie<\/option><option value='DE' >Allemagne<\/option><option value='AD' >Andorre<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctique<\/option><option value='AG' >Antigua-et-Barbuda<\/option><option value='SA' >Arabie Saoudite<\/option><option value='AR' >Argentine<\/option><option value='AM' >Arm\u00e9nie<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australie<\/option><option value='AT' >Autriche<\/option><option value='AZ' >Azerba\u00efdjan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahre\u00efn<\/option><option value='BD' >Bangladesh<\/option><option value='BY' >Belarus<\/option><option value='BE' >Belgique<\/option><option value='BZ' >Belize<\/option><option value='BJ' >B\u00e9nin<\/option><option value='BM' >Bermudes<\/option><option value='BT' >Bhoutan<\/option><option value='BO' >Bolivie<\/option><option value='BQ' >Bonaire, Saint-Eustache et Saba<\/option><option value='BA' >Bosnie-Herz\u00e9govine<\/option><option value='BW' >Botswana<\/option><option value='BR' >Br\u00e9sil<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarie<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodge<\/option><option value='CM' >Cameroun<\/option><option value='CA' >Canada<\/option><option value='CV' >Cap-Vert<\/option><option value='CL' >Chili<\/option><option value='CN' >Chine<\/option><option value='CY' >Chypre<\/option><option value='CO' >Colombie<\/option><option value='KM' >Comores<\/option><option value='CG' >Congo<\/option><option value='KR' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='KP' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >C\u00f4te d\u2019Ivoire<\/option><option value='HR' >Croatie<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='DK' >Danemark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominique<\/option><option value='EG' >\u00c9gypte<\/option><option value='AE' >\u00c9mirats arabes unis<\/option><option value='EC' >\u00c9quateur<\/option><option value='ER' >\u00c9rythr\u00e9e<\/option><option value='ES' >Espagne<\/option><option value='EE' >Estonie<\/option><option value='SZ' >Eswatini<\/option><option value='PS' >\u00c9tat palestinien<\/option><option value='US' >\u00c9tats-Unis<\/option><option value='ET' >\u00c9thiopie<\/option><option value='RU' >F\u00e9d\u00e9ration Russe<\/option><option value='FJ' >Fidji<\/option><option value='FI' >Finlande<\/option><option value='FR' >France<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambie<\/option><option value='GE' >G\u00e9orgie<\/option><option value='GS' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Gr\u00e8ce<\/option><option value='GD' >Grenade<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernesey<\/option><option value='GN' >Guin\u00e9e<\/option><option value='GQ' >Guin\u00e9e \u00e9quatoriale<\/option><option value='GW' >Guin\u00e9e-Bissau<\/option><option value='GF' >Guyane<\/option><option value='GY' >Guyane<\/option><option value='HT' >Ha\u00efti<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongrie<\/option><option value='BV' >\u00cele Bouvet<\/option><option value='CX' >\u00cele Christmas<\/option><option value='IM' >\u00cele de Man<\/option><option value='MU' >\u00cele Maurice<\/option><option value='NF' >\u00cele Norfolk<\/option><option value='AX' >\u00celes \u00c5land<\/option><option value='KY' >\u00celes Cayman<\/option><option value='CC' >\u00celes Cocos<\/option><option value='CK' >\u00celes Cook<\/option><option value='SJ' >\u00celes de Svalbard et Jan Mayen<\/option><option value='FK' >\u00celes Falkland<\/option><option value='FO' >\u00celes F\u00e9ro\u00e9<\/option><option value='HM' >\u00celes Heard et McDonald<\/option><option value='MP' >\u00celes Mariannes du Nord<\/option><option value='MH' >\u00celes Marshall<\/option><option value='UM' >\u00celes mineures am\u00e9ricaines<\/option><option value='PN' >\u00celes Pitcairn<\/option><option value='SB' >\u00celes Salomon<\/option><option value='TC' >\u00celes Turques et Ca\u00efques<\/option><option value='VI' >\u00celes Vierges am\u00e9ricaines<\/option><option value='VG' >\u00celes Vierges britanniques<\/option><option value='IN' >Inde<\/option><option value='ID' >Indon\u00e9sie<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IE' >Irlande<\/option><option value='IS' >Islande<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Italie<\/option><option value='JM' >Jama\u00efque<\/option><option value='JP' >Japon<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordanie<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KG' >Kirghizistan<\/option><option value='KI' >Kiribati<\/option><option value='KW' >Kowe\u00eft<\/option><option value='BB' >La Barbade<\/option><option value='RE' >La R\u00e9union<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Lettonie<\/option><option value='LB' >Liban<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libye<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lituanie<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao<\/option><option value='MK' >Mac\u00e9doine du Nord<\/option><option value='MG' >Madagascar<\/option><option value='MY' >Malaisie<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malte<\/option><option value='MA' >Maroc<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritanie<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexique<\/option><option value='FM' >Micron\u00e9sie<\/option><option value='MD' >Moldavie<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolie<\/option><option value='ME' >Mont\u00e9n\u00e9gro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibie<\/option><option value='NR' >Nauru<\/option><option value='NP' >N\u00e9pal<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nig\u00e9ria<\/option><option value='NU' >Niu\u00e9<\/option><option value='NO' >Norv\u00e8ge<\/option><option value='NC' >Nouvelle-Cal\u00e9donie<\/option><option value='NZ' >Nouvelle-Z\u00e9lande<\/option><option value='OM' >Oman<\/option><option value='UG' >Ouganda<\/option><option value='UZ' >Ouzb\u00e9kistan<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PA' >Panama<\/option><option value='PG' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='PY' >Paraguay<\/option><option value='NL' >Pays-Bas<\/option><option value='PE' >P\u00e9rou<\/option><option value='PH' >Philippines<\/option><option value='PL' >Pologne<\/option><option value='PF' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='PR' >Porto Rico<\/option><option value='PT' >Portugal<\/option><option value='QA' >Qatar<\/option><option value='SY' >R\u00e9publique arabe syrienne<\/option><option value='CF' >R\u00e9publique centrafricaine<\/option><option value='CD' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='LA' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='DO' >R\u00e9publique Dominicaine<\/option><option value='CZ' >R\u00e9publique Tch\u00e8que<\/option><option value='RO' >Roumanie<\/option><option value='GB' >Royaume-Uni<\/option><option value='RW' >Rwanda<\/option><option value='EH' >Sahara occidental<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre et Miquelon<\/option><option value='KN' >Saint-Christophe-et-Nevis<\/option><option value='SM' >Saint-Marin<\/option><option value='VA' >Saint-Si\u00e8ge<\/option><option value='VC' >Saint-Vincent-et-les Grenadines<\/option><option value='SH' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='LC' >Sainte-Lucie<\/option><option value='SV' >Salvador<\/option><option value='WS' >Samoa<\/option><option value='AS' >Samoa am\u00e9ricaines<\/option><option value='ST' >Sao Tom\u00e9 et Principe<\/option><option value='SN' >S\u00e9n\u00e9gal<\/option><option value='RS' >Serbie<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapour<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovaquie<\/option><option value='SI' >Slov\u00e9nie<\/option><option value='SO' >Somalie<\/option><option value='SD' >Soudan<\/option><option value='SS' >Soudan du Sud<\/option><option value='LK' >Sri Lanka<\/option><option value='SE' >Su\u00e8de<\/option><option value='CH' >Suisse<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadjikistan<\/option><option value='TW' >Ta\u00efwan<\/option><option value='TZ' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='TD' >Tchad<\/option><option value='TF' >Terres Australes Fran\u00e7aises<\/option><option value='IO' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='TH' >Tha\u00eflande<\/option><option value='TL' >Timor oriental<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinit\u00e9 et Tobago<\/option><option value='TN' >Tunisie<\/option><option value='TM' >Turkm\u00e9nistan<\/option><option value='TR' >Turquie<\/option><option value='TV' >Tuvalu<\/option><option value='UA' >Ukraine<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis et Futuna<\/option><option value='YE' >Y\u00e9men<\/option><option value='ZM' >Zambie<\/option><option value='ZW' >Zimbabwe<\/option><\/select>\n                                        <label for='input_1_9_6' id='input_1_9_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_10'><span class='gform-field-label__text'>E-mail<\/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_10' id='input_1_10' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_11\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_11'><span class='gform-field-label__text'>Emplacement actuel du navire<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_11' id='input_1_11' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_12\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_12'><span class='gform-field-label__text'>Ann\u00e9e du navire<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_1_12' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_13\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_13'><span class='gform-field-label__text'>Marque et mod\u00e8le<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_1_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_14\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_14'><span class='gform-field-label__text'>Longueur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_1_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_15\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_15'><span class='gform-field-label__text'>Moteur<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_1_15' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_47\" class=\"gfield gfield--type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_47'><span class='gform-field-label__text'>Avez-vous des photos num\u00e9riques des d\u00e9g\u00e2ts ?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_47' id='input_1_47' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Oui' >Oui<\/option><option value='Non' >Non<\/option><\/select><\/div><\/li><li id=\"field_1_18\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_18'><span class='gform-field-label__text'>Op\u00e9rateur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_1_18' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_18\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_1_18'>Si le navire n'\u00e9tait pas en op\u00e9ration au moment du sinistre, veuillez indiquer \u00ab aucun \u00bb ou \u00ab S\/O \u00bb<\/div><\/li><li id=\"field_1_21\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_21'><span class='gform-field-label__text'>Description compl\u00e8te de l&#039;accident et des \u00e9v\u00e9nements ult\u00e9rieurs par l&#039;op\u00e9rateur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_1_21' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><small>Include name & address of any injured persons in description of accident.<\/small><\/p><\/li><li id=\"field_1_23\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_23'><span class='gform-field-label__text'>Date of loss<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/jj\/aaaa'\n\t\t\t\t\tid='input_1_23'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_23'\n\t\t\t\t value=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\taria-required=\"true\"\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_1_23' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_1_23' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_1_23' aria-label='Date of loss: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_1_25\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_25'><span class='gform-field-label__text'>Temps de perte<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_1_25' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_26\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_26'><span class='gform-field-label__text'>Lieu de l&#039;accident\/incident<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_1_26' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_22\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><hr\/><\/li><li id=\"field_1_29\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 >Autre navire<br><\/li><li id=\"field_1_30\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_30'><span class='gform-field-label__text'>Propri\u00e9taire de l&#039;autre navire impliqu\u00e9<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_1_30' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_32\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_1_32' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_1_32_1_container' >\n                                        <input type='text' name='input_32.1' id='input_1_32_1' value=''    aria-required='false'    \/>\n                                        <label for='input_1_32_1' id='input_1_32_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_1_32_2_container' >\n                                        <input type='text' name='input_32.2' id='input_1_32_2' value=''     aria-required='false'   \/>\n                                        <label for='input_1_32_2' id='input_1_32_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_1_32_3_container' >\n                                    <input type='text' name='input_32.3' id='input_1_32_3' value=''    aria-required='false'    \/>\n                                    <label for='input_1_32_3' id='input_1_32_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_1_32_4_container' >\n                                        <input type='text' name='input_32.4' id='input_1_32_4' value=''      aria-required='false'    \/>\n                                        <label for='input_1_32_4' id='input_1_32_4_label' class='gform-field-label gform-field-label--type-sub '>\u00c9tat\/Province\/R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_1_32_5_container' >\n                                    <input type='text' name='input_32.5' id='input_1_32_5' value=''    aria-required='false'    \/>\n                                    <label for='input_1_32_5' id='input_1_32_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_1_32_6_container' >\n                                        <select name='input_32.6' id='input_1_32_6'   aria-required='false'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='ZA' >Afrique du Sud<\/option><option value='AL' >Albanie<\/option><option value='DZ' >Alg\u00e9rie<\/option><option value='DE' >Allemagne<\/option><option value='AD' >Andorre<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctique<\/option><option value='AG' >Antigua-et-Barbuda<\/option><option value='SA' >Arabie Saoudite<\/option><option value='AR' >Argentine<\/option><option value='AM' >Arm\u00e9nie<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australie<\/option><option value='AT' >Autriche<\/option><option value='AZ' >Azerba\u00efdjan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahre\u00efn<\/option><option value='BD' >Bangladesh<\/option><option value='BY' >Belarus<\/option><option value='BE' >Belgique<\/option><option value='BZ' >Belize<\/option><option value='BJ' >B\u00e9nin<\/option><option value='BM' >Bermudes<\/option><option value='BT' >Bhoutan<\/option><option value='BO' >Bolivie<\/option><option value='BQ' >Bonaire, Saint-Eustache et Saba<\/option><option value='BA' >Bosnie-Herz\u00e9govine<\/option><option value='BW' >Botswana<\/option><option value='BR' >Br\u00e9sil<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgarie<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodge<\/option><option value='CM' >Cameroun<\/option><option value='CA' >Canada<\/option><option value='CV' >Cap-Vert<\/option><option value='CL' >Chili<\/option><option value='CN' >Chine<\/option><option value='CY' >Chypre<\/option><option value='CO' >Colombie<\/option><option value='KM' >Comores<\/option><option value='CG' >Congo<\/option><option value='KR' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='KP' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >C\u00f4te d\u2019Ivoire<\/option><option value='HR' >Croatie<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='DK' >Danemark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominique<\/option><option value='EG' >\u00c9gypte<\/option><option value='AE' >\u00c9mirats arabes unis<\/option><option value='EC' >\u00c9quateur<\/option><option value='ER' >\u00c9rythr\u00e9e<\/option><option value='ES' >Espagne<\/option><option value='EE' >Estonie<\/option><option value='SZ' >Eswatini<\/option><option value='PS' >\u00c9tat palestinien<\/option><option value='US' >\u00c9tats-Unis<\/option><option value='ET' >\u00c9thiopie<\/option><option value='RU' >F\u00e9d\u00e9ration Russe<\/option><option value='FJ' >Fidji<\/option><option value='FI' >Finlande<\/option><option value='FR' >France<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambie<\/option><option value='GE' >G\u00e9orgie<\/option><option value='GS' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Gr\u00e8ce<\/option><option value='GD' >Grenade<\/option><option value='GL' >Groenland<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernesey<\/option><option value='GN' >Guin\u00e9e<\/option><option value='GQ' >Guin\u00e9e \u00e9quatoriale<\/option><option value='GW' >Guin\u00e9e-Bissau<\/option><option value='GF' >Guyane<\/option><option value='GY' >Guyane<\/option><option value='HT' >Ha\u00efti<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hongrie<\/option><option value='BV' >\u00cele Bouvet<\/option><option value='CX' >\u00cele Christmas<\/option><option value='IM' >\u00cele de Man<\/option><option value='MU' >\u00cele Maurice<\/option><option value='NF' >\u00cele Norfolk<\/option><option value='AX' >\u00celes \u00c5land<\/option><option value='KY' >\u00celes Cayman<\/option><option value='CC' >\u00celes Cocos<\/option><option value='CK' >\u00celes Cook<\/option><option value='SJ' >\u00celes de Svalbard et Jan Mayen<\/option><option value='FK' >\u00celes Falkland<\/option><option value='FO' >\u00celes F\u00e9ro\u00e9<\/option><option value='HM' >\u00celes Heard et McDonald<\/option><option value='MP' >\u00celes Mariannes du Nord<\/option><option value='MH' >\u00celes Marshall<\/option><option value='UM' >\u00celes mineures am\u00e9ricaines<\/option><option value='PN' >\u00celes Pitcairn<\/option><option value='SB' >\u00celes Salomon<\/option><option value='TC' >\u00celes Turques et Ca\u00efques<\/option><option value='VI' >\u00celes Vierges am\u00e9ricaines<\/option><option value='VG' >\u00celes Vierges britanniques<\/option><option value='IN' >Inde<\/option><option value='ID' >Indon\u00e9sie<\/option><option value='IQ' >Irak<\/option><option value='IR' >Iran<\/option><option value='IE' >Irlande<\/option><option value='IS' >Islande<\/option><option value='IL' >Isra\u00ebl<\/option><option value='IT' >Italie<\/option><option value='JM' >Jama\u00efque<\/option><option value='JP' >Japon<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordanie<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KG' >Kirghizistan<\/option><option value='KI' >Kiribati<\/option><option value='KW' >Kowe\u00eft<\/option><option value='BB' >La Barbade<\/option><option value='RE' >La R\u00e9union<\/option><option value='LS' >Lesotho<\/option><option value='LV' >Lettonie<\/option><option value='LB' >Liban<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libye<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lituanie<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao<\/option><option value='MK' >Mac\u00e9doine du Nord<\/option><option value='MG' >Madagascar<\/option><option value='MY' >Malaisie<\/option><option value='MW' >Malawi<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malte<\/option><option value='MA' >Maroc<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritanie<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexique<\/option><option value='FM' >Micron\u00e9sie<\/option><option value='MD' >Moldavie<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolie<\/option><option value='ME' >Mont\u00e9n\u00e9gro<\/option><option value='MS' >Montserrat<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibie<\/option><option value='NR' >Nauru<\/option><option value='NP' >N\u00e9pal<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nig\u00e9ria<\/option><option value='NU' >Niu\u00e9<\/option><option value='NO' >Norv\u00e8ge<\/option><option value='NC' >Nouvelle-Cal\u00e9donie<\/option><option value='NZ' >Nouvelle-Z\u00e9lande<\/option><option value='OM' >Oman<\/option><option value='UG' >Ouganda<\/option><option value='UZ' >Ouzb\u00e9kistan<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PA' >Panama<\/option><option value='PG' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='PY' >Paraguay<\/option><option value='NL' >Pays-Bas<\/option><option value='PE' >P\u00e9rou<\/option><option value='PH' >Philippines<\/option><option value='PL' >Pologne<\/option><option value='PF' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='PR' >Porto Rico<\/option><option value='PT' >Portugal<\/option><option value='QA' >Qatar<\/option><option value='SY' >R\u00e9publique arabe syrienne<\/option><option value='CF' >R\u00e9publique centrafricaine<\/option><option value='CD' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='LA' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='DO' >R\u00e9publique Dominicaine<\/option><option value='CZ' >R\u00e9publique Tch\u00e8que<\/option><option value='RO' >Roumanie<\/option><option value='GB' >Royaume-Uni<\/option><option value='RW' >Rwanda<\/option><option value='EH' >Sahara occidental<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre et Miquelon<\/option><option value='KN' >Saint-Christophe-et-Nevis<\/option><option value='SM' >Saint-Marin<\/option><option value='VA' >Saint-Si\u00e8ge<\/option><option value='VC' >Saint-Vincent-et-les Grenadines<\/option><option value='SH' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='LC' >Sainte-Lucie<\/option><option value='SV' >Salvador<\/option><option value='WS' >Samoa<\/option><option value='AS' >Samoa am\u00e9ricaines<\/option><option value='ST' >Sao Tom\u00e9 et Principe<\/option><option value='SN' >S\u00e9n\u00e9gal<\/option><option value='RS' >Serbie<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapour<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovaquie<\/option><option value='SI' >Slov\u00e9nie<\/option><option value='SO' >Somalie<\/option><option value='SD' >Soudan<\/option><option value='SS' >Soudan du Sud<\/option><option value='LK' >Sri Lanka<\/option><option value='SE' >Su\u00e8de<\/option><option value='CH' >Suisse<\/option><option value='SR' >Suriname<\/option><option value='TJ' >Tadjikistan<\/option><option value='TW' >Ta\u00efwan<\/option><option value='TZ' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='TD' >Tchad<\/option><option value='TF' >Terres Australes Fran\u00e7aises<\/option><option value='IO' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='TH' >Tha\u00eflande<\/option><option value='TL' >Timor oriental<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinit\u00e9 et Tobago<\/option><option value='TN' >Tunisie<\/option><option value='TM' >Turkm\u00e9nistan<\/option><option value='TR' >Turquie<\/option><option value='TV' >Tuvalu<\/option><option value='UA' >Ukraine<\/option><option value='UY' >Uruguay<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Vietnam<\/option><option value='WF' >Wallis et Futuna<\/option><option value='YE' >Y\u00e9men<\/option><option value='ZM' >Zambie<\/option><option value='ZW' >Zimbabwe<\/option><\/select>\n                                        <label for='input_1_32_6' id='input_1_32_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_1_33\" class=\"gfield gfield--type-phone gfield--phone-format-standard field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_33'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_33' id='input_1_33' type='tel' value='' class='large'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_1_34\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_34'><span class='gform-field-label__text'>Nom de la compagnie d&#039;assurance<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_1_34' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_35\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_35'><span class='gform-field-label__text'>Num\u00e9ro de police<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_1_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_36\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_36'><span class='gform-field-label__text'>L&#039;un ou l&#039;autre des navires \u00e9tait-il en course ?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_1_36' class='large gfield_select'     aria-invalid=\"false\" ><option value='N\/D' >N\/D<\/option><option value='Oui' >Oui<\/option><option value='Non' >Non<\/option><\/select><\/div><\/li><li id=\"field_1_37\" class=\"gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_37'><span class='gform-field-label__text'>Une \u00ab protestation \u00bb a-t-elle \u00e9t\u00e9 d\u00e9pos\u00e9e ?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_37' id='input_1_37' class='large gfield_select'     aria-invalid=\"false\" ><option value='N\/D' >N\/D<\/option><option value='Oui' >Oui<\/option><option value='Non' >Non<\/option><\/select><\/div><\/li><li id=\"field_1_38\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_38'><span class='gform-field-label__text'>Signal\u00e9 aux autorit\u00e9s ?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_1_38' class='large gfield_select'  aria-describedby=\"gfield_description_1_38\"  aria-required=\"true\" aria-invalid=\"false\" ><option value='Oui' >Oui<\/option><option value='Non' >Non<\/option><\/select><\/div><div class='gfield_description' id='gfield_description_1_38'>In case of injuries, theft, vandalism, or any criminal activity, or collisions where the damage exceeds $1,000 or affects seaworthiness, report the incident to the appropriate authorities promptly. (In most cases your local police). <\/div><\/li><li id=\"field_1_42\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_42'><span class='gform-field-label__text'>Si oui, \u00e0 qui ?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_1_42' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_43\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_43'><span class='gform-field-label__text'>Avez-vous des questions ou des pr\u00e9occupations concernant le processus de r\u00e9clamation?<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_43' id='input_1_43' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_49\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_1_49'><span class='gform-field-label__text'>R\u00e9clamation rapport\u00e9e par<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_1_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_1_41\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p><small>Veuillez fournir le nom de l'agent, son num\u00e9ro de badge, sa force de police et\/ou son d\u00e9tachement et son num\u00e9ro de t\u00e9l\u00e9phone<\/small><\/p><\/li><li id=\"field_1_28\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3>Avis important<\/h3>\n<p>\n\n<ol>\n<li>Sauf \u00e0 vos propres frais, vous ne devez assumer aucune obligation, admettre aucune responsabilit\u00e9, autoriser des r\u00e9parations ou approuver des devis sans consentement \u00e9crit.\n<\/li>\n<li>Les d\u00e9penses raisonnables que vous engagez pour pr\u00e9venir les blessures, minimiser la perte ou prot\u00e9ger le bateau assur\u00e9 sont approuv\u00e9es.\n<\/li>\n<li>Consultez le libell\u00e9 de la police et\/ou contactez Skippers' Plan \/ Arthur J. Gallagher Canada Limited au 1-800-661-7211 si vous avez des questions.\n<\/li>\n<\/ol>\n\n<\/p><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_1' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Soumettre<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_1' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_1' id='gform_theme_1' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_1' id='gform_style_settings_1' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='USD' value='Vg42yAxRqyVLL\/Y\/yNC1j92Tgs9Ou8v7y9\/EfMw8xdDuftNYyLa5s3h4GTMSRD\/z01m0RvaahMKmgwdeIWOO4iyEafH9iXDK6\/aa5jSCYqBs97w=' \/>\n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='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' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_target_page_number_1' id='gform_target_page_number_1' value='0' \/>\n            <input type='hidden' autocomplete='off' class='gform_hidden' name='gform_source_page_number_1' id='gform_source_page_number_1' value='1' \/>\n            <input type='hidden' name='gform_field_values' value='' \/>\n            \n        <\/div>\n                        <\/form>\n                        <\/div><\/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\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Rapport de r\u00e9clamation d&#8217;embarcation<\/p>\n","protected":false},"author":1,"featured_media":30029,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"footnotes":""},"class_list":["post-29422","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO Pro 5.0.3 - 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