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class=\u0022content-container\u0022\u003E\n  \n  \u003Cform class=\u0022webform-submission-form webform-submission-add-form webform-submission-damage-form webform-submission-damage-add-form js-webform-details-toggle webform-details-toggle antibot\u0022 data-drupal-selector=\u0022webform-submission-damage-add-form\u0022 enctype=\u0022multipart\/form-data\u0022 data-action=\u0022\/fr\/contact\/next\/damage\u0022 action=\u0022\/antibot\u0022 method=\u0022post\u0022 id=\u0022webform-submission-damage-add-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\n  \n  \u003Cnoscript\u003E\n  \u003Cdiv class=\u0022antibot-no-js antibot-message antibot-message-warning\u0022\u003EYou must have JavaScript enabled to use this form.\u003C\/div\u003E\n\u003C\/noscript\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-personal-info\u0022 id=\u0022edit-personal-info\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EDonn\u00e9es personnelles\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-firstname js-form-item-firstname\u0022\u003E\n      \u003Clabel for=\u0022edit-firstname\u0022 class=\u0022js-form-required form-required\u0022\u003EPr\u00e9nom\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-firstname\u0022 type=\u0022text\u0022 id=\u0022edit-firstname\u0022 name=\u0022firstname\u0022 value=\u0022\u0022 size=\u002260\u0022 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data-drupal-selector=\u0022edit-flexbox-01\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-01\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-street js-form-item-street\u0022\u003E\n      \u003Clabel for=\u0022edit-street\u0022 class=\u0022js-form-required form-required\u0022\u003ERue\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-street\u0022 type=\u0022text\u0022 id=\u0022edit-street\u0022 name=\u0022street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-number js-form-item-number\u0022\u003E\n      \u003Clabel for=\u0022edit-number\u0022 class=\u0022js-form-required form-required\u0022\u003EN\u00b0\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-number\u0022 type=\u0022number\u0022 id=\u0022edit-number\u0022 name=\u0022number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-bus js-form-item-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-bus\u0022\u003EBo\u00eete\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-bus\u0022 type=\u0022text\u0022 id=\u0022edit-bus\u0022 name=\u0022bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-02\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-02\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-postal-code js-form-item-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-postal-code\u0022 class=\u0022js-form-required form-required\u0022\u003ECode postal\u003C\/label\u003E\n        \u003Cinput 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form-required\u0022\u003EE-mail\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-email\u0022 type=\u0022email\u0022 id=\u0022edit-email\u0022 name=\u0022email\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022254\u0022 class=\u0022form-email required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-04\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-04\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-contract-number js-form-item-contract-number\u0022\u003E\n      \u003Clabel for=\u0022edit-contract-number\u0022\u003ENum\u00e9ro de contrat\u003C\/label\u003E\n    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webform-type-datetime js-form-item form-item js-form-type-datetime form-item-date-damage js-form-item-date-damage\u0022\u003E\n      \u003Clabel class=\u0022js-form-required form-required\u0022\u003EDate de sinistre\u003C\/label\u003E\n        \u003Cdiv id=\u0022edit-date-damage\u0022 class=\u0022container-inline\u0022\u003E\n  \u003Cdiv class=\u0022js-form-item form-item js-form-type-date form-item-date-damage-date js-form-item-date-damage-date form-no-label\u0022\u003E\n      \u003Clabel for=\u0022edit-date-damage-date\u0022 class=\u0022visually-hidden js-form-required form-required\u0022\u003EDate de sinistre: Date\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-date-damage-date\u0022 type=\u0022date\u0022 id=\u0022edit-date-damage-date\u0022 name=\u0022date_damage[date]\u0022 value=\u0022\u0022 size=\u002212\u0022 class=\u0022form-date required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-form-item form-item js-form-type-webform-time form-item-date-damage-time js-form-item-date-damage-time form-no-label\u0022\u003E\n      \u003Clabel for=\u0022edit-date-damage-time\u0022 class=\u0022visually-hidden js-form-required form-required\u0022\u003EDate de sinistre: Heure\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-date-damage-time\u0022 type=\u0022time\u0022 step=\u002260\u0022 id=\u0022edit-date-damage-time\u0022 name=\u0022date_damage[time]\u0022 value=\u0022\u0022 size=\u002212\u0022 maxlength=\u002212\u0022 class=\u0022form-time webform-time required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-location-damage js-form-item-location-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-location-damage\u0022 class=\u0022js-form-required form-required\u0022\u003ELieu du sinistre\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-location-damage\u0022 type=\u0022text\u0022 id=\u0022edit-location-damage\u0022 name=\u0022location_damage\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text required\u0022 required=\u0022required\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-what-happened js-form-item-what-happened\u0022\u003E\n      \u003Clabel for=\u0022edit-what-happened\u0022 class=\u0022js-form-required form-required\u0022\u003EQu\u0027est-il arriv\u00e9 exactement ?\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-what-happened\u0022 id=\u0022edit-what-happened\u0022 name=\u0022what_happened\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea required resize-vertical\u0022 required=\u0022required\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-which-policy js-form-item-which-policy\u0022\u003E\n      \u003Clabel for=\u0022edit-which-policy\u0022\u003EQuelle police est concern\u00e9e ?\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-which-policy\u0022 id=\u0022edit-which-policy\u0022 name=\u0022which_policy\u0022 class=\u0022form-select\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- S\u00e9lectionner -\u003C\/option\u003E\u003Coption value=\u0022car\u0022\u003EVoiture\u003C\/option\u003E\u003Coption value=\u0022fire\u0022\u003EIncendie\u003C\/option\u003E\u003Coption value=\u0022liability\u0022\u003EResponsabilit\u00e9\u003C\/option\u003E\u003Coption value=\u0022legal_counsal\u0022\u003EProtection juridique\u003C\/option\u003E\u003Coption value=\u0022hospitalization\u0022\u003EHospitalisation\u003C\/option\u003E\u003Coption value=\u0022personal\u0022\u003EAccident personnel \/ revenu garanti\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EAutre \/ je ne sais pas\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset class=\u0022js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-details-damage\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;filled\u0026quot;:true}}}\u0022 id=\u0022edit-details-damage\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ELes d\u00e9tails concernant le sinistre\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-car\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-car\u0022\u003E\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-damage-type js-form-item-damage-type\u0022\u003E\n      \u003Clabel for=\u0022edit-damage-type\u0022\u003EType de sinistre\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-damage-type\u0022 id=\u0022edit-damage-type\u0022 name=\u0022damage_type\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- S\u00e9lectionner -\u003C\/option\u003E\u003Coption value=\u0022theft\u0022\u003EVol\u003C\/option\u003E\u003Coption value=\u0022glass_breakage\u0022\u003EBris de vitre\u003C\/option\u003E\u003Coption value=\u0022with_third_parties\u0022\u003EAccident avec des tiers\u003C\/option\u003E\u003Coption value=\u0022without_third_parties\u0022\u003EAccident sans tiers\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-vehicle\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-vehicle\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EV\u00e9hicule\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-license-plate js-form-item-license-plate\u0022\u003E\n      \u003Clabel for=\u0022edit-license-plate\u0022\u003EPlaque d\u0027immatriculation\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-license-plate\u0022 type=\u0022text\u0022 id=\u0022edit-license-plate\u0022 name=\u0022license_plate\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-vehicle-location js-form-item-vehicle-location\u0022\u003E\n      \u003Clabel for=\u0022edit-vehicle-location\u0022\u003EO\u00f9 se trouve le v\u00e9hicule actuellement ?\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-vehicle-location\u0022 type=\u0022text\u0022 id=\u0022edit-vehicle-location\u0022 name=\u0022vehicle_location\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-name-address-repairer js-form-item-name-address-repairer\u0022\u003E\n      \u003Clabel for=\u0022edit-name-address-repairer\u0022\u003ENom et adresse de votre r\u00e9parateur\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-name-address-repairer\u0022 type=\u0022text\u0022 id=\u0022edit-name-address-repairer\u0022 name=\u0022name_address_repairer\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-driver\u0022 id=\u0022edit-driver\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ELe conducteur du v\u00e9hicule au moment de l\u0027accident\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox-06\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-06\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-driver-first-name js-form-item-driver-first-name\u0022\u003E\n      \u003Clabel for=\u0022edit-driver-first-name\u0022\u003EPr\u00e9nom\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-driver-first-name\u0022 type=\u0022text\u0022 id=\u0022edit-driver-first-name\u0022 name=\u0022driver_first_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-driver-last-name js-form-item-driver-last-name\u0022\u003E\n      \u003Clabel for=\u0022edit-driver-last-name\u0022\u003ENom\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-driver-last-name\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-driver-last-name\u0022 name=\u0022driver_last_name\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-number-drivers-license js-form-item-number-drivers-license\u0022\u003E\n      \u003Clabel for=\u0022edit-number-drivers-license\u0022\u003ENum\u00e9ro du permis de conduire\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-number-drivers-license\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-number-drivers-license\u0022 name=\u0022number_drivers_license\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-damage\u0022 id=\u0022edit-damage\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ESinistre\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-damage-description js-form-item-damage-description\u0022\u003E\n      \u003Clabel for=\u0022edit-damage-description\u0022\u003ED\u00e9crivez les d\u00e9g\u00e2ts au v\u00e9hicule.\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-damage-description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022 id=\u0022edit-damage-description\u0022 name=\u0022damage_description\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-material-damage js-form-item-material-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-material-damage\u0022\u003ED\u00e9crivez tous les d\u00e9g\u00e2ts mat\u00e9riels (d\u00e9g\u00e2ts autres qu\u0027\u00e0 votre propre v\u00e9hicule et celui de la partie adverse).\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-material-damage\u0022 id=\u0022edit-material-damage\u0022 name=\u0022material_damage\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-counterparty\u0022 id=\u0022edit-counterparty\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EContrepartie\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-counterparty-available\u0022 id=\u0022edit-counterparty-available--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;\u0026quot;:\u0026quot;\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-counterparty-available--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EY avait-il une contrepartie impliqu\u00e9e dans l\u0027accident ?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-counterparty-available\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-yes\u0022 name=\u0022counterparty_available\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-yes\u0022 class=\u0022option\u0022\u003EOui\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-yes-unknown\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-yes-unknown\u0022 name=\u0022counterparty_available\u0022 value=\u0022yes_unknown\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-yes-unknown\u0022 class=\u0022option\u0022\u003EOui, inconnu\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-counterparty-available js-form-item-counterparty-available\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-available-no\u0022 type=\u0022radio\u0022 id=\u0022edit-counterparty-available-no\u0022 name=\u0022counterparty_available\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-counterparty-available-no\u0022 class=\u0022option\u0022\u003ENon \/ non applicable\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-counterparty-container\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022counterparty_available\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-counterparty-container\u0022\u003E\u003Cdiv data-drupal-selector=\u0022edit-flexbox-07\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-07\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-first-name js-form-item-counterparty-first-name\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-first-name\u0022\u003EPr\u00e9nom\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-first-name\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-first-name\u0022 name=\u0022counterparty_first_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-last-name js-form-item-counterparty-last-name\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-last-name\u0022\u003ENom\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-last-name\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-last-name\u0022 name=\u0022counterparty_last_name\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-08\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-08\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-street js-form-item-counterparty-street\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-street\u0022\u003ERue\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-street\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-street\u0022 name=\u0022counterparty_street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-counterparty-number js-form-item-counterparty-number\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-number\u0022\u003EN\u00b0\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-number\u0022 type=\u0022number\u0022 id=\u0022edit-counterparty-number\u0022 name=\u0022counterparty_number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-bus js-form-item-counterparty-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-bus\u0022\u003EBo\u00eete\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-bus\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-bus\u0022 name=\u0022counterparty_bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-09\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-09\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-counterparty-postal-code js-form-item-counterparty-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-postal-code\u0022\u003ECode postal\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-postal-code\u0022 type=\u0022number\u0022 id=\u0022edit-counterparty-postal-code\u0022 name=\u0022counterparty_postal_code\u0022 value=\u0022\u0022 step=\u0022any\u0022 min=\u00221000\u0022 max=\u00229999\u0022 class=\u0022form-number\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-city js-form-item-counterparty-city\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-city\u0022\u003ELieu\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-city\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-city\u0022 name=\u0022counterparty_city\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-10\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-10\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-tel webform-type-tel js-form-item form-item js-form-type-tel form-item-counterparty-phone js-form-item-counterparty-phone\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-phone\u0022\u003ET\u00e9l\u00e9phone \/ mobile\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-phone\u0022 type=\u0022tel\u0022 id=\u0022edit-counterparty-phone\u0022 name=\u0022counterparty_phone\u0022 value=\u0022\u0022 size=\u002230\u0022 maxlength=\u0022128\u0022 class=\u0022form-tel\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-counterparty-insurance-company js-form-item-counterparty-insurance-company\u0022\u003E\n      \u003Clabel for=\u0022edit-counterparty-insurance-company\u0022\u003ECompagnie d\u0027assurance\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-counterparty-insurance-company\u0022 type=\u0022text\u0022 id=\u0022edit-counterparty-insurance-company\u0022 name=\u0022counterparty_insurance_company\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-responsible js-form-item-responsible\u0022\u003E\n      \u003Clabel for=\u0022edit-responsible\u0022\u003ESelon vous, qui est responsable du sinistre ?\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-responsible\u0022 id=\u0022edit-responsible\u0022 name=\u0022responsible\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- S\u00e9lectionner -\u003C\/option\u003E\u003Coption value=\u0022counterparty\u0022\u003ELa contrepartie \u00e9tait responsable\u003C\/option\u003E\u003Coption value=\u0022me\u0022\u003EJe suis responsable\u003C\/option\u003E\u003Coption value=\u0022both\u0022\u003ELes deux parties ont fait une fausse manoeuvre\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EAutre \/ je ne sais pas\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-verbalizing-entity-group\u0022 id=\u0022edit-verbalizing-entity-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAutorit\u00e9s verbalisantes\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-police-report\u0022 id=\u0022edit-police-report--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-police-report--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EY a-t-il un PV ?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-police-report\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-police-report js-form-item-police-report\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-police-report-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-police-report-yes\u0022 name=\u0022police_report\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-police-report-yes\u0022 class=\u0022option\u0022\u003EOui\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-police-report js-form-item-police-report\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-police-report-no\u0022 type=\u0022radio\u0022 id=\u0022edit-police-report-no\u0022 name=\u0022police_report\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-police-report-no\u0022 class=\u0022option\u0022\u003ENon\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-pv-nummer js-form-item-pv-nummer\u0022\u003E\n      \u003Clabel for=\u0022edit-pv-nummer\u0022\u003ENum\u00e9ro de PV (si connu)\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-pv-nummer\u0022 type=\u0022text\u0022 id=\u0022edit-pv-nummer\u0022 name=\u0022pv_nummer\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022police_report\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-alcoholtest\u0022 id=\u0022edit-alcoholtest--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-alcoholtest--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003E Y at-il eu un test respiratoire ou un test sanguin ?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-alcoholtest\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-no\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-no\u0022 name=\u0022alcoholtest\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-no\u0022 class=\u0022option\u0022\u003ENon\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-negative\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-negative\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_negative\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-negative\u0022 class=\u0022option\u0022\u003EOui, r\u00e9sultat n\u00e9gatif\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-positive\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-positive\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_positive\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-positive\u0022 class=\u0022option\u0022\u003EOui, r\u00e9sultat positif\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-alcoholtest js-form-item-alcoholtest\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-alcoholtest-yes-unknown\u0022 type=\u0022radio\u0022 id=\u0022edit-alcoholtest-yes-unknown\u0022 name=\u0022alcoholtest\u0022 value=\u0022yes_unknown\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-alcoholtest-yes-unknown\u0022 class=\u0022option\u0022\u003EOui, je ne connais pas le r\u00e9sultat\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-witnesses-group\u0022 id=\u0022edit-witnesses-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ET\u00e9moins\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-witnesses\u0022 id=\u0022edit-witnesses--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-witnesses--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EY a-t-il des t\u00e9moins de l\u0027accident ?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-witnesses\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-witnesses js-form-item-witnesses\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-witnesses-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-witnesses-yes\u0022 name=\u0022witnesses\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-witnesses-yes\u0022 class=\u0022option\u0022\u003EOui\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-witnesses js-form-item-witnesses\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-witnesses-no\u0022 type=\u0022radio\u0022 id=\u0022edit-witnesses-no\u0022 name=\u0022witnesses\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-witnesses-no\u0022 class=\u0022option\u0022\u003ENon\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-witnesses-info js-form-item-witnesses-info\u0022\u003E\n      \u003Clabel for=\u0022edit-witnesses-info\u0022\u003ENom et coordonn\u00e9es des t\u00e9moins\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-witnesses-info\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022witnesses\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-witnesses-info\u0022 name=\u0022witnesses_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-injured-group\u0022 id=\u0022edit-injured-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EBless\u00e9s\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cfieldset data-drupal-selector=\u0022edit-injured\u0022 id=\u0022edit-injured--wrapper\u0022 class=\u0022radios--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-radios webform-type-radios js-form-item form-item js-form-wrapper form-wrapper\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;car\u0026quot;}}}\u0022\u003E\n      \u003Clegend id=\u0022edit-injured--wrapper-legend\u0022\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EY at-il des bless\u00e9s dans l\u0027accident ?\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022edit-injured\u0022 class=\u0022js-webform-radios webform-options-display-one-column\u0022\u003E\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-injured js-form-item-injured\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-injured-yes\u0022 type=\u0022radio\u0022 id=\u0022edit-injured-yes\u0022 name=\u0022injured\u0022 value=\u0022yes\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-injured-yes\u0022 class=\u0022option\u0022\u003EOui\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-type-radio webform-type-radio js-form-item form-item js-form-type-radio form-item-injured js-form-item-injured\u0022\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-injured-no\u0022 type=\u0022radio\u0022 id=\u0022edit-injured-no\u0022 name=\u0022injured\u0022 value=\u0022no\u0022 class=\u0022form-radio\u0022 \/\u003E\n\n        \u003Clabel for=\u0022edit-injured-no\u0022 class=\u0022option\u0022\u003ENon\u003C\/label\u003E\n      \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-injured-info js-form-item-injured-info\u0022\u003E\n      \u003Clabel for=\u0022edit-injured-info\u0022\u003ENom, adresse et date de naissance de la victime\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-injured-info\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022injured\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-injured-info\u0022 name=\u0022injured_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-injured-injuries js-form-item-injured-injuries\u0022\u003E\n      \u003Clabel for=\u0022edit-injured-injuries\u0022\u003ED\u00e9crirvez les blessures\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-injured-injuries\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022injured\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;yes\u0026quot;}}}\u0022 id=\u0022edit-injured-injuries\u0022 name=\u0022injured_injuries\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-fire\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 id=\u0022edit-fire\u0022\u003E\u003Cfieldset data-drupal-selector=\u0022edit-fire-address-group\u0022 id=\u0022edit-fire-address-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAdresse du risque assur\u00e9\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv data-drupal-selector=\u0022edit-flexbox-11\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-11\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-street js-form-item-fire-street\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-street\u0022\u003ERue\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-street\u0022 type=\u0022text\u0022 id=\u0022edit-fire-street\u0022 name=\u0022fire_street\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-fire-number js-form-item-fire-number\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-number\u0022\u003EN\u00b0\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-number\u0022 type=\u0022number\u0022 id=\u0022edit-fire-number\u0022 name=\u0022fire_number\u0022 value=\u0022\u0022 step=\u0022any\u0022 class=\u0022form-number\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-bus js-form-item-fire-bus\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-bus\u0022\u003EBo\u00eete\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-bus\u0022 type=\u0022text\u0022 id=\u0022edit-fire-bus\u0022 name=\u0022fire_bus\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-flexbox-12\u0022 class=\u0022webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper\u0022 id=\u0022edit-flexbox-12\u0022\u003E\u003Cdiv class=\u0022webform-flex webform-flex--1\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-number webform-type-number js-form-item form-item js-form-type-number form-item-fire-postal-code js-form-item-fire-postal-code\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-postal-code\u0022\u003ECode postal\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-postal-code\u0022 type=\u0022number\u0022 id=\u0022edit-fire-postal-code\u0022 name=\u0022fire_postal_code\u0022 value=\u0022\u0022 step=\u0022any\u0022 min=\u00221000\u0022 max=\u00229999\u0022 class=\u0022form-number\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022webform-flex webform-flex--2\u0022\u003E\u003Cdiv class=\u0022webform-flex--container\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textfield webform-type-textfield js-form-item form-item js-form-type-textfield form-item-fire-city js-form-item-fire-city\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-city\u0022\u003ELieu\u003C\/label\u003E\n        \u003Cinput data-drupal-selector=\u0022edit-fire-city\u0022 type=\u0022text\u0022 id=\u0022edit-fire-city\u0022 name=\u0022fire_city\u0022 value=\u0022\u0022 size=\u002260\u0022 maxlength=\u0022255\u0022 class=\u0022form-text\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 \/\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-fire-damage-type-group\u0022 id=\u0022edit-fire-damage-type-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EType de sinistre\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-select webform-type-select js-form-item form-item js-form-type-select form-item-fire-damage-type js-form-item-fire-damage-type\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-damage-type\u0022\u003EType de sinistre\u003C\/label\u003E\n        \u003Cselect data-drupal-selector=\u0022edit-fire-damage-type\u0022 id=\u0022edit-fire-damage-type\u0022 name=\u0022fire_damage_type\u0022 class=\u0022form-select\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022\u003E\u003Coption value=\u0022\u0022 selected=\u0022selected\u0022\u003E- S\u00e9lectionner -\u003C\/option\u003E\u003Coption value=\u0022fire_explosion\u0022\u003EIncendie \/ explosion\u003C\/option\u003E\u003Coption value=\u0022electrical\u0022\u003EDes appareils \u00e9lectriques\u003C\/option\u003E\u003Coption value=\u0022flood\u0022\u003EInondation\u003C\/option\u003E\u003Coption value=\u0022storm\u0022\u003ESinistre caus\u00e9 par temp\u00eate et gr\u00eale\u003C\/option\u003E\u003Coption value=\u0022water\u0022\u003ED\u00e9gat des eaux\u003C\/option\u003E\u003Coption value=\u0022theft\u0022\u003EVol\u003C\/option\u003E\u003Coption value=\u0022other\u0022\u003EAutre \/ je ne sais pas\u003C\/option\u003E\u003C\/select\u003E\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-fire-damage-group\u0022 id=\u0022edit-fire-damage-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003ESinistre\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-fire-damage js-form-item-fire-damage\u0022\u003E\n      \u003Clabel for=\u0022edit-fire-damage\u0022\u003EDescription du sinistre\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-fire-damage\u0022 aria-describedby=\u0022edit-fire-damage--description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:\u0026quot;fire\u0026quot;}}}\u0022 id=\u0022edit-fire-damage\u0022 name=\u0022fire_damage\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n            \u003Cdiv class=\u0022description\u0022\u003E\n      \u003Cdiv id=\u0022edit-fire-damage--description\u0022 class=\u0022webform-element-description\u0022\u003EDonnez par exemple une description des d\u00e9g\u00e2ts au b\u00e2timent, au contenu et aux tiers, des r\u00e9parations qui sont n\u00e9cessaires et qui peut les effectuer, une estimation des d\u00e9g\u00e2ts, une identification des bless\u00e9s \u00e9ventuels, \u2026 Via le champ \u201cannexes et documents\u201d vous pouvez transmettre les pi\u00e8ces probantes et justificatives (photos, factures d\u2019achat, documents de la police). Mais attention, si vous \u00eates locataire, les d\u00e9g\u00e2ts doivent \u00eatre communiqu\u00e9s par le propri\u00e9taire \u00e0 son assureur !\u003C\/div\u003E\n\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003C\/div\u003E\n\u003Cdiv class=\u0022js-webform-states-hidden js-form-wrapper form-wrapper\u0022 data-drupal-selector=\u0022edit-other\u0022 data-drupal-states=\u0022{\u0026quot;visible\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:{\u0026quot;pattern\u0026quot;:\u0026quot;^(liability|legal_counsal|hospitalization|personal|other)$\u0026quot;}}}}\u0022 id=\u0022edit-other\u0022\u003E\u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-other-damage-description js-form-item-other-damage-description\u0022\u003E\n      \u003Clabel for=\u0022edit-other-damage-description\u0022\u003EDescription du sinistre\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-other-damage-description\u0022 data-drupal-states=\u0022{\u0026quot;required\u0026quot;:{\u0026quot;.webform-submission-damage-add-form :input[name=\\u0022which_policy\\u0022]\u0026quot;:{\u0026quot;value\u0026quot;:{\u0026quot;pattern\u0026quot;:\u0026quot;^(liability|legal_counsal|hospitalization|personal|other)$\u0026quot;}}}}\u0022 id=\u0022edit-other-damage-description\u0022 name=\u0022other_damage_description\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-extra-info-group\u0022 id=\u0022edit-extra-info-group\u0022 class=\u0022required js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend js-form-required form-required\u0022\u003ERemarques \/ informations compl\u00e9mentaires\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv class=\u0022js-webform-type-textarea webform-type-textarea js-form-item form-item js-form-type-textarea form-item-exta-info js-form-item-exta-info\u0022\u003E\n      \u003Clabel for=\u0022edit-exta-info\u0022\u003ERemarques \/ informations compl\u00e9mentaires\u003C\/label\u003E\n        \u003Cdiv\u003E\n  \u003Ctextarea data-drupal-selector=\u0022edit-exta-info\u0022 id=\u0022edit-exta-info\u0022 name=\u0022exta_info\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea resize-vertical\u0022\u003E\u003C\/textarea\u003E\n\u003C\/div\u003E\n\n        \u003C\/div\u003E\n\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cfieldset data-drupal-selector=\u0022edit-documents-group\u0022 id=\u0022edit-documents-group\u0022 class=\u0022js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper\u0022\u003E\n      \u003Clegend\u003E\n    \u003Cspan class=\u0022fieldset-legend\u0022\u003EAnnexes et documents\u003C\/span\u003E\n  \u003C\/legend\u003E\n  \u003Cdiv class=\u0022fieldset-wrapper\u0022\u003E\n                \u003Cdiv id=\u0022ajax-wrapper\u0022\u003E\u003Cdiv class=\u0022js-webform-type-webform-document-file webform-type-webform-document-file js-form-item form-item js-form-type-webform-document-file form-item-documents js-form-item-documents\u0022\u003E\n      \u003Clabel for=\u0022edit-documents-upload\u0022 id=\u0022edit-documents--label\u0022\u003EAnnexes et documents\u003C\/label\u003E\n        \u003Cdiv id=\u0022edit-documents\u0022 class=\u0022js-webform-document-file webform-document-file js-form-managed-file form-managed-file\u0022\u003E\n  \u003Cinput aria-describedby=\u0022edit-documents--description\u0022 data-drupal-selector=\u0022edit-documents-upload\u0022 multiple=\u0022multiple\u0022 type=\u0022file\u0022 id=\u0022edit-documents-upload\u0022 name=\u0022files[documents][]\u0022 size=\u002222\u0022 class=\u0022js-form-file form-file\u0022 \/\u003E\n\u003Cinput class=\u0022js-hide button js-form-submit form-submit\u0022 data-drupal-selector=\u0022edit-documents-upload-button\u0022 formnovalidate=\u0022formnovalidate\u0022 type=\u0022submit\u0022 id=\u0022edit-documents-upload-button\u0022 name=\u0022documents_upload_button\u0022 value=\u0022Transf\u00e9rer\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-documents-fids\u0022 type=\u0022hidden\u0022 name=\u0022documents[fids]\u0022 \/\u003E\n\n\u003C\/div\u003E\n\n            \u003Cdiv class=\u0022description\u0022\u003E\n      \u003Cdiv id=\u0022edit-documents--description\u0022 class=\u0022webform-element-description\u0022\u003EVous pouvez t\u00e9l\u00e9charger jusqu\u0027\u00e0 5 fichiers de type \u0022jpeg\u0022, \u0022jpg\u0022, \u0022png\u0022, \u0022PDF\u0022, \u0022doc\u0022 ou \u0022docx\u0022. La taille totale de tous les fichiers ne doit pas d\u00e9passer 6 Mb.\u003Cbr \/\u003E\u003C\/div\u003E\n\n    \u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n          \u003C\/div\u003E\n\u003C\/fieldset\u003E\n\u003Cdiv data-drupal-selector=\u0022edit-actions\u0022 class=\u0022form-actions webform-actions js-form-wrapper form-wrapper\u0022 id=\u0022edit-actions\u0022\u003E\u003Cinput class=\u0022webform-button--submit button button--primary js-form-submit form-submit\u0022 data-drupal-selector=\u0022edit-actions-submit\u0022 type=\u0022submit\u0022 id=\u0022edit-actions-submit\u0022 name=\u0022op\u0022 value=\u0022Envoyer\u0022 \/\u003E\n\n\u003C\/div\u003E\n\u003Cinput autocomplete=\u0022off\u0022 data-drupal-selector=\u0022form-sr4ymccyjqdm78m-wr7vuunscpblh21hgcqym-hywf8\u0022 type=\u0022hidden\u0022 name=\u0022form_build_id\u0022 value=\u0022form-sR4YmCcYJqDm78M_wR7vuunScpBLH21HGCqYM_Hywf8\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-webform-submission-damage-add-form\u0022 type=\u0022hidden\u0022 name=\u0022form_id\u0022 value=\u0022webform_submission_damage_add_form\u0022 \/\u003E\n\u003Cinput data-drupal-selector=\u0022edit-antibot-key\u0022 type=\u0022hidden\u0022 name=\u0022antibot_key\u0022 value=\u0022\u0022 \/\u003E\n\n\n  \n\u003C\/form\u003E\n\n\u003C\/div\u003E\n","settings":null}]