[hidden lang default:get] [hidden temp_password-hidden] [hidden delta-hidden] [hidden max_diff-hidden "10"] [hidden num_contrat] [hidden apporteur default:get]
<div class="declenche-devis">
    <div class="row">
        <div class="col-12 error"></div>
        <div class="col-12 ml-2 mr-4">
            <h2>Business Travel Insurance</h2>
            <div class="row">
                <div class="col">
                    <fieldset>
                        <label class="text-uppercase" for="duration_date">Travel Period</label>
                        <div class="input-group daterange">
                            <label id="daterange-start-label">Departure Date</label>[text date-depart id:duration_date class:form-control class:daterange-start readonly default:get]
                            <label id="daterange-end-label">Return Date</label>[text date-fin class:form-control class:daterange-end readonly default:get]<span class="input-group-append" role="right-icon"><button class="btn-transparent" type="button"><i class="fa fa-calendar"></i></button></span></div>
                        <h6 class="text-uppercase">For annual insurance (multitrip) check the following box</h6>
                        <div class="row align-items-center justify-content-center">
                            <div class="col-12 col-sm-3">
                                [checkbox multitrip class:annuel "Multitrip"]
                            </div>
                            <div class="col-12 col-sm-4 text-date pb-1">
                                [group text]
                                <p style="font-size: 1rem">Start Date :</p>
                                [/group]
                            </div>
                            <div class="col-12 col-sm-3 pr-2">
                                [group annuel] [date date-multi] [/group]
                            </div>
                        </div>
                    </fieldset>
                </div>
                [diffdate resultatDuree date1:date-depart date2:date-fin get:d]
            </div>
            <div class="row">
                <div class="col pl-2"><small class="date-difference" style="opacity: 0.73;"></small></div>
            </div>
            <div class="row">
                <div class="row">
                    <div class="col-6">
                        <fieldset>
                            <label class="text-uppercase">Provenance</label>
                            <div class="input-group mt-1">[select_pays* provenance_pays class:combobox class:w-100 class:swisscare-style default:get]</div>
                        </fieldset>

                    </div>
                    <div class="col-6">
                        <fieldset>
                            <label>DESTINATION</label>
                            <div class="input-group mt-1">[select_pays* destination_pays class:combobox class:w-100 class:swisscare-style default:get]</div>
                        </fieldset>
                    </div>
                </div>

                [hidden number-pers default:get] [hidden devis-st]
                <div class="col-12 mt-3">
                    <div class="pl-2 pr-2" style="background-color: darkorange">
                        <p class="mustache text-white">Estimated cost of your Travel Insurance : <span class="devis-st">€ [devis-st]</span> VAT Inc.</p>
                    </div>
                    
                    <h2>Liste des assurés</h2>

                    <div class="row mt-1 mr-4" id="assure">
                        <div class="col-12">

                            <div class="row mt-2" v-for="(person, index) in people" :data-loop-index="index">
                                [hidden personne--num_client]
                                <div class="col-xl-12 pl-2">
                                    <h3 class="title">Insured n°{{index+1}}<strong class="mustache devis-pp"> - Price: € [[personne--devis-pp]]</strong></h3>
                                </div>
                                <div class="row">
                                    <div class="col-12 col-sm-4 pl-2 pr-2">
                                        <fieldset>
                                            <label>NAME</label>[text* personne--nom id:personne--nom]</fieldset>
                                    </div>
                                    <div class="col-12 col-sm-4 pl-2 pr-2">
                                        <fieldset>
                                            <label>FIRST NAME</label>[text* personne--prenom id:personne--prenom]</fieldset>
                                    </div>
                                    <div class="col-12 col-sm-4 pl-2 pr-2">
                                        <fieldset>
                                            <label class="text-uppercase">Birthdate</label>[date personne--date-naiss id:personne--date-naiss class:w-100]</fieldset>[diffdate personne--age id:personne--age date1:personne--date-naiss date2:now get:y]
                                    </div>

                                    <div class="col-12 col sm-4 pl-2 pr-2">
                                        [group sans-multitrip]
                                        <fieldset>
                                            <label>Do you work in an high-risk occupation ?<small> ( ie : firefighters, security officers, stuntmen, building workers, mining or extraction of raw material workers (including drivers and machine operators), employees of forest and wood-derived industries  (sawmill, logging or pruning jobs, chainsaw  and logging gear operators)</small></label>
                                            <div class="card-wrapper">
                                                [option_card personne--mr id:personne--mr class:launch-tarif col-opt1:SILVER line-opt1:0 col-opt2:MR_SILVER line-opt2:0 "No" "Yes"]
                                         <p class="price_text_translater" style="display:none">Price:</p></div>
                                        </fieldset>
                                        [/group] 

                                        [group avec-multitrip]
                                        <fieldset>
                                            <label>Do you work in an high-risk occupation ?<small> ( ie : firefighters, security officers, stuntmen, building workers, mining or extraction of raw material workers (including drivers and machine operators), employees of forest and wood-derived industries  (sawmill, logging or pruning jobs, chainsaw  and logging gear operators)</small></label>
                                            <div class="card-wrapper">
                                                [option_card personne--mr id:personne--mr col-opt1:SILVER line-opt1:1 col-opt2:MR_SILVER line-opt2:1 "No" "Yes"]
                                            <p class="price_text_translater" style="display:none">Price:</p></div>
                                        </fieldset>
                                        [/group]
                                    </div>
                                    <div class="col-12 col sm-4 pl-2 pr-2">
                                        [group capital] 
                                        [group capital-non]
                                        <fieldset>
                                            <label>Desired pay-out capital in the event of death, total or partial permanent invalidity :</label>
                                            <div class="card-wrapper">
                                                [option_card personne--optfm id:personne--optkdc col-opt1:SILVER line-opt1:1 col-opt2:SILVER line-opt2:2 "50000€|50000" "150000€|150000"]
                                            </div>
                                        </fieldset>
                                        [/group] 

                                        [group capital-oui]
                                        <fieldset>
                                            <label>Desired pay-out capital in the event of death, total or partial permanent invalidity :</label>
                                            <div class="card-wrapper">
                                                [option_card personne--optfm id:personne--optkdc col-opt1:MR_SILVER line-opt1:1 col-opt2:MR_SILVER line-opt2:2 "50000€|50000" "150000€|150000"]
                                            </div>
                                        </fieldset>
                                        [/group] [/group]
                                    </div>

                                    <div class="col-12 col sm-4 pl-2 pr-2">
                                        [group trajet]
                                        [group trajet-50000-non]
                                        <fieldset>
                                            <label>Choose the policy suited to your needs</label>
                                            <div class="card-wrapper">
                                                [option_card personne--trajets id:personne--trajets class:launch-tarif col-opt1:SILVER line-opt1:1 col-opt2:PLATINIUM line-opt2:1 col-opt3:PLATINIUM_FAMILLE line-opt3:1 "Silver|Silver" "Platinium|Platinium" "Platinium Family|Platinium_famille"]
                                                <p id="p-Silver" style="display:none">Business Trips Only</p>
                                                <p id="p-Platinium" style="display:none">Business and Personal Trips</p>
                                                <p id="p-Platinium_famille" style="display:none">Business and Personal Trips for you and your family</p>
                                            </div>
                                        </fieldset>
                                        [/group]
                                        [group trajet-150000-non]
                                        <fieldset>
                                            <label>Choose the policy suited to your needs</label>
                                            <div class="card-wrapper">
                                                [option_card personne--trajets id:personne--trajets class:launch-tarif col-opt1:SILVER line-opt1:2 col-opt2:PLATINIUM line-opt2:2 col-opt3:PLATINIUM_FAMILLE line-opt3:2 "Silver|Silver" "Platinium|Platinium" "Platinium Family|Platinium_famille"]
                                                <p id="p-Silver" style="display:none">Business Trips Only</p>
                                                <p id="p-Platinium" style="display:none">Business and Personal Trips</p>
                                                <p id="p-Platinium_famille" style="display:none">Business and Personal Trips for you and your family</p>
                                            </div>
                                        </fieldset>
                                        [/group]
                                        [group trajet-50000-oui]
                                        <fieldset>
                                            <label>Choose the policy suited to your needs</label>
                                            <div class="card-wrapper">
                                                [option_card personne--trajets id:personne--trajets class:launch-tarif col-opt1:MR_SILVER line-opt1:1 col-opt2:MR_PLATINIUM line-opt2:1 col-opt3:MR_PLATINIUM_FAM line-opt3:1 "Silver|Silver" "Platinium|Platinium" "Platinium Family|Platinium_famille"]
                                                <p id="p-Silver" style="display:none">Business Trips Only</p>
                                                <p id="p-Platinium" style="display:none">Business and Personal Trips</p>
                                                <p id="p-Platinium_famille" style="display:none">Business and Personal Trips for you and your family</p>
                                            </div>
                                        </fieldset>
                                        [/group]
                                        [group trajet-150000-oui]
                                        <fieldset>
                                            <label>Choose the policy suited to your needs</label>
                                            <div class="card-wrapper">
                                                 [option_card personne--trajets id:personne--trajets class:launch-tarif col-opt1:MR_SILVER line-opt1:2 col-opt2:MR_PLATINIUM line-opt2:2 col-opt3:MR_PLATINIUM_FAM line-opt3:2 "Silver|Silver" "Platinium|Platinium" "Platinium Family|Platinium_famille"]
                                                <p id="p-Silver" style="display:none">Business Trips Only</p>
                                                <p id="p-Platinium" style="display:none">Business and Personal Trips</p>
                                                <p id="p-Platinium_famille" style="display:none">Business and Personal Trips for you and your family</p>
                                            </div>
                                        </fieldset>
                                        [/group]
                                        [/group]
                                    </div>

                                    <div class="close-col">
                                        <div class="delete" v-on:click="deletePerson(index)"><i class="fa fa-trash-o" style="font-size: 25px;color: rgb(247,1,1);"></i></div>
                                    </div>

                                </div>
                            </div>
                            <div class="col-12 mt-3">
                                <div class="btn-plus" v-on:click="add()">
                                    <i class="fa fa-plus-circle" style="font-size: 35px;color: rgba(33,37,41,0.51);"></i>
                                </div>
                            </div>
                        </div>
                        <div class="col-12">
                            <div class="row mt-4">
                                <div class="col-12 mt-2">
                                    <label class="checkbox-group">[acceptance terms]<small>The information collected on this page is subject to a treatment designed to receive information about our services, and to follow up and training of your application. Your personal information is exclusively intended for the persons authorized to process these requests. By clicking on "Next", I acknowledge having read the <strong> <a href="http://193.70.73.91/wp-content/uploads/2020/01/PGPD-AGIS-2020.pdf" target="_blank"> AGIS data protection policy</a></strong> having appointed a Data Protection Officer to the CNIL, by proving your identity, you can exercise your rights of access, rectification or deletion of information about you. You can also, for legitimate reasons, oppose the processing of your data. Please send us an email to dpo@agis-group.com.</small>[/acceptance]</label>
                                </div>
                            </div>
                        </div>
                        <div class="col col-12 d-flex justify-content-end">
                            <input type="button" id="prevBtn" style="margin-rigth: 15px;" class="wpcf7-form-control wpcf7-submit button prevBtn btn-radius button-secondary" value="Previous" />[submit id:nextBtn class:nextBtn class:btn-radius "Next"]
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script>
window.labels = {
      "conjoint": {
        "titre": "Spouse",
        "conjoint-nom": "Name",
        "conjoint-prenom": "First Name",
        "conjoint-datenais": "Birthdate"
      },
      "enfants": {
        "titre": "Children (under 21)",
        "enfant-num": "n°*num*",
        "enfant-nom": "Name",
        "enfant-prenom": "First Name",
        "enfant-datenaiss": "Birthdate",
        "enfant-action": "Action"
      },
      "buttons": {
        "ajout": "Add",
        "suppression": "Delete"
      },
      'accordion': {
        "activeText": "Hide family members",
        "inactiveText": "Manage family members"
      }
    };
</script>