{"id":4481,"date":"2012-09-29T11:58:04","date_gmt":"2012-09-29T11:58:04","guid":{"rendered":"http:\/\/@WEBSITE_1@\/?page_id=4481"},"modified":"2018-06-23T08:47:16","modified_gmt":"2018-06-23T08:47:16","slug":"offerte-vapz","status":"publish","type":"page","link":"https:\/\/www.gbwoluwe.be\/en\/offerte-vapz\/","title":{"rendered":"Quotation VSPSS"},"content":{"rendered":"<p>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_24' ><div id='gf_24' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_24'  action=\"\/en\/wp-json\/wp\/v2\/pages\/4481#gf_24\" data-formid='24' novalidate>\n        <div id='gf_progressbar_wrapper_24' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>4<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_25' style='width:25%;'><span>25%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_24_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_24' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_24_25\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_25' class='gfield_label gform-field-label' for='input_24_25'><span class='gform-field-label__text'>X\/Twitter<\/span><\/label><div class='ginput_container'><input name='input_25' id='input_24_25' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_24_25'>This field is for validation purposes and should be left unchanged.<\/div><\/li><li id=\"field_24_2\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Policyholder<\/h2><\/li><li id=\"field_24_3\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_3' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_24_3'>\n                            \n                            <span id='input_24_3_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_24_3_3' id='input_24_3_3_label' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_3.3' id='input_24_3_3' value=''   aria-required='true'     aria-labelledby=\"input_24_3_3_label gfield_label_24_3\"\/>\n                                                <\/span>\n                            \n                            <span id='input_24_3_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_24_3_6' id='input_24_3_6_label' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_3.6' id='input_24_3_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_24_4\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_24_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_24_4_1_container' >\n                                        <label for='input_24_4_1' id='input_24_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_4.1' id='input_24_4_1' value=''    aria-required='true'    aria-labelledby=\"input_24_4_1_label gfield_label_24_4\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_24_4_3_container' >\n                                    <label for='input_24_4_3' id='input_24_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_4.3' id='input_24_4_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_4.4' id='input_24_4_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_24_4_5_container' >\n                                    <label for='input_24_4_5' id='input_24_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                    <input type='text' name='input_4.5' id='input_24_4_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_24_4_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_24_5\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_5' class='gfield_label gform-field-label' for='input_24_5'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_24_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_24_6\" class=\"gfield gfield--type-phone gfield--phone-format-international gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_6' class='gfield_label gform-field-label' for='input_24_6'><span class='gform-field-label__text'>Telephone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_24_6' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_24_7\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_7' class='gfield_label gform-field-label' for='input_24_7'><span class='gform-field-label__text'>Start date independent activity<\/span><\/label><div class='ginput_container ginput_container_date'>\n\t\t\t\t\t<input\n\t\t\t\t\tplaceholder='mm\/dd\/yyyy'\n\t\t\t\t\tid='input_24_7'\n\t\t\t\t\tclass='datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon'\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='input_7'\n\t\t\t\t\tvalue=''\n\t\t\t\t\t \n\t\t\t\t\taria-invalid=\"false\" \n\t\t\t\t\t\n\t\t\t\t\t \n\t\t\t\t\t\n\t\t\t\t\tdata-mask=\"99\/99\/9999\"\n\t\t\t\t\t\/>\n\t\t\t\t<kbd id='keyboardHint_input_24_7' hidden class='down'><\/kbd>\n\t\t\t\t<button type='button' id='datepicker_toggle_input_24_7' class='gform-datepicker-toggle gform-datepicker-toggle--default accCalendar aria-date-picker gform-button gform-theme-button gform-theme-button--simple gform-theme-button--simple-in-ctrl' aria-expanded='false' aria-controls='input_24_7' aria-label='Start date independent activity: Choose date on calendar' >\n\t\t\t\t\t\t\t<span class=\"gform-calendar-icon gform-datepicker-toggle-icon gform-datepicker-toggle-icon--default dashicons dashicons-calendar-alt\" aria-hidden=\"true\"><\/span>\n\t\t\t\t\t\t<\/button>\n\t\t\t<\/div><\/li><li id=\"field_24_8\" class=\"gfield gfield--type-select field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_8' class='gfield_label gform-field-label' for='input_24_8'><span class='gform-field-label__text'>The insured is a cooperating spouse?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_8' id='input_24_8' class='medium gfield_select'     aria-invalid=\"false\" ><option value='No' >No<\/option><option value='Yes' >Yes<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                         <button type='button' id='gform_next_button_24_1' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_24_2' class='gform_page' data-js='page-field-id-1' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_24_2' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_24_10\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Social Contribution<\/h2><div class='gsection_description' id='gfield_description_24_10'>(See latest payment social contribution from social secretariat)<\/div><\/li><li id=\"field_24_11\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_11' class='gfield_label gform-field-label' for='input_24_11'><span class='gform-field-label__text'>Last paid social contribution<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_11' id='input_24_11' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_24_15\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_15' class='gfield_label gform-field-label' for='input_24_15'><span class='gform-field-label__text'>In quarter<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_15' id='input_24_15' type='text' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_24_14\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_14' class='gfield_label gform-field-label' for='input_24_14'><span class='gform-field-label__text'>Year<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_14' id='input_24_14' type='number' step='any'   value='' class='small'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_24_16\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_16' class='gfield_label gform-field-label' for='input_24_16'><span class='gform-field-label__text'>Calculated on a net taxable income of<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_16' id='input_24_16' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><li id=\"field_24_17\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_24_17' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Social contribution was calculated for<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_24_17'>\n\t\t\t<li class='gchoice gchoice_24_17_0'>\n\t\t\t\t<input name='input_17' type='radio' value='Established self-employed (pay 3 years ago)'  id='choice_24_17_0'    \/>\n\t\t\t\t<label for='choice_24_17_0' id='label_24_17_0' class='gform-field-label gform-field-label--type-inline'>Established self-employed (pay 3 years ago)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_24_17_1'>\n\t\t\t\t<input name='input_17' type='radio' value='Starting self-employed (min. contribution)'  id='choice_24_17_1'    \/>\n\t\t\t\t<label for='choice_24_17_1' id='label_24_17_1' class='gform-field-label gform-field-label--type-inline'>Starting self-employed (min. contribution)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_24_17_2'>\n\t\t\t\t<input name='input_17' type='radio' value='Starting self-employed (estimated wage)'  id='choice_24_17_2'    \/>\n\t\t\t\t<label for='choice_24_17_2' id='label_24_17_2' class='gform-field-label gform-field-label--type-inline'>Starting self-employed (estimated wage)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_24_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_24_9' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_24_3' class='gform_page' data-js='page-field-id-9' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_24_3' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_24_19\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Target amount<\/h2><\/li><li id=\"field_24_20\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_24_20' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Fiscal Maximum<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_24_20'><li class='gchoice gchoice_24_20_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_20.1' type='checkbox'  value='8,17% of your income'  id='choice_24_20_1'    aria-labelledby=\"label_24_20_1 gfield_label_24_20\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_24_20_1' id='label_24_20_1' class='gform-field-label gform-field-label--type-inline'>8,17% of your income<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_24_21\" class=\"gfield gfield--type-html gfield_html gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><\/br><\/br>\nor\n<\/br><\/br><\/li><li id=\"field_24_22\" class=\"gfield gfield--type-number field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_24_22' class='gfield_label gform-field-label' for='input_24_22'><span class='gform-field-label__text'>Self-determined amount<\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_22' id='input_24_22' type='text' step='any'   value='' class='medium'      aria-invalid=\"false\"  \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer left_label'>\n                        <button type='button' id='gform_previous_button_24_18' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_24_18' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Volgende<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_24_4' class='gform_page' data-js='page-field-id-18' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_24_4' class='gform_fields left_label form_sublabel_above description_below validation_below' data-column-layout='fill'><li id=\"field_24_23\" class=\"gfield gfield--type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><h2 class=\"gsection_title\">Premium payment<\/h2><\/li><li id=\"field_24_24\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"><label id='gfield_label_24_24' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Premium distribution<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_24_24'>\n\t\t\t<li class='gchoice gchoice_24_24_0'>\n\t\t\t\t<input name='input_24' type='radio' value='Monthly'  id='choice_24_24_0'    \/>\n\t\t\t\t<label for='choice_24_24_0' id='label_24_24_0' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_24_24_1'>\n\t\t\t\t<input name='input_24' type='radio' value='Quarterly'  id='choice_24_24_1'    \/>\n\t\t\t\t<label for='choice_24_24_1' id='label_24_24_1' class='gform-field-label gform-field-label--type-inline'>Quarterly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_24_24_2'>\n\t\t\t\t<input name='input_24' type='radio' value='Half Yearly'  id='choice_24_24_2'    \/>\n\t\t\t\t<label for='choice_24_24_2' id='label_24_24_2' class='gform-field-label gform-field-label--type-inline'>Half Yearly<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_24_24_3'>\n\t\t\t\t<input name='input_24' type='radio' value='Yearly'  id='choice_24_24_3'    \/>\n\t\t\t\t<label for='choice_24_24_3' id='label_24_24_3' class='gform-field-label gform-field-label--type-inline'>Yearly<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer left_label'><button type='submit' id='gform_previous_button_24' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_24' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Send<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_24' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_24' id='gform_theme_24' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_24' id='gform_style_settings_24' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_24' value='1' \/>\n            <input 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