{"id":23880,"date":"2025-03-17T11:29:21","date_gmt":"2025-03-17T10:29:21","guid":{"rendered":"https:\/\/ecclesia.nl\/?post_type=verzekeringen&#038;p=23880"},"modified":"2025-05-14T09:07:53","modified_gmt":"2025-05-14T07:07:53","slug":"naverrekening","status":"publish","type":"verzekeringen","link":"https:\/\/ecclesia.nl\/en\/verzekeringen\/naverrekening\/","title":{"rendered":"Opgave naverrekening"},"content":{"rendered":"\n<div class=\"wp-block-cover alignfull is-light is-style-slanted is-style-default\" data-aos=\"flip-down\" data-aos-duration=\"1200\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-0 has-background-dim\" style=\"background-color:#6f8c94\"><\/span><img decoding=\"async\" width=\"2560\" height=\"1709\" class=\"wp-block-cover__image-background wp-image-18346\" alt=\"\" src=\"https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-scaled.jpg\" style=\"object-position:39% 35%\" data-object-fit=\"cover\" data-object-position=\"39% 35%\" srcset=\"https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-scaled.jpg 2560w, https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-300x200.jpg 300w, https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-1024x683.jpg 1024w, https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-768x513.jpg 768w, https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-1536x1025.jpg 1536w, https:\/\/ecclesia.nl\/wp-content\/uploads\/2024\/04\/Cyber_shutterstock_370107740-2048x1367.jpg 2048w\" sizes=\"(max-width: 2560px) 100vw, 2560px\" \/><div class=\"wp-block-cover__inner-container is-layout-constrained wp-container-core-cover-is-layout-eed21e6d wp-block-cover-is-layout-constrained\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-689cb6da wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column aos-flip-left is-layout-flow wp-block-column-is-layout-flow\">\n<h1 class=\"wp-block-heading\">Opgave naverrekening<\/h1>\n\n\n\n<p class=\"is-style-lead wp-block-paragraph\">U heeft van ons een verzoek ontvangen om uw opgave door te geven.<\/p>\n\n\n\n<p class=\"is-style-default wp-block-paragraph\">Elk jaar vragen wij u om uw bedrijfsgegevens te actualiseren. Dit zodat uw verzekeringen up-to-date blijven. De premie die u betaalt, is een voorschot en gebaseerd op de gegevens die op dat moment bekend zijn. Na afloop van het jaar vergelijkt Ecclesia deze gegevens met de definitieve cijfers van uw bedrijf.  Zo zorgen we ervoor dat uw verzekeringen altijd aansluiten bij uw actuele situatie.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group has-gray-background-color has-background is-layout-constrained wp-container-core-group-is-layout-6d34ec63 wp-block-group-is-layout-constrained\" style=\"margin-top:0;margin-bottom:0;padding-top:var(--wp--preset--spacing--50);padding-right:var(--wp--preset--spacing--50);padding-bottom:var(--wp--preset--spacing--50);padding-left:var(--wp--preset--spacing--50)\"><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 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var 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 gravity-theme gform-theme--no-framework gppt-has-page-transitions_wrapper gform-theme__no-reset--el_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_69' style='display:none'><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_69' id='gform_69' class='gppt-has-page-transitions gform-theme__no-reset--el ' action='\/en\/wp-json\/wp\/v2\/verzekeringen\/23880' data-formid='69' novalidate><input type=\"hidden\" value=\"0\" name=\"gpps_page_progression_69\" \/><div id='gf_page_steps_69' class='gf_page_steps'><div id='gf_step_69_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_8' class='gf_step gf_step_pending'><span class='gf_step_number'>8<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_9' class='gf_step gf_step_pending'><span class='gf_step_number'>9<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_10' class='gf_step gf_step_pending'><span class='gf_step_number'>10<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_11' class='gf_step gf_step_pending'><span class='gf_step_number'>11<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_12' class='gf_step gf_step_pending'><span class='gf_step_number'>12<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_13' class='gf_step gf_step_pending'><span class='gf_step_number'>13<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_14' class='gf_step gf_step_pending'><span class='gf_step_number'>14<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_15' class='gf_step gf_step_pending'><span class='gf_step_number'>15<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_16' class='gf_step gf_step_pending'><span class='gf_step_number'>16<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_17' class='gf_step gf_step_pending'><span class='gf_step_number'>17<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_18' class='gf_step gf_step_pending'><span class='gf_step_number'>18<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_19' class='gf_step gf_step_pending'><span class='gf_step_number'>19<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_20' class='gf_step gf_step_pending'><span class='gf_step_number'>20<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_21' class='gf_step gf_step_pending'><span class='gf_step_number'>21<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_22' class='gf_step gf_step_pending'><span class='gf_step_number'>22<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_23' class='gf_step gf_step_pending'><span class='gf_step_number'>23<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_24' class='gf_step gf_step_pending'><span class='gf_step_number'>24<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_25' class='gf_step gf_step_pending'><span class='gf_step_number'>25<\/span><span class='gf_step_label'><\/span><\/div><div id='gf_step_69_26' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>26<\/span><span class='gf_step_label'><\/span><\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_69_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_69' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_1805\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Invulinstructie<\/h3><div class='gsection_description' id='gfield_description_69_1805'>U staat op het punt om een opgave naverrekening in te dienen. In onderstaand veld is het mogelijk om meerdere verzekeringen te selecteren. De geselecteerde verzekeringen zullen in de navolgende schermen getoond worden. Wij adviseren u om de correspondentie die u per mail of post van ons heeft ontvangen bij de hand te houden. Daarin staan alle gegevens die u nodig heeft.\n\nBelangrijk:\nNeem alles zorgvuldig en volledig over, zodat we uw naverrekening snel en correct kunnen verwerken.\n\nHet is mogeljk tussentijds op te slaan en later verder te gaan. Kies daarvoor de button &#8220;Tussentijds opslaan&#8221;.<\/div><\/div><div id=\"field_69_1806\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Meerdere polissen van hetzelfde soort verzekering?<\/h3><div class='gsection_description' id='gfield_description_69_1806'>Als u meerdere polissen heeft van hetzelfde soort verzekering (elk met een uniek polisnummer), dan moet u het proces opnieuw doorlopen. Na het indienen verschijnt op het scherm een link waarmee u direct een nieuwe opgave kunt starten.<\/div><\/div><div id=\"field_69_1797\" class=\"gfield gfield--type-multiselect gfield--input-type-multiselect gfield--width-full Verzekeringskeuze gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_1797'>Voor welke verzekering(en) wenst u een opgave naverrekening door te geven?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_1797'>Selecteer de verzekering(en) waarvoor u een opgave naverrekening wilt doen. U kunt de soort verzekering terugvinden in onze correspondentie.<\/div><div class='ginput_container ginput_container_multiselect'><select multiple='multiple'  size='7' name='input_1797[]' id='input_69_1797' class='large gfield_select'   aria-invalid=\"false\" aria-required=\"true\" aria-describedby=\"gfield_description_69_1797\"><option value='Aanbouwverzekering' >Aanbouwverzekering<\/option><option value='AVB Excedent' >AVB Excedent<\/option><option value='Bedrijfsaansprakelijkheidsverzekering (AVB)' >Bedrijfsaansprakelijkheidsverzekering (AVB)<\/option><option value='Beroeps- en bedrijfsaansprakelijkheid (BAV\/AVB)' >Beroeps- en bedrijfsaansprakelijkheid (BAV\/AVB)<\/option><option value='Beroepsaansprakelijkheid (BAV)' >Beroepsaansprakelijkheid (BAV)<\/option><option value='Brand- en bedrijfsschadeverzekering' >Brand- en bedrijfsschadeverzekering<\/option><option value='CAR-\/Montageverzekering' >CAR-\/Montageverzekering<\/option><option value='Collectieve ongevallen' >Collectieve ongevallen<\/option><option value='Doorlopende CAR-\/Montageverzekering' >Doorlopende CAR-\/Montageverzekering<\/option><option value='Doorlopende Construction All Risk (CAR)' >Doorlopende Construction All Risk (CAR)<\/option><option value='Gecombineerde aansprakelijkheid' >Gecombineerde aansprakelijkheid<\/option><option value='Juwelier Blockpolis' >Juwelier Blockpolis<\/option><option value='Kunst- en kostbaarhedenverzekering' >Kunst- en kostbaarhedenverzekering<\/option><option value='Ladingaansprakelijkheid' >Ladingaansprakelijkheid<\/option><option value='Landmateriaalverzekering' >Landmateriaalverzekering<\/option><option value='Logistieke aansprakelijkheid' >Logistieke aansprakelijkheid<\/option><option value='Machine- en bedrijfsschadeverzekering' >Machine- en bedrijfsschadeverzekering<\/option><option value='Machineschadeverzekering' >Machineschadeverzekering<\/option><option value='Multiline verzekering' >Multiline verzekering<\/option><option value='Transport- en verblijfverzekering' >Transport- en verblijfverzekering<\/option><option value='Transport, reis en scheepvaartverzekering' >Transport, reis en scheepvaartverzekering<\/option><option value='Transportverzekering' >Transportverzekering<\/option><option value='Vervoerdersaansprakelijkheidsverzekering' >Vervoerdersaansprakelijkheidsverzekering<\/option><option value='Zonnepanelenverzekering' >Zonnepanelenverzekering<\/option><\/select><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_69_522' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_2_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_2' class='gform_page' data-js='page-field-id-522' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_523\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">AVB Excedent<\/h3><\/div><div id=\"field_69_524\" class=\"gfield gfield--type-text gfield--input-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_69_524'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_524' id='input_69_524' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_525\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_525'>Totale loonsom 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_525' id='input_69_525' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_526\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_526'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_526' id='input_69_526' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_527\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_527'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_527' id='input_69_527' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_528\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_528'>Inkomen eigenaren\/firmanten 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_528' id='input_69_528' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_529\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_529'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_529' id='input_69_529' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_530\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_530'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_530' id='input_69_530' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_531\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_531'>Totale bruto jaaromzet 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_531' id='input_69_531' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_532\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_532'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_532' id='input_69_532' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_533\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_533'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_533' id='input_69_533' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_534\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Export<\/h3><\/div><fieldset id=\"field_69_535\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar USA\/Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_535'>\n\t\t\t<div class='gchoice gchoice_69_535_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_535' type='radio' value='Ja'  id='choice_69_535_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_535_0' id='label_69_535_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_535_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_535' type='radio' value='Nee'  id='choice_69_535_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_535_1' id='label_69_535_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_536\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_536'>Bruto jaaromzet export 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_536' id='input_69_536' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_537\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_537'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_537' id='input_69_537' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_538\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_538'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_538' id='input_69_538' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_539\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_539'>Graag een toelichting betreft de export naar USA\/Canada:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_539' id='input_69_539' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_540\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar andere landen dan USA of Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_540'>\n\t\t\t<div class='gchoice gchoice_69_540_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_540' type='radio' value='Ja'  id='choice_69_540_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_540_0' id='label_69_540_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_540_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_540' type='radio' value='Nee'  id='choice_69_540_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_540_1' id='label_69_540_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_643\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Lijst<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Land<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Bruto jaaromzet 2024<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2025<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2026<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_643_cell1 gform-grid-col' data-label='Land'><input aria-invalid='false' aria-required=\"true\"  aria-label='Land, Row 1' data-aria-label-template='Land, Row {0}' type='text' name='input_643[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_643_cell2 gform-grid-col' data-label='Bruto jaaromzet 2024'><input aria-invalid='false' aria-required=\"true\"  aria-label='Bruto jaaromzet 2024, Row 1' data-aria-label-template='Bruto jaaromzet 2024, Row {0}' type='text' name='input_643[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_643_cell3 gform-grid-col' data-label='Prognose 2025'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2025, Row 1' data-aria-label-template='Prognose 2025, Row {0}' type='text' name='input_643[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_643_cell4 gform-grid-col' data-label='Prognose 2026'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2026, Row 1' data-aria-label-template='Prognose 2026, Row {0}' type='text' name='input_643[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 4)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 4)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_69_557\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_557'>Graag een toelichting betreft de export naar andere landen:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_557' id='input_69_557' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_558\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Gebouw(en)<\/h3><\/div><fieldset id=\"field_69_559\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Huiseigenaar of panden in beheer (anders dan bedrijfspanden)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_559'>\n\t\t\t<div class='gchoice gchoice_69_559_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_559' type='radio' value='Ja'  id='choice_69_559_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_559_0' id='label_69_559_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_559_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_559' type='radio' value='Nee'  id='choice_69_559_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_559_1' id='label_69_559_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_560\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_560'>Totale herbouwwaarde van het (verhuurd) onroerend goed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_560' id='input_69_560' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_561\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Naverrekening op basis van andere factoren<\/h3><\/div><fieldset id=\"field_69_562\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Mogelijk is uw premie vastgesteld op basis van andere factoren, is dit het geval?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_562'>Raadpleeg hiervoor onze correspondentie en\/of uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_562'>\n\t\t\t<div class='gchoice gchoice_69_562_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_562' type='radio' value='Ja'  id='choice_69_562_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_562\"   \/>\n\t\t\t\t\t<label for='choice_69_562_0' id='label_69_562_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_562_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_562' type='radio' value='Nee'  id='choice_69_562_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_562_1' id='label_69_562_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_563\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_69_563'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_563' id='input_69_563' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_564\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_564'>Gegevens 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_564' id='input_69_564' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_565\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_565'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_565' id='input_69_565' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_566\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_566'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_566' id='input_69_566' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_567\" class=\"gfield gfield--type-text gfield--input-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_69_567'>Overig, namelijk:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_567' id='input_69_567' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_568\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_568'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_568' id='input_69_568' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_569\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_569'>Gegevens 2024<\/label><div class='ginput_container ginput_container_text'><input name='input_569' id='input_69_569' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_570\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_570'>Prognose 2025<\/label><div class='ginput_container ginput_container_text'><input name='input_570' id='input_69_570' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_571\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_571'>Prognose 2026<\/label><div class='ginput_container ginput_container_text'><input name='input_571' id='input_69_571' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_572\" class=\"gfield gfield--type-text gfield--input-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_69_572'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_572' id='input_69_572' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_573\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Actuele situatie\/hoedanigheid<\/h3><\/div><fieldset id=\"field_69_574\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is de polisomschrijving (hoedanigheid) nog in lijn met uw activiteiten?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_574'>Raadpleeg hiervoor uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_574'>\n\t\t\t<div class='gchoice gchoice_69_574_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_574' type='radio' value='Ja'  id='choice_69_574_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_574\"   \/>\n\t\t\t\t\t<label for='choice_69_574_0' id='label_69_574_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_574_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_574' type='radio' value='Nee'  id='choice_69_574_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_574_1' id='label_69_574_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_575\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_575'>Graag een actuele omschrijving van uw werkzaamheden en\/of geleverde producten\/diensten:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_575' id='input_69_575' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_217' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_217' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_3_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_3' class='gform_page' data-js='page-field-id-217' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_218\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Bedrijfsaansprakelijkheidsverzekering (AVB)<\/h3><\/div><div id=\"field_69_19\" class=\"gfield gfield--type-text gfield--input-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_69_19'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_69_19' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_21\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_21'>Totale loonsom 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_21' id='input_69_21' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_427\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_427'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_427' id='input_69_427' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_428\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_428'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_428' id='input_69_428' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_321\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_321'>Inkomen eigenaren\/firmanten 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_321' id='input_69_321' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_429\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_429'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_429' id='input_69_429' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_430\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_430'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_430' id='input_69_430' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_18\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_18'>Totale bruto jaaromzet 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_18' id='input_69_18' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_431\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_431'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_431' id='input_69_431' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_432\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_432'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_432' id='input_69_432' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_386\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Export<\/h3><\/div><fieldset id=\"field_69_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar USA\/Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_25'>\n\t\t\t<div class='gchoice gchoice_69_25_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Ja'  id='choice_69_25_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_25_0' id='label_69_25_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_25_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_25' type='radio' value='Nee'  id='choice_69_25_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_25_1' id='label_69_25_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_24\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_24'>Bruto jaaromzet export 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_24' id='input_69_24' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_425\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_425'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_425' id='input_69_425' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_426\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_426'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_426' id='input_69_426' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_323\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_323'>Graag een toelichting betreft de export naar USA\/Canada:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_323' id='input_69_323' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_324\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar andere landen dan USA of Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_324'>\n\t\t\t<div class='gchoice gchoice_69_324_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='Ja'  id='choice_69_324_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_324_0' id='label_69_324_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_324_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_324' type='radio' value='Nee'  id='choice_69_324_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_324_1' id='label_69_324_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_644\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Lijst<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Land<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Bruto jaaromzet 2024<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2025<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2026<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_644_cell1 gform-grid-col' data-label='Land'><input aria-invalid='false' aria-required=\"true\"  aria-label='Land, Row 1' data-aria-label-template='Land, Row {0}' type='text' name='input_644[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_644_cell2 gform-grid-col' data-label='Bruto jaaromzet 2024'><input aria-invalid='false' aria-required=\"true\"  aria-label='Bruto jaaromzet 2024, Row 1' data-aria-label-template='Bruto jaaromzet 2024, Row {0}' type='text' name='input_644[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_644_cell3 gform-grid-col' data-label='Prognose 2025'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2025, Row 1' data-aria-label-template='Prognose 2025, Row {0}' type='text' name='input_644[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_644_cell4 gform-grid-col' data-label='Prognose 2026'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2026, Row 1' data-aria-label-template='Prognose 2026, Row {0}' type='text' name='input_644[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 4)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 4)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_69_326\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_326'>Graag een toelichting betreft de export naar andere landen:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_326' id='input_69_326' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_387\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Gebouw(en)<\/h3><\/div><fieldset id=\"field_69_327\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Huiseigenaar of panden in beheer (anders dan bedrijfspanden)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_327'>\n\t\t\t<div class='gchoice gchoice_69_327_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_327' type='radio' value='Ja'  id='choice_69_327_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_327_0' id='label_69_327_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_327_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_327' type='radio' value='Nee'  id='choice_69_327_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_327_1' id='label_69_327_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_329\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_329'>Totale herbouwwaarde van het (verhuurd) onroerend goed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_329' id='input_69_329' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_388\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Naverrekening op basis van andere factoren<\/h3><\/div><fieldset id=\"field_69_330\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Mogelijk is uw premie vastgesteld op basis van andere factoren, is dit het geval?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_330'>Raadpleeg hiervoor onze correspondentie en\/of uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_330'>\n\t\t\t<div class='gchoice gchoice_69_330_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='Ja'  id='choice_69_330_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_330\"   \/>\n\t\t\t\t\t<label for='choice_69_330_0' id='label_69_330_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_330_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_330' type='radio' value='Nee'  id='choice_69_330_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_330_1' id='label_69_330_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_331\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_69_331'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_331' id='input_69_331' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_332\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_332'>Gegevens 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_332' id='input_69_332' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_333\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_333'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_333' id='input_69_333' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_334\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_334'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_334' id='input_69_334' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_404\" class=\"gfield gfield--type-text gfield--input-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_69_404'>Overig, namelijk:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_404' id='input_69_404' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_335\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_335'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_335' id='input_69_335' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_336\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_336'>Gegevens 2024<\/label><div class='ginput_container ginput_container_text'><input name='input_336' id='input_69_336' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_337\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_337'>Prognose 2025<\/label><div class='ginput_container ginput_container_text'><input name='input_337' id='input_69_337' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_338\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_338'>Prognose 2026<\/label><div class='ginput_container ginput_container_text'><input name='input_338' id='input_69_338' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_405\" class=\"gfield gfield--type-text gfield--input-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_69_405'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_405' id='input_69_405' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_389\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Actuele situatie\/hoedanigheid<\/h3><\/div><fieldset id=\"field_69_340\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is de polisomschrijving (hoedanigheid) nog in lijn met uw activiteiten?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_340'>Raadpleeg hiervoor uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_340'>\n\t\t\t<div class='gchoice gchoice_69_340_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='Ja'  id='choice_69_340_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_340\"   \/>\n\t\t\t\t\t<label for='choice_69_340_0' id='label_69_340_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_340_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_340' type='radio' value='Nee'  id='choice_69_340_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_340_1' id='label_69_340_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_341\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_341'>Graag een actuele omschrijving van uw werkzaamheden en\/of geleverde producten\/diensten:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_341' id='input_69_341' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_472' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_472' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_4_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_4' class='gform_page' data-js='page-field-id-472' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_438\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Beroeps- en bedrijfsaansprakelijkheid (BAV\/AVB)<\/h3><\/div><div id=\"field_69_439\" class=\"gfield gfield--type-text gfield--input-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_69_439'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_439' id='input_69_439' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_440\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_440'>Omzet Nederland 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_440' id='input_69_440' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_441\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_441'>Prognose omzet 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_441' id='input_69_441' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_442\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_442'>Prognose omzet 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_442' id='input_69_442' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_467\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Export<\/h3><\/div><fieldset id=\"field_69_443\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar USA\/Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_443'>\n\t\t\t<div class='gchoice gchoice_69_443_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='Ja'  id='choice_69_443_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_443_0' id='label_69_443_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_443_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_443' type='radio' value='Nee'  id='choice_69_443_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_443_1' id='label_69_443_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_445\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_445'>Bruto jaaromzet export 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_445' id='input_69_445' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_481\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_481'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_481' id='input_69_481' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_447\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_447'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_447' id='input_69_447' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_1800\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_1800'>Graag een toelichting betreft de export naar USA\/Canada:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1800' id='input_69_1800' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_444\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar andere landen dan USA of Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_444'>\n\t\t\t<div class='gchoice gchoice_69_444_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_444' type='radio' value='Ja'  id='choice_69_444_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_444_0' id='label_69_444_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_444_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_444' type='radio' value='Nee'  id='choice_69_444_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_444_1' id='label_69_444_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_645\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Lijst<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Land<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Bruto jaaromzet 2024<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2025<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2026<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_645_cell1 gform-grid-col' data-label='Land'><input aria-invalid='false' aria-required=\"true\"  aria-label='Land, Row 1' data-aria-label-template='Land, Row {0}' type='text' name='input_645[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_645_cell2 gform-grid-col' data-label='Bruto jaaromzet 2024'><input aria-invalid='false' aria-required=\"true\"  aria-label='Bruto jaaromzet 2024, Row 1' data-aria-label-template='Bruto jaaromzet 2024, Row {0}' type='text' name='input_645[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_645_cell3 gform-grid-col' data-label='Prognose 2025'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2025, Row 1' data-aria-label-template='Prognose 2025, Row {0}' type='text' name='input_645[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_645_cell4 gform-grid-col' data-label='Prognose 2026'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2026, Row 1' data-aria-label-template='Prognose 2026, Row {0}' type='text' name='input_645[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 4)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 4)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_69_1798\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_1798'>Graag een toelichting betreft de export naar andere landen:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1798' id='input_69_1798' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_464\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Actuele situatie\/hoedanigheid<\/h3><\/div><fieldset id=\"field_69_465\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is de polisomschrijving (hoedanigheid) nog in lijn met uw activiteiten?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_465'>Raadpleeg hiervoor uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_465'>\n\t\t\t<div class='gchoice gchoice_69_465_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_465' type='radio' value='Ja'  id='choice_69_465_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_465\"   \/>\n\t\t\t\t\t<label for='choice_69_465_0' id='label_69_465_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_465_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_465' type='radio' value='Nee'  id='choice_69_465_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_465_1' id='label_69_465_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_466\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_466'>Graag een actuele omschrijving van uw werkzaamheden en\/of geleverde producten\/diensten:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_466' id='input_69_466' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_305' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_305' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_5_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_5' class='gform_page' data-js='page-field-id-305' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_473\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Beroepsaansprakelijkheid (BAV)<\/h3><\/div><div id=\"field_69_474\" class=\"gfield gfield--type-text gfield--input-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_69_474'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_474' id='input_69_474' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_475\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_475'>Omzet Nederland 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_475' id='input_69_475' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_476\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_476'>Prognose omzet 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_476' id='input_69_476' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_477\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_477'>Prognose omzet 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_477' id='input_69_477' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_478\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Export<\/h3><\/div><fieldset id=\"field_69_479\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar USA\/Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_479'>\n\t\t\t<div class='gchoice gchoice_69_479_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_479' type='radio' value='Ja'  id='choice_69_479_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_479_0' id='label_69_479_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_479_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_479' type='radio' value='Nee'  id='choice_69_479_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_479_1' id='label_69_479_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_480\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_480'>Bruto jaaromzet export 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_480' id='input_69_480' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_446\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_446'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_446' id='input_69_446' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_482\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_482'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_482' id='input_69_482' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_1801\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_1801'>Graag een toelichting betreft de export naar USA\/Canada:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1801' id='input_69_1801' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_483\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar andere landen dan USA of Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_483'>\n\t\t\t<div class='gchoice gchoice_69_483_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_483' type='radio' value='Ja'  id='choice_69_483_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_483_0' id='label_69_483_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_483_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_483' type='radio' value='Nee'  id='choice_69_483_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_483_1' id='label_69_483_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_646\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Lijst<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Land<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Bruto jaaromzet 2024<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2025<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2026<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_646_cell1 gform-grid-col' data-label='Land'><input aria-invalid='false' aria-required=\"true\"  aria-label='Land, Row 1' data-aria-label-template='Land, Row {0}' type='text' name='input_646[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_646_cell2 gform-grid-col' data-label='Bruto jaaromzet 2024'><input aria-invalid='false' aria-required=\"true\"  aria-label='Bruto jaaromzet 2024, Row 1' data-aria-label-template='Bruto jaaromzet 2024, Row {0}' type='text' name='input_646[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_646_cell3 gform-grid-col' data-label='Prognose 2025'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2025, Row 1' data-aria-label-template='Prognose 2025, Row {0}' type='text' name='input_646[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_646_cell4 gform-grid-col' data-label='Prognose 2026'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2026, Row 1' data-aria-label-template='Prognose 2026, Row {0}' type='text' name='input_646[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 4)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 4)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_69_1799\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_1799'>Graag een toelichting betreft de export naar andere landen:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1799' id='input_69_1799' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_500\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Actuele situatie\/hoedanigheid<\/h3><\/div><fieldset id=\"field_69_501\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is de polisomschrijving (hoedanigheid) nog in lijn met uw activiteiten?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_501'>Raadpleeg hiervoor uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_501'>\n\t\t\t<div class='gchoice gchoice_69_501_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_501' type='radio' value='Ja'  id='choice_69_501_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_501\"   \/>\n\t\t\t\t\t<label for='choice_69_501_0' id='label_69_501_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_501_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_501' type='radio' value='Nee'  id='choice_69_501_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_501_1' id='label_69_501_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_502\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_502'>Graag een actuele omschrijving van uw werkzaamheden en\/of geleverde producten\/diensten:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_502' id='input_69_502' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_576' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_576' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_6_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_6' class='gform_page' data-js='page-field-id-576' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_577\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Gecombineerde aansprakelijkheid<\/h3><\/div><div id=\"field_69_578\" class=\"gfield gfield--type-text gfield--input-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_69_578'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_578' id='input_69_578' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_579\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_579'>Totale loonsom 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_579' id='input_69_579' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_580\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_580'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_580' id='input_69_580' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_581\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_581'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_581' id='input_69_581' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_582\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_582'>Inkomen eigenaren\/firmanten 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_582' id='input_69_582' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_583\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_583'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_583' id='input_69_583' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_584\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_584'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_584' id='input_69_584' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_585\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_585'>Totale bruto jaaromzet 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_585' id='input_69_585' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_586\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_586'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_586' id='input_69_586' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_587\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_587'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_587' id='input_69_587' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_588\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Export<\/h3><\/div><fieldset id=\"field_69_589\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar USA\/Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_589'>\n\t\t\t<div class='gchoice gchoice_69_589_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_589' type='radio' value='Ja'  id='choice_69_589_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_589_0' id='label_69_589_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_589_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_589' type='radio' value='Nee'  id='choice_69_589_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_589_1' id='label_69_589_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_590\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_590'>Bruto jaaromzet export 2024 (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_590' id='input_69_590' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_591\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_591'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_591' id='input_69_591' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_592\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_592'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_592' id='input_69_592' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_593\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_593'>Graag een toelichting betreft de export naar USA\/Canada:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_593' id='input_69_593' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_594\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Vindt er export plaats naar andere landen dan USA of Canada?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_594'>\n\t\t\t<div class='gchoice gchoice_69_594_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_594' type='radio' value='Ja'  id='choice_69_594_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_594_0' id='label_69_594_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_594_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_594' type='radio' value='Nee'  id='choice_69_594_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_594_1' id='label_69_594_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_647\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Lijst<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Land<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Bruto jaaromzet 2024<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2025<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Prognose 2026<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_647_cell1 gform-grid-col' data-label='Land'><input aria-invalid='false' aria-required=\"true\"  aria-label='Land, Row 1' data-aria-label-template='Land, Row {0}' type='text' name='input_647[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_647_cell2 gform-grid-col' data-label='Bruto jaaromzet 2024'><input aria-invalid='false' aria-required=\"true\"  aria-label='Bruto jaaromzet 2024, Row 1' data-aria-label-template='Bruto jaaromzet 2024, Row {0}' type='text' name='input_647[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_647_cell3 gform-grid-col' data-label='Prognose 2025'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2025, Row 1' data-aria-label-template='Prognose 2025, Row {0}' type='text' name='input_647[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_647_cell4 gform-grid-col' data-label='Prognose 2026'><input aria-invalid='false' aria-required=\"true\"  aria-label='Prognose 2026, Row 1' data-aria-label-template='Prognose 2026, Row {0}' type='text' name='input_647[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 4)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 4)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_69_611\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_611'>Graag een toelichting betreft de export naar andere landen:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_611' id='input_69_611' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_69_612\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Gebouw(en)<\/h3><\/div><fieldset id=\"field_69_613\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Huiseigenaar of panden in beheer (anders dan bedrijfspanden)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_613'>\n\t\t\t<div class='gchoice gchoice_69_613_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_613' type='radio' value='Ja'  id='choice_69_613_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_613_0' id='label_69_613_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_613_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_613' type='radio' value='Nee'  id='choice_69_613_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_613_1' id='label_69_613_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_614\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_614'>Totale herbouwwaarde van het (verhuurd) onroerend goed<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_614' id='input_69_614' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_615\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Naverrekening op basis van andere factoren<\/h3><\/div><fieldset id=\"field_69_616\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Mogelijk is uw premie vastgesteld op basis van andere factoren, is dit het geval?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_616'>Raadpleeg hiervoor onze correspondentie en\/of uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_616'>\n\t\t\t<div class='gchoice gchoice_69_616_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_616' type='radio' value='Ja'  id='choice_69_616_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_616\"   \/>\n\t\t\t\t\t<label for='choice_69_616_0' id='label_69_616_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_616_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_616' type='radio' value='Nee'  id='choice_69_616_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_616_1' id='label_69_616_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_617\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter 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_69_617'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_617' id='input_69_617' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_618\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_618'>Gegevens 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_618' id='input_69_618' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_619\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_619'>Prognose 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_619' id='input_69_619' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_620\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter 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_69_620'>Prognose 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_620' id='input_69_620' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_621\" class=\"gfield gfield--type-text gfield--input-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_69_621'>Overig, namelijk:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_621' id='input_69_621' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_622\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_622'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_622' id='input_69_622' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal leden' >Aantal leden<\/option><option value='Aantal leerlingen\/studenten' >Aantal leerlingen\/studenten<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Omzet asbest' >Omzet asbest<\/option><option value='Omzet detachering\/uitzenden personen' >Omzet detachering\/uitzenden personen<\/option><option value='Omzet overige activiteiten' >Omzet overige activiteiten<\/option><option value='Omzet reis\/hotel arrangementen' >Omzet reis\/hotel arrangementen<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><option value='Omzet schoonmaakactiviteiten' >Omzet schoonmaakactiviteiten<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_623\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_623'>Gegevens 2024<\/label><div class='ginput_container ginput_container_text'><input name='input_623' id='input_69_623' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_624\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_624'>Prognose 2025<\/label><div class='ginput_container ginput_container_text'><input name='input_624' id='input_69_624' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_625\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-quarter field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_625'>Prognose 2026<\/label><div class='ginput_container ginput_container_text'><input name='input_625' id='input_69_625' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_626\" class=\"gfield gfield--type-text gfield--input-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_69_626'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_626' id='input_69_626' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_627\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Actuele situatie\/hoedanigheid<\/h3><\/div><fieldset id=\"field_69_628\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is de polisomschrijving (hoedanigheid) nog in lijn met uw activiteiten?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_69_628'>Raadpleeg hiervoor uw polis<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_628'>\n\t\t\t<div class='gchoice gchoice_69_628_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_628' type='radio' value='Ja'  id='choice_69_628_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_69_628\"   \/>\n\t\t\t\t\t<label for='choice_69_628_0' id='label_69_628_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_628_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_628' type='radio' value='Nee'  id='choice_69_628_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_628_1' id='label_69_628_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_629\" class=\"gfield gfield--type-textarea gfield--input-type-textarea 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_69_629'>Graag een actuele omschrijving van uw werkzaamheden en\/of geleverde producten\/diensten:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_629' id='input_69_629' class='textarea large'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_57' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_57' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_7_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_7' class='gform_page' data-js='page-field-id-57' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_41\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Brand- en bedrijfsschadeverzekering<\/h3><\/div><div id=\"field_69_63\" class=\"gfield gfield--type-text gfield--input-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_69_63'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_69_63' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_65\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_65'>Bruto winst 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_65'>Onder bruto winst voor bedrijfsschade verstaan we: de vaste lasten plus de netto winst of het netto verlies (oftewel: omzet minus variabele kosten).<\/div><div class='ginput_container ginput_container_number'><input name='input_65' id='input_69_65' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_65\" \/><\/div><\/div><div id=\"field_69_66\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_66'>Prognose winst 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_66' id='input_69_66' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_56\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_56'>Prognose winst 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_56' id='input_69_56' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_69_67\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wenst u de verzekerde som aan te passen aan de prognose?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_67'>\n\t\t\t<div class='gchoice gchoice_69_67_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Ja'  id='choice_69_67_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_67_0' id='label_69_67_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_67_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_67' type='radio' value='Nee'  id='choice_69_67_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_67_1' id='label_69_67_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_68\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Zo ja, voor welk(e) jaar\/jaren?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_68'>\n\t\t\t<div class='gchoice gchoice_69_68_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='2025'  id='choice_69_68_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_68_0' id='label_69_68_0' class='gform-field-label gform-field-label--type-inline'>2025<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_68_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='2026'  id='choice_69_68_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_68_1' id='label_69_68_1' class='gform-field-label gform-field-label--type-inline'>2026<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_437' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_437' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_8_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_8' class='gform_page' data-js='page-field-id-437' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_8' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_27\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Juwelier Blockpolis<\/h3><\/div><div id=\"field_69_49\" class=\"gfield gfield--type-text gfield--input-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_69_49'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_69_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_53\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_53'>Bruto winst 2024<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_53' id='input_69_53' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_64\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_64'>Prognose winst 2025<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_64' id='input_69_64' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_58\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-third 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_69_58'>Prognose winst 2026<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_58' id='input_69_58' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_69_59\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wenst u de verzekerde som aan te passen aan de prognose?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_59'>\n\t\t\t<div class='gchoice gchoice_69_59_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Ja'  id='choice_69_59_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_59_0' id='label_69_59_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_59_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_59' type='radio' value='Nee'  id='choice_69_59_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_59_1' id='label_69_59_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_69_318\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Zo ja, voor welk(e) jaar\/jaren?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_318'>\n\t\t\t<div class='gchoice gchoice_69_318_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='2025'  id='choice_69_318_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_318_0' id='label_69_318_0' class='gform-field-label gform-field-label--type-inline'>2025<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_318_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_318' type='radio' value='2026'  id='choice_69_318_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_318_1' id='label_69_318_1' class='gform-field-label gform-field-label--type-inline'>2026<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_194' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_194' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_9_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_9' class='gform_page' data-js='page-field-id-194' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_9' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_197\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Collectieve ongevallen<\/h3><\/div><div id=\"field_69_199\" class=\"gfield gfield--type-text gfield--input-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_69_199'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_199' id='input_69_199' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_201\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_201'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_201' id='input_69_201' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal assistenten\/medewerkers' >Aantal assistenten\/medewerkers<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Aantal vrijwilligers' >Aantal vrijwilligers<\/option><option value='Andere verzekerde groepen, namelijk\u2026' >Andere verzekerde groepen, namelijk\u2026<\/option><option value='SV-loon' >SV-loon<\/option><option value='Totale jaarloon' >Totale jaarloon<\/option><\/select><\/div><\/div><div id=\"field_69_203\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_203'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_203' id='input_69_203' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_433\" class=\"gfield gfield--type-text gfield--input-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_69_433'>Andere verzekerde groepen, namelijk:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_433' id='input_69_433' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_207\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_207'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_207' id='input_69_207' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal assistenten\/medewerkers' >Aantal assistenten\/medewerkers<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Aantal vrijwilligers' >Aantal vrijwilligers<\/option><option value='Andere verzekerde groepen, namelijk\u2026' >Andere verzekerde groepen, namelijk\u2026<\/option><option value='SV-loon' >SV-loon<\/option><option value='Totale jaarloon' >Totale jaarloon<\/option><\/select><\/div><\/div><div id=\"field_69_210\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_210'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_210' id='input_69_210' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_434\" class=\"gfield gfield--type-text gfield--input-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_69_434'>Andere verzekerde groepen, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_434' id='input_69_434' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_206\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_206'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_206' id='input_69_206' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal assistenten\/medewerkers' >Aantal assistenten\/medewerkers<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Aantal vrijwilligers' >Aantal vrijwilligers<\/option><option value='Andere verzekerde groepen, namelijk\u2026' >Andere verzekerde groepen, namelijk\u2026<\/option><option value='SV-loon' >SV-loon<\/option><option value='Totale jaarloon' >Totale jaarloon<\/option><\/select><\/div><\/div><div id=\"field_69_209\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_209'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_209' id='input_69_209' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_435\" class=\"gfield gfield--type-text gfield--input-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_69_435'>Andere verzekerde groepen, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_435' id='input_69_435' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_205\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_205'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_205' id='input_69_205' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal assistenten\/medewerkers' >Aantal assistenten\/medewerkers<\/option><option value='Aantal directieleden' >Aantal directieleden<\/option><option value='Aantal personeelsleden' >Aantal personeelsleden<\/option><option value='Aantal vrijwilligers' >Aantal vrijwilligers<\/option><option value='Andere verzekerde groepen, namelijk\u2026' >Andere verzekerde groepen, namelijk\u2026<\/option><option value='SV-loon' >SV-loon<\/option><option value='Totale jaarloon' >Totale jaarloon<\/option><\/select><\/div><\/div><div id=\"field_69_208\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_208'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_208' id='input_69_208' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_436\" class=\"gfield gfield--type-text gfield--input-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_69_436'>Andere verzekerde groepen, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_436' id='input_69_436' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_196' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_196' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_10_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_10' class='gform_page' data-js='page-field-id-196' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_198\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Kunst- en kostbaarhedenverzekering<\/h3><\/div><div id=\"field_69_200\" class=\"gfield gfield--type-text gfield--input-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_69_200'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_200' id='input_69_200' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_202\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_202'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_202' id='input_69_202' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_204\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_204'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_204' id='input_69_204' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_468\" class=\"gfield gfield--type-text gfield--input-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_69_468'>Overig, namelijk:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_468' id='input_69_468' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_213\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_213'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_213' id='input_69_213' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_216\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_216'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_216' id='input_69_216' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_471\" class=\"gfield gfield--type-text gfield--input-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_69_471'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_471' id='input_69_471' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_212\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_212'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_212' id='input_69_212' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_215\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_215'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_215' id='input_69_215' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_470\" class=\"gfield gfield--type-text gfield--input-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_69_470'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_470' id='input_69_470' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_211\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_211'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_211' id='input_69_211' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Overig, namelijk\u2026' >Overig, namelijk\u2026<\/option><\/select><\/div><\/div><div id=\"field_69_214\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_214'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_214' id='input_69_214' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_469\" class=\"gfield gfield--type-text gfield--input-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_69_469'>Overig, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_469' id='input_69_469' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_38' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_38' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_11_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_11' class='gform_page' data-js='page-field-id-38' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_43\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Doorlopende Construction All Risk (CAR)<\/h3><\/div><div id=\"field_69_78\" class=\"gfield gfield--type-text gfield--input-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_69_78'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_69_78' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_79\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_79'>Werkelijke (bouw)omzet binnen Nederland<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_79' id='input_69_79' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_80\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_80'>Werkelijke (bouw)omzet binnen de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_80'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_80' id='input_69_80' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_80\" \/><\/div><\/div><div id=\"field_69_249\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_249'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_249' id='input_69_249' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_250\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_250'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_250' id='input_69_250' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_252\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_252'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_252' id='input_69_252' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_251\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_251'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_251' id='input_69_251' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_253\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_253'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_253' id='input_69_253' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_254\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_254'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_254' id='input_69_254' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_255\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_255'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_255' id='input_69_255' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_256\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_256'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_256' id='input_69_256' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_81\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_81'>Werkelijke (bouw)omzet buiten de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_81'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_81' id='input_69_81' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_81\" \/><\/div><\/div><div id=\"field_69_275\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_275'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_275' id='input_69_275' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_276\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_276'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_276' id='input_69_276' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_281\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_281'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_281' id='input_69_281' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_283\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_283'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_283' id='input_69_283' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_280\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_280'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_280' id='input_69_280' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_284\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_284'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_284' id='input_69_284' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_279\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_279'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_279' id='input_69_279' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_282\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_282'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_282' id='input_69_282' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_82\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_82'>Projectwaarde grootste werk<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_82' id='input_69_82' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_37' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_37' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_12_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_12' class='gform_page' data-js='page-field-id-37' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_12' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_45\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">CAR-\/Montageverzekering<\/h3><\/div><div id=\"field_69_84\" class=\"gfield gfield--type-text gfield--input-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_69_84'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_69_84' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_85\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_85'>Werkelijke (bouw)omzet binnen Nederland<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_85' id='input_69_85' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_86\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_86'>Werkelijke (bouw)omzet binnen de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_86'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_86' id='input_69_86' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_86\" \/><\/div><\/div><div id=\"field_69_257\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_257'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_257' id='input_69_257' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_258\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_258'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_258' id='input_69_258' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_262\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_262'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_262' id='input_69_262' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_261\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_261'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_261' id='input_69_261' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_259\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_259'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_259' id='input_69_259' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_260\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_260'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_260' id='input_69_260' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_263\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_263'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_263' id='input_69_263' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_264\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_264'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_264' id='input_69_264' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_87\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_87'>Werkelijke (bouw)omzet buiten de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_87'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_87' id='input_69_87' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_87\" \/><\/div><\/div><div id=\"field_69_273\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_273'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_273' id='input_69_273' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_274\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_274'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_274' id='input_69_274' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_287\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_287'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_287' id='input_69_287' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_290\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_290'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_290' id='input_69_290' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_286\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_286'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_286' id='input_69_286' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_289\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_289'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_289' id='input_69_289' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_285\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_285'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_285' id='input_69_285' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_288\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_288'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_288' id='input_69_288' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_93\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_93'>Projectwaarde grootste werk<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_93' id='input_69_93' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_13_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_13' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_13' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_46\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Doorlopende CAR-\/Montageverzekering<\/h3><\/div><div id=\"field_69_89\" class=\"gfield gfield--type-text gfield--input-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_69_89'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_69_89' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_90\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_90'>Werkelijke (bouw)omzet binnen Nederland<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_90' id='input_69_90' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_91\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_91'>Werkelijke (bouw)omzet binnen de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_91'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_91' id='input_69_91' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_91\" \/><\/div><\/div><div id=\"field_69_265\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_265'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_265' id='input_69_265' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_266\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_266'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_266' id='input_69_266' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_269\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_269'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_269' id='input_69_269' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_272\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_272'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_272' id='input_69_272' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_268\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_268'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_268' id='input_69_268' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_271\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_271'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_271' id='input_69_271' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_267\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_267'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_267' id='input_69_267' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_270\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_270'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_270' id='input_69_270' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_92\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_92'>Werkelijke (bouw)omzet buiten de EER<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_92'>Graag per land specificeren. Vul 0 in indien niet van toepassing.<\/div><div class='ginput_container ginput_container_number'><input name='input_92' id='input_69_92' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_69_92\" \/><\/div><\/div><div id=\"field_69_277\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_277'>Land<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_277' id='input_69_277' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_278\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half 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_69_278'>Werkelijke (bouw)omzet<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_278' id='input_69_278' type='text' value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_293\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_293'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_293' id='input_69_293' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_296\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_296'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_296' id='input_69_296' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_292\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_292'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_292' id='input_69_292' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_295\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_295'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_295' id='input_69_295' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_291\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_291'>Land<\/label><div class='ginput_container ginput_container_text'><input name='input_291' id='input_69_291' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_294\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_294'>Werkelijke (bouw)omzet<\/label><div class='ginput_container ginput_container_text'><input name='input_294' id='input_69_294' type='text' value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_88\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_88'>Projectwaarde grootste werk<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_88' id='input_69_88' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_36' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_36' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_14_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_14' class='gform_page' data-js='page-field-id-36' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_14' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Machineschadeverzekering<\/h3><\/div><div id=\"field_69_94\" class=\"gfield gfield--type-text gfield--input-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_69_94'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_69_94' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_95\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_95'>Werkelijk belang<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_95' id='input_69_95' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_98\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Stijging van meer dan 10%?<\/h3><div class='gsection_description' id='gfield_description_69_98'>Indien u verwacht dat het te verzekeren belang in het volgende verzekeringsjaar met meer dan 10% zal stijgen, adviseren wij u ons een opgave te doen van het nieuw te verzekeren belang.<\/div><\/div><div id=\"field_69_96\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_96'>Nieuw te verzekeren bedrag<\/label><div class='ginput_container ginput_container_number'><input name='input_96' id='input_69_96' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_77' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_77' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_15_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_15' class='gform_page' data-js='page-field-id-77' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_15' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_83\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Machine- en bedrijfsschadeverzekering<\/h3><\/div><div id=\"field_69_102\" class=\"gfield gfield--type-text gfield--input-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_69_102'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_102' id='input_69_102' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_103\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_103'>Werkelijk belang<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_103' id='input_69_103' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_104\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Stijging van meer dan 10%?<\/h3><div class='gsection_description' id='gfield_description_69_104'>Indien u verwacht dat het te verzekeren belang in het volgende verzekeringsjaar met meer dan 10% zal stijgen, adviseren wij u ons een opgave te doen van het nieuw te verzekeren belang.<\/div><\/div><div id=\"field_69_105\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_105'>Nieuw te verzekeren bedrag<\/label><div class='ginput_container ginput_container_number'><input name='input_105' id='input_69_105' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_99' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_99' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_16_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_16' class='gform_page' data-js='page-field-id-99' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_16' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_100\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Zonnepanelenverzekering<\/h3><\/div><div id=\"field_69_106\" class=\"gfield gfield--type-text gfield--input-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_69_106'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_69_106' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_107\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_107'>Werkelijk belang<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_107' id='input_69_107' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_108\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Stijging van meer dan 10%?<\/h3><div class='gsection_description' id='gfield_description_69_108'>Indien u verwacht dat het te verzekeren belang in het volgende verzekeringsjaar met meer dan 10% zal stijgen, adviseren wij u ons een opgave te doen van het nieuw te verzekeren belang.<\/div><\/div><div id=\"field_69_109\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_109'>Nieuw te verzekeren bedrag<\/label><div class='ginput_container ginput_container_number'><input name='input_109' id='input_69_109' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_101' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_101' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_17_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_17' class='gform_page' data-js='page-field-id-101' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_17' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_111\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Aanbouwverzekering<\/h3><\/div><div id=\"field_69_110\" class=\"gfield gfield--type-text gfield--input-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_69_110'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_110' id='input_69_110' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_127\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_127'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_127' id='input_69_127' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value=''  class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><\/select><\/div><\/div><div id=\"field_69_132\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_132'>Vul hier uw opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_132' id='input_69_132' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_138\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_138'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_138' id='input_69_138' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Omzet reparatie\/onderhoud' >Omzet reparatie\/onderhoud<\/option><\/select><\/div><\/div><div id=\"field_69_137\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_137'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_137' id='input_69_137' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_112' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_112' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_18_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_18' class='gform_page' data-js='page-field-id-112' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_18' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_126\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Landmateriaalverzekering<\/h3><\/div><div id=\"field_69_122\" class=\"gfield gfield--type-text gfield--input-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_69_122'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_122' id='input_69_122' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_128\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_128'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_128' id='input_69_128' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Collegiale inhuur' >Collegiale inhuur<\/option><option value='Huurpenningen' >Huurpenningen<\/option><option value='Investeringswaarde verhuurpark' >Investeringswaarde verhuurpark<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Totale waarde verzekerde objecten' >Totale waarde verzekerde objecten<\/option><\/select><\/div><\/div><div id=\"field_69_135\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_135'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_135' id='input_69_135' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_139\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_139'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_139' id='input_69_139' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Collegiale inhuur' >Collegiale inhuur<\/option><option value='Huurpenningen' >Huurpenningen<\/option><option value='Investeringswaarde verhuurpark' >Investeringswaarde verhuurpark<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Totale waarde verzekerde objecten' >Totale waarde verzekerde objecten<\/option><\/select><\/div><\/div><div id=\"field_69_140\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_140'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_140' id='input_69_140' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_141\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_141'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_141' id='input_69_141' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Collegiale inhuur' >Collegiale inhuur<\/option><option value='Huurpenningen' >Huurpenningen<\/option><option value='Investeringswaarde verhuurpark' >Investeringswaarde verhuurpark<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Totale waarde verzekerde objecten' >Totale waarde verzekerde objecten<\/option><\/select><\/div><\/div><div id=\"field_69_142\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_142'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_142' id='input_69_142' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_143\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_143'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_143' id='input_69_143' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Collegiale inhuur' >Collegiale inhuur<\/option><option value='Huurpenningen' >Huurpenningen<\/option><option value='Investeringswaarde verhuurpark' >Investeringswaarde verhuurpark<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Totale waarde verzekerde objecten' >Totale waarde verzekerde objecten<\/option><\/select><\/div><\/div><div id=\"field_69_144\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_144'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_144' id='input_69_144' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_343' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_343' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_19_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_19' class='gform_page' data-js='page-field-id-343' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_19' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_342\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Logistieke aansprakelijkheid<\/h3><\/div><div id=\"field_69_344\" class=\"gfield gfield--type-text gfield--input-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_69_344'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_344' id='input_69_344' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_650\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_650'>Bruto jaaromzet (exclusief btw)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_650' id='input_69_650' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_630\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_630'>Ander onderdeel (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_630' id='input_69_630' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_348\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_348'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_348' id='input_69_348' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_119' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_119' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_20_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_20' class='gform_page' data-js='page-field-id-119' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_354\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Ladingaansprakelijkheid<\/h3><\/div><div id=\"field_69_355\" class=\"gfield gfield--type-text gfield--input-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_69_355'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_355' id='input_69_355' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_649\" class=\"gfield gfield--type-number gfield--input-type-number 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_69_649'>Bruto opgereden vrachtbedrag<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_649' id='input_69_649' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_631\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_631'>Ander onderdeel (indien van toepassing)<\/label><div class='ginput_container ginput_container_text'><input name='input_631' id='input_69_631' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_359\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_359'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_359' id='input_69_359' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_353' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_353' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_21_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_21' class='gform_page' data-js='page-field-id-353' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_21' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_125\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Multiline verzekering<\/h3><\/div><div id=\"field_69_121\" class=\"gfield gfield--type-text gfield--input-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_69_121'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_121' id='input_69_121' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_145\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_145'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_145' id='input_69_145' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief betaalde zeevracht)' >Bruto jaaromzet (exclusief betaalde zeevracht)<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto opgereden vrachtbedrag' >Bruto opgereden vrachtbedrag<\/option><option value='Omzet koel-\/vriesvervoer' >Omzet koel-\/vriesvervoer<\/option><option value='Omzet uitbesteed vervoer' >Omzet uitbesteed vervoer<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><\/select><\/div><\/div><div id=\"field_69_146\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_146'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_146' id='input_69_146' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_147\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_147'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_147' id='input_69_147' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief betaalde zeevracht)' >Bruto jaaromzet (exclusief betaalde zeevracht)<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto opgereden vrachtbedrag' >Bruto opgereden vrachtbedrag<\/option><option value='Omzet koel-\/vriesvervoer' >Omzet koel-\/vriesvervoer<\/option><option value='Omzet uitbesteed vervoer' >Omzet uitbesteed vervoer<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><\/select><\/div><\/div><div id=\"field_69_148\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_148'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_148' id='input_69_148' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_149\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_149'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_149' id='input_69_149' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief betaalde zeevracht)' >Bruto jaaromzet (exclusief betaalde zeevracht)<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto opgereden vrachtbedrag' >Bruto opgereden vrachtbedrag<\/option><option value='Omzet koel-\/vriesvervoer' >Omzet koel-\/vriesvervoer<\/option><option value='Omzet uitbesteed vervoer' >Omzet uitbesteed vervoer<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><\/select><\/div><\/div><div id=\"field_69_150\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_150'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_150' id='input_69_150' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_151\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_151'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_151' id='input_69_151' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief betaalde zeevracht)' >Bruto jaaromzet (exclusief betaalde zeevracht)<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto opgereden vrachtbedrag' >Bruto opgereden vrachtbedrag<\/option><option value='Omzet koel-\/vriesvervoer' >Omzet koel-\/vriesvervoer<\/option><option value='Omzet uitbesteed vervoer' >Omzet uitbesteed vervoer<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><\/select><\/div><\/div><div id=\"field_69_152\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_152'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_152' id='input_69_152' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_118' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_118' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_22_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_22' class='gform_page' data-js='page-field-id-118' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_22' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_124\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Transportverzekering<\/h3><\/div><div id=\"field_69_120\" class=\"gfield gfield--type-text gfield--input-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_69_120'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_120' id='input_69_120' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_153\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_153'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_153' id='input_69_153' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_154\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_154'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_154' id='input_69_154' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_164\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_164'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_164' id='input_69_164' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_157\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_157'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_157' id='input_69_157' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_155\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_155'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_155' id='input_69_155' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_156\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_156'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_156' id='input_69_156' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_159\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_159'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_159' id='input_69_159' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_158\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_158'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_158' id='input_69_158' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_653\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_653'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_653' id='input_69_653' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_654\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_654'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_654' id='input_69_654' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_652\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_652'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_652' id='input_69_652' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_656\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_656'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_656' id='input_69_656' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_651\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_651'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_651' id='input_69_651' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal evenementen' >Aantal evenementen<\/option><option value='Bedrijfsomzet' >Bedrijfsomzet<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Getranporteerde omzet (verkoop)' >Getranporteerde omzet (verkoop)<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet inkomende zendingen' >Vervoersomzet inkomende zendingen<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet uitgaand' >Vervoersomzet uitgaand<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Vervoersomzet West-Europa' >Vervoersomzet West-Europa<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_655\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_655'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_655' id='input_69_655' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_161' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_161' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_23_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_23' class='gform_page' data-js='page-field-id-161' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_23' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_167\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Transport- en verblijfverzekering<\/h3><\/div><div id=\"field_69_166\" class=\"gfield gfield--type-text gfield--input-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_69_166'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_166' id='input_69_166' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_165\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_165'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_165' id='input_69_165' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Gemiddelde opslagwaarde' >Gemiddelde opslagwaarde<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Iran' >Vervoersomzet Iran<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_160\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_160'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_160' id='input_69_160' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_168\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_168'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_168' id='input_69_168' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Gemiddelde opslagwaarde' >Gemiddelde opslagwaarde<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Iran' >Vervoersomzet Iran<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_169\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_169'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_169' id='input_69_169' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_170\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_170'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_170' id='input_69_170' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Gemiddelde opslagwaarde' >Gemiddelde opslagwaarde<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Iran' >Vervoersomzet Iran<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_171\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_171'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_171' id='input_69_171' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_172\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_172'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_172' id='input_69_172' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal voertuigen' >Aantal voertuigen<\/option><option value='Aantal tentoonstellingen' >Aantal tentoonstellingen<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Gemiddelde opslagwaarde' >Gemiddelde opslagwaarde<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Iran' >Vervoersomzet Iran<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_173\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_173'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_173' id='input_69_173' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_163' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_163' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_24_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_24' class='gform_page' data-js='page-field-id-163' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_24' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_174\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Transport, reis en scheepvaartverzekering<\/h3><\/div><div id=\"field_69_176\" class=\"gfield gfield--type-text gfield--input-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_69_176'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_176' id='input_69_176' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_178\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_178'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_178' id='input_69_178' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_183\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_183'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_183' id='input_69_183' type='text' step='any'   value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_182\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_182'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_182' id='input_69_182' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_184\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_184'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_184' id='input_69_184' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_181\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_181'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_181' id='input_69_181' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_185\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_185'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_185' id='input_69_185' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_180\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_180'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_180' id='input_69_180' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_186\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_186'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_186' id='input_69_186' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_635\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_635'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_635' id='input_69_635' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_639\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_639'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_639' id='input_69_639' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_634\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_634'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_634' id='input_69_634' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_638\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_638'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_638' id='input_69_638' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_633\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_633'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_633' id='input_69_633' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Aantal transporten' >Aantal transporten<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Bruto omzet koel-\/vries' >Bruto omzet koel-\/vries<\/option><option value='Montageomzet EER' >Montageomzet EER<\/option><option value='Omzet service\/onderhoud\/montage' >Omzet service\/onderhoud\/montage<\/option><option value='Omzet verhuur' >Omzet verhuur<\/option><option value='Veilingomzet kunst, antiek, curiosa &amp; inboedel' >Veilingomzet kunst, antiek, curiosa &amp; inboedel<\/option><option value='Vervoerde omzet gesplitst (zie uw polis)' >Vervoerde omzet gesplitst (zie uw polis)<\/option><option value='Vervoersomzet Benelux' >Vervoersomzet Benelux<\/option><option value='Vervoersomzet EER' >Vervoersomzet EER<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><option value='Vervoersomzet Nederland' >Vervoersomzet Nederland<\/option><option value='Vervoersomzet overige zendingen' >Vervoersomzet overige zendingen<\/option><option value='Vervoersomzet per binnenvaartschip' >Vervoersomzet per binnenvaartschip<\/option><option value='Vervoersomzet Tanzania' >Vervoersomzet Tanzania<\/option><option value='Vervoersomzet USA\/Canada' >Vervoersomzet USA\/Canada<\/option><option value='Vervoersomzet Verre Oosten' >Vervoersomzet Verre Oosten<\/option><option value='Vervoersomzet Wereld' >Vervoersomzet Wereld<\/option><option value='Waarde per pakket Benelux' >Waarde per pakket Benelux<\/option><option value='Werkelijk vervoerde omzet' >Werkelijk vervoerde omzet<\/option><\/select><\/div><\/div><div id=\"field_69_637\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_637'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_637' id='input_69_637' type='text' step='any'   value='' class='large'      aria-invalid=\"false\"  \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_162' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_162' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_25_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_25' class='gform_page' data-js='page-field-id-162' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_25' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_175\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Vervoerdersaansprakelijkheidsverzekering<\/h3><\/div><div id=\"field_69_177\" class=\"gfield gfield--type-text gfield--input-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_69_177'>Polisnummer<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_177' id='input_69_177' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_179\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half 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_69_179'>Selecteer uw onderdeel<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_179' id='input_69_179' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><\/select><\/div><\/div><div id=\"field_69_190\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half 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_69_190'>Vul hier opgave in<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_190' id='input_69_190' type='text' step='any'   value='' class='large'    placeholder='\u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_189\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_189'>Selecteer uw onderdeel<\/label><div class='ginput_container ginput_container_select'><select name='input_189' id='input_69_189' class='large gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Maak hier uw keuze<\/option><option value='Bruto jaaromzet (exclusief btw)' >Bruto jaaromzet (exclusief btw)<\/option><option value='Vervoersomzet Europa' >Vervoersomzet Europa<\/option><\/select><\/div><\/div><div id=\"field_69_192\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_192'>Vul hier opgave in<\/label><div class='ginput_container ginput_container_number'><input name='input_192' id='input_69_192' type='text' step='any'   value='' class='large'    placeholder='\u20ac'  aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_69_228\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Uw (bedrijfs)gegevens<\/h3><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_69_1782' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='button' id='gform_next_button_69_1782' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Volgende'  \/> <button type='button'  id='gform_save_69_26_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button>\n                    <\/div>\n                <\/div>\n                <div id='gform_page_69_26' class='gform_page' data-js='page-field-id-1782' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_69_26' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_69_1783\" class=\"gfield gfield--type-text gfield--input-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_69_1783'>Bedrijfsnaam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1783' id='input_69_1783' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"organization\" \/><\/div><\/div><div id=\"field_69_1784\" class=\"gfield gfield--type-text gfield--input-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_69_1784'>Kamer van Koophandel nummer (KVK)<\/label><div class='ginput_container ginput_container_text'><input name='input_1784' id='input_69_1784' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_69_1785\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Naam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><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_69_1785'>\n                            \n                            <span id='input_69_1785_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_69_1785_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_1785.3' id='input_69_1785_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_69_1785_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_69_1785_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_1785.6' id='input_69_1785_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_69_1786\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half 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_69_1786'>Telefoon<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_1786' id='input_69_1786' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" \/><\/div><\/div><div id=\"field_69_1787\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_1787'>Mobiel<\/label><div class='ginput_container ginput_container_text'><input name='input_1787' id='input_69_1787' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_1788\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_1788'>E-mailadres<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_69_1788'>U krijgt een kopie van uw opgave(n) toegestuurd op dit mailadres.<\/div><div class='ginput_container ginput_container_text'><input name='input_1788' id='input_69_1788' type='text' value='' class='large'  aria-describedby=\"gfield_description_69_1788\"   aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\" \/><\/div><\/div><div id=\"field_69_1789\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-default-icon 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_69_1789'>Datum<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_1789' id='input_69_1789' type='text' value='' class='datepicker gform-datepicker dmy_dash datepicker_with_icon gdatepicker_with_icon'   placeholder='dd-mm-yyyy' aria-describedby=\"input_69_1789_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_69_1789_date_format' class='screen-reader-text'>DD dash MM dash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_69_1789' class='gform_hidden' value='https:\/\/ecclesia.nl\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><fieldset id=\"field_69_1790\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wenst u nog een opmerking of toelichting bij te voegen?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_1790'>\n\t\t\t<div class='gchoice gchoice_69_1790_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1790' type='radio' value='Ja'  id='choice_69_1790_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_1790_0' id='label_69_1790_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_1790_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1790' type='radio' value='Nee'  id='choice_69_1790_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_1790_1' id='label_69_1790_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_1791\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_1791'>Opmerking (optioneel)<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_1791' id='input_69_1791' class='textarea large'   maxlength='300' placeholder='Vul hier uw opmerking en\/of toelichting in.'  aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_69_1792\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Wenst u een bijlage toe te voegen?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_69_1792'>\n\t\t\t<div class='gchoice gchoice_69_1792_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1792' type='radio' value='Ja'  id='choice_69_1792_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_1792_0' id='label_69_1792_0' class='gform-field-label gform-field-label--type-inline'>Ja<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_69_1792_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_1792' type='radio' value='Nee'  id='choice_69_1792_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_69_1792_1' id='label_69_1792_1' class='gform-field-label gform-field-label--type-inline'>Nee<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_69_1793\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_69_1793'>Upload bestand (optioneel)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_69_1793' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_69_1793&quot;,&quot;container&quot;:&quot;gform_multifile_upload_69_1793&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_69_1793&quot;,&quot;filelist&quot;:&quot;gform_preview_69_1793&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/ecclesia.nl\\\/en\\\/?gf_page=75a2d49a9d67232&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/ecclesia.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/ecclesia.nl\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;jpg,pdf&quot;}],&quot;max_file_size&quot;:&quot;15360000b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:69,&quot;field_id&quot;:1793,&quot;_gform_file_upload_nonce_69_1793&quot;:&quot;eccb33b47a&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;8&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_69_1793&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_69_1793' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_69_1793' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_69_1793\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_69_1793'>Accepted file types: jpg, pdf, Max. file size: 15 MB, Max. files: 8.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_69_1793'><\/ul> <div id='gform_preview_69_1793' class='ginput_preview_list'><\/div><\/div><\/div><div id=\"field_69_9997\" class=\"gfield gfield--type-section gsection my-honeypot-section field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><h3 class=\"gsection_title\">Sectie<\/h3><\/div><div id=\"field_69_9999\" class=\"gfield gfield--type-text my-honeypot-field field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_69_9999'>Laat dit veld leeg<\/label><div class='ginput_container ginput_container_text'><input name='input_9999' id='input_69_9999' type='text' value='' class=''      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_69_9998\" class=\"gfield gfield--type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_9998' id='input_69_9998' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='1782564383' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><input type='submit' id='gform_previous_button_69' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' value='Vorige'  \/> <input type='submit' id='gform_submit_button_69' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Opgave(n) indienen'  \/> <button type='button'  id='gform_save_69_footer_link' onclick='gform.submission.handleButtonClick(this);' data-submission-type='save-continue' class='gform_save_link gform-theme-button gform-theme-button--secondary button'  ><svg aria-hidden=\"true\" focusable=\"false\" width=\"16\" height=\"16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M0 8a4 4 0 004 4h3v3a1 1 0 102 0v-3h3a4 4 0 100-8 4 4 0 10-8 0 4 4 0 00-4 4zm9 4H7V7.414L5.707 8.707a1 1 0 01-1.414-1.414l3-3a1 1 0 011.414 0l3 3a1 1 0 01-1.414 1.414L9 7.414V12z\" fill=\"#6B7280\"\/><\/svg> Tussentijds opslaan<\/button><input type='hidden' name='gform_ajax' value='form_id=69&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles={&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;,&quot;labelFontSize&quot;:&quot;14&quot;,&quot;labelColor&quot;:&quot;#000000&quot;,&quot;descriptionFontSize&quot;:&quot;13&quot;}&amp;hash=11f890f906ca8fa90eca85c4c3e14345' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_69' value='iframe' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_69' id='gform_theme_69' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_69' id='gform_style_settings_69' value='{&quot;inputPrimaryColor&quot;:&quot;#204ce5&quot;,&quot;labelFontSize&quot;:&quot;14&quot;,&quot;labelColor&quot;:&quot;#000000&quot;,&quot;descriptionFontSize&quot;:&quot;13&quot;}' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_69' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='69' \/>\n            <input type='hidden' class='gform_hidden' name='gform_save' id='gform_save_69' value='' \/>\n                             <input type='hidden' class='gform_hidden' name='gform_resume_token' id='gform_resume_token_69' value='' \/>\n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='EUR' value='isZWvlxhZ2ktcj9\/FzorCWLX+S2T2ycdhfwI7KPMG62cqQElrUSgseQKYeOotBtH5WFWqCd6nTDB7gRlfST811JrhrlL0nQB\/doK+axKzgqDrWg=' \/>\n            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