{"id":115,"date":"2020-09-14T09:30:47","date_gmt":"2020-09-14T14:30:47","guid":{"rendered":"http:\/\/marcusagent.com\/?page_id=115"},"modified":"2021-10-26T17:15:11","modified_gmt":"2021-10-26T22:15:11","slug":"marine-insurance","status":"publish","type":"page","link":"https:\/\/marcusagent.com\/marine-insurance\/","title":{"rendered":"Marine Insurance"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"115\" class=\"elementor elementor-115\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7fd26cef elementor-section-height-min-height elementor-section-items-bottom elementor-section-boxed elementor-section-height-default\" data-id=\"7fd26cef\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t\t<div class=\"elementor-background-overlay\"><\/div>\n\t\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6446a5ef\" data-id=\"6446a5ef\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-205804c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"205804c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2db9e58\" data-id=\"2db9e58\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8bb97ed elementor-widget elementor-widget-text-editor\" data-id=\"8bb97ed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><a href=\"https:\/\/marcusagent.com\/wp-content\/uploads\/2021\/04\/marine-insurance-application-FINAL-FILLABLE-1.pdf\"><strong>Prefer to fill out by hand? Click here to download a printable version<\/strong><\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f9136f5 uael-gf-ajax-yes uael-gf-check-yes uael-gf-style-box uael-gf-input-size-sm uael-gf-button-left uael-gf-btn-size-sm elementor-widget elementor-widget-uael-gf-styler\" data-id=\"f9136f5\" data-element_type=\"widget\" data-widget_type=\"uael-gf-styler.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<div class=\"uael-gf-style uael-gf-check-style elementor-clickable\">\n\t<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_safari gform_wrapper gravity-theme gform-theme--no-framework gf_stylespro_wrapper sp_flat_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_7' style='display:none'><div id='gf_7' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_7' id='gform_7' class=' gf_stylespro sp_flat' action='\/wp-json\/wp\/v2\/pages\/115#gf_7' data-formid='7' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Ldp8PYcAAAAAINtibmU-8VaOxIEUjlWW9EpdmEj' data-tabindex='1'><input id=\"input_61f87a908f62b0d49b87899acce0b1b4\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_61f87a908f62b0d49b87899acce0b1b4\" value=\"\"\/><\/div>\n        <div id='gf_progressbar_wrapper_7' class='gf_progressbar_wrapper'>\n        \t<p class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>6<\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_blue' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_blue percentbar_16' style='width:16%;'><span>16%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_7_1' class='gform_page ' data-js='page-field-id-1' >\n                                    <div class='gform_page_fields'><div id='gform_fields_7' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_7_135\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_135\" ><h3 class=\"gsection_title\">Insured Information<\/h3><\/div><div id=\"field_7_3\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_left o_medium\"  data-field-class=\"gf_left o_medium\" data-js-reload=\"field_7_3\" ><label class='gfield_label gform-field-label' for='input_7_3'>Policy to be issued in the name of:<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_7_3' type='text' value='' class='small'   tabindex='2'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_4\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_4\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Residence Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_7_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_7_4_1' value='' tabindex='3'   aria-required='false'    \/>\n                                        <label for='input_7_4_1' id='input_7_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_7_4_3' value='' tabindex='4'   aria-required='false'    \/>\n                                    <label for='input_7_4_3' id='input_7_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_4_4_container' >\n                                        <input type='text' name='input_4.4' id='input_7_4_4' value='' tabindex='6'     aria-required='false'    \/>\n                                        <label for='input_7_4_4' id='input_7_4_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_7_4_5' value='' tabindex='7'   aria-required='false'    \/>\n                                    <label for='input_7_4_5' id='input_7_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_7_4_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_7_5\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_5\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mailing Address (If Different)<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_7_5' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_5_1_container' >\n                                        <input type='text' name='input_5.1' id='input_7_5_1' value='' tabindex='8'   aria-required='false'    \/>\n                                        <label for='input_7_5_1' id='input_7_5_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_5_3_container' >\n                                    <input type='text' name='input_5.3' id='input_7_5_3' value='' tabindex='9'   aria-required='false'    \/>\n                                    <label for='input_7_5_3' id='input_7_5_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_5_4_container' >\n                                        <input type='text' name='input_5.4' id='input_7_5_4' value='' tabindex='11'     aria-required='false'    \/>\n                                        <label for='input_7_5_4' id='input_7_5_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_5_5_container' >\n                                    <input type='text' name='input_5.5' id='input_7_5_5' value='' tabindex='12'   aria-required='false'    \/>\n                                    <label for='input_7_5_5' id='input_7_5_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_5.6' id='input_7_5_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_7_6\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_6\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name of Owner (If Different)\/Additional Owner<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_7_6'>\n                            \n                            <span id='input_7_6_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.3' id='input_7_6_3' value='' tabindex='14'  aria-required='false'     \/>\n                                                    <label for='input_7_6_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_7_6_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.4' id='input_7_6_4' value='' tabindex='15'  aria-required='false'     \/>\n                                                    <label for='input_7_6_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_7_6_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_6.6' id='input_7_6_6' value='' tabindex='16'  aria-required='false'     \/>\n                                                    <label for='input_7_6_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_7_7\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_7\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Residence Address of Owner<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_7_7' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_7_1_container' >\n                                        <input type='text' name='input_7.1' id='input_7_7_1' value='' tabindex='18'   aria-required='false'    \/>\n                                        <label for='input_7_7_1' id='input_7_7_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_7_3_container' >\n                                    <input type='text' name='input_7.3' id='input_7_7_3' value='' tabindex='19'   aria-required='false'    \/>\n                                    <label for='input_7_7_3' id='input_7_7_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_7_4_container' >\n                                        <input type='text' name='input_7.4' id='input_7_7_4' value='' tabindex='21'     aria-required='false'    \/>\n                                        <label for='input_7_7_4' id='input_7_7_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_7_5_container' >\n                                    <input type='text' name='input_7.5' id='input_7_7_5' value='' tabindex='22'   aria-required='false'    \/>\n                                    <label for='input_7_7_5' id='input_7_7_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_7.6' id='input_7_7_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_7_8\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_8\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Billing Address of Owner (If Different)<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_7_8' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_8_1_container' >\n                                        <input type='text' name='input_8.1' id='input_7_8_1' value='' tabindex='23'   aria-required='false'    \/>\n                                        <label for='input_7_8_1' id='input_7_8_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_8_3_container' >\n                                    <input type='text' name='input_8.3' id='input_7_8_3' value='' tabindex='24'   aria-required='false'    \/>\n                                    <label for='input_7_8_3' id='input_7_8_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_8_4_container' >\n                                        <input type='text' name='input_8.4' id='input_7_8_4' value='' tabindex='26'     aria-required='false'    \/>\n                                        <label for='input_7_8_4' id='input_7_8_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_8_5_container' >\n                                    <input type='text' name='input_8.5' id='input_7_8_5' value='' tabindex='27'   aria-required='false'    \/>\n                                    <label for='input_7_8_5' id='input_7_8_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_8.6' id='input_7_8_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_7_9' class='gform_next_button gform-theme-button button' value='Next' tabindex='28' onclick='jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_2' class='gform_page' data-js='page-field-id-9' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_2' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_7_136\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_136\" ><h3 class=\"gsection_title\">Owner\/Operator Information<\/h3><\/div><div id=\"field_7_14\" class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left o_medium\"  data-field-class=\"gf_third gf_left o_medium\" data-js-reload=\"field_7_14\" ><label class='gfield_label gform-field-label' for='input_7_14'>Primary Owner&#039;s Phone Number<\/label><div class='ginput_container ginput_container_phone'><input name='input_14' id='input_7_14' type='tel' value='' class='small' tabindex='29'   aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_7_10\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_10\" ><label class='gfield_label gform-field-label' for='input_7_10'>Primary Owner&#039;s SSN<\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_7_10' type='text' value='' class='small'   tabindex='30'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_11\" class=\"gfield gfield--type-email field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_right o_medium\"  data-field-class=\"gf_third gf_right o_medium\" data-js-reload=\"field_7_11\" ><label class='gfield_label gform-field-label' for='input_7_11'>Primary Owner&#039;s Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_11' id='input_7_11' type='email' value='' class='small' tabindex='31'    aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_7_12\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_newline gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_newline gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_12\" ><legend class='gfield_label gform-field-label' >Primary Owner&#039;s Marital Status<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_12'>\n\t\t\t<div class='gchoice gchoice_7_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Single'  id='choice_7_12_0' onchange='gformToggleRadioOther( this )'  tabindex='32'  \/>\n\t\t\t\t\t<label for='choice_7_12_0' id='label_7_12_0' class='gform-field-label gform-field-label--type-inline'>Single<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Married'  id='choice_7_12_1' onchange='gformToggleRadioOther( this )'  tabindex='33'  \/>\n\t\t\t\t\t<label for='choice_7_12_1' id='label_7_12_1' class='gform-field-label gform-field-label--type-inline'>Married<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_13\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right gf_list_3col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_right gf_list_3col gfsp_dot o_medium\" data-js-reload=\"field_7_13\" ><legend class='gfield_label gform-field-label' >Primary Owner&#039;s Home Ownership\/Residence Status<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_13'>\n\t\t\t<div class='gchoice gchoice_7_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Own'  id='choice_7_13_0' onchange='gformToggleRadioOther( this )'  tabindex='34'  \/>\n\t\t\t\t\t<label for='choice_7_13_0' id='label_7_13_0' class='gform-field-label gform-field-label--type-inline'>Own<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Rent'  id='choice_7_13_1' onchange='gformToggleRadioOther( this )'  tabindex='35'  \/>\n\t\t\t\t\t<label for='choice_7_13_1' id='label_7_13_1' class='gform-field-label gform-field-label--type-inline'>Rent<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_13_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='gf_other_choice'  id='choice_7_13_2' onchange='gformToggleRadioOther( this )'  tabindex='36'  \/>\n\t\t\t\t\t<label for='choice_7_13_2' id='label_7_13_2' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_7_13_other' class='gchoice_other_control' name='input_13_other' type='text' value='Other' aria-label='Other Choice, please specify' tabindex='36' disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_15\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_newline gf_left o_medium\"  data-field-class=\"gf_half gf_newline gf_left o_medium\" data-js-reload=\"field_7_15\" ><label class='gfield_label gform-field-label' for='input_7_15'>Primary Owner\/Beneficial Owner&#039;s Occupation<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_7_15' type='text' value='' class='small'   tabindex='37'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_16\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right o_medium\"  data-field-class=\"gf_half gf_right o_medium\" data-js-reload=\"field_7_16\" ><label class='gfield_label gform-field-label' for='input_7_16'>Primary Owner\/Beneficial Owner&#039;s Employer\/Name of Business<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_7_16' type='text' value='' class='small'   tabindex='38'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_20\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_newline gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_newline gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_20\" ><legend class='gfield_label gform-field-label' >Does primary operator hold a U.S.C.G. license?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_20'>\n\t\t\t<div class='gchoice gchoice_7_20_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='Yes'  id='choice_7_20_0' onchange='gformToggleRadioOther( this )'  tabindex='39'  \/>\n\t\t\t\t\t<label for='choice_7_20_0' id='label_7_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_20_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_20' type='radio' value='No'  id='choice_7_20_1' onchange='gformToggleRadioOther( this )'  tabindex='40'  \/>\n\t\t\t\t\t<label for='choice_7_20_1' id='label_7_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_21\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_right gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_21\" ><legend class='gfield_label gform-field-label' >Is there a paid captain?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_21'>\n\t\t\t<div class='gchoice gchoice_7_21_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='Yes'  id='choice_7_21_0' onchange='gformToggleRadioOther( this )'  tabindex='41'  \/>\n\t\t\t\t\t<label for='choice_7_21_0' id='label_7_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_21_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_21' type='radio' value='No'  id='choice_7_21_1' onchange='gformToggleRadioOther( this )'  tabindex='42'  \/>\n\t\t\t\t\t<label for='choice_7_21_1' id='label_7_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_137\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_newline gf_left o_medium\"  data-field-class=\"gf_half gf_newline gf_left o_medium\" data-js-reload=\"field_7_137\" ><label class='gfield_label gform-field-label' for='input_7_137'>Attach Copy<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='477102080' \/><input name='input_137' id='input_7_137' type='file' class='medium' aria-describedby=\"gfield_upload_rules_7_137\" onchange='javascript:gformValidateFileSize( this, 477102080 );' tabindex='43' \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_7_137'>Max. file size: 455 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_7_137'><\/div><\/div><\/div><div id=\"field_7_138\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right o_medium\"  data-field-class=\"gf_half gf_right o_medium\" data-js-reload=\"field_7_138\" ><label class='gfield_label gform-field-label' for='input_7_138'>Attach Copy<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='477102080' \/><input name='input_138' id='input_7_138' type='file' class='medium' aria-describedby=\"gfield_upload_rules_7_138\" onchange='javascript:gformValidateFileSize( this, 477102080 );' tabindex='44' \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_7_138'>Max. file size: 455 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_7_138'><\/div><\/div><\/div><fieldset id=\"field_7_22\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_22\" ><legend class='gfield_label gform-field-label' >Does captain hold a U.S.C.G. license?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_22'>\n\t\t\t<div class='gchoice gchoice_7_22_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='Yes'  id='choice_7_22_0' onchange='gformToggleRadioOther( this )'  tabindex='45'  \/>\n\t\t\t\t\t<label for='choice_7_22_0' id='label_7_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_22_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_22' type='radio' value='No'  id='choice_7_22_1' onchange='gformToggleRadioOther( this )'  tabindex='46'  \/>\n\t\t\t\t\t<label for='choice_7_22_1' id='label_7_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_23\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right o_medium\"  data-field-class=\"gf_half gf_right o_medium\" data-js-reload=\"field_7_23\" ><label class='gfield_label gform-field-label' for='input_7_23'>Total Number of Paid Crew (Including Captain)<\/label><div class='ginput_container ginput_container_number'><input name='input_23' id='input_7_23' type='number' step='any'   value='' class='small' tabindex='47'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_139\" class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" data-js-reload=\"field_7_139\" ><label class='gfield_label gform-field-label' for='input_7_139'>Attach Copy<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='477102080' \/><input name='input_139' id='input_7_139' type='file' class='medium' aria-describedby=\"gfield_upload_rules_7_139\" onchange='javascript:gformValidateFileSize( this, 477102080 );' tabindex='48' \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_7_139'>Max. file size: 455 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_7_139'><\/div><\/div><\/div><div id=\"field_7_25\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_25\" ><h3 class=\"gsection_title\">Regular Operators<\/h3><\/div><fieldset id=\"field_7_141\" class=\"gfield gfield--type-list field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible o_medium\"  data-field-class=\"o_medium\" data-js-reload=\"field_7_141\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Add one or multiple<\/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\">Regular Operator Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">DOB<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Boating Courses? (Y\/N)<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Driver License Number<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">State<\/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_141_cell1 gform-grid-col' data-label='Regular Operator Name'><input aria-invalid='false'   aria-label='Regular Operator Name, Row 1' data-aria-label-template='Regular Operator Name, Row {0}' type='text' name='input_141[]' value='' tabindex='49'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_141_cell2 gform-grid-col' data-label='DOB'><input aria-invalid='false'   aria-label='DOB, Row 1' data-aria-label-template='DOB, Row {0}' type='text' name='input_141[]' value='' tabindex='50'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_141_cell3 gform-grid-col' data-label='Boating Courses? (Y\/N)'><input aria-invalid='false'   aria-label='Boating Courses? (Y\/N), Row 1' data-aria-label-template='Boating Courses? (Y\/N), Row {0}' type='text' name='input_141[]' value='' tabindex='51'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_141_cell4 gform-grid-col' data-label='Driver License Number'><input aria-invalid='false'   aria-label='Driver License Number, Row 1' data-aria-label-template='Driver License Number, Row {0}' type='text' name='input_141[]' value='' tabindex='52'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_141_cell5 gform-grid-col' data-label='State'><input aria-invalid='false'   aria-label='State, Row 1' data-aria-label-template='State, Row {0}' type='text' name='input_141[]' value='' tabindex='53'  \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type=\"button\"  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 5)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 5)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_32\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_quarter gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_32\" ><legend class='gfield_label gform-field-label' >Does primary owner currently have insurance for this vessel?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_32'>\n\t\t\t<div class='gchoice gchoice_7_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Yes'  id='choice_7_32_0' onchange='gformToggleRadioOther( this )'  tabindex='54'  \/>\n\t\t\t\t\t<label for='choice_7_32_0' id='label_7_32_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='No'  id='choice_7_32_1' onchange='gformToggleRadioOther( this )'  tabindex='55'  \/>\n\t\t\t\t\t<label for='choice_7_32_1' id='label_7_32_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_33\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" data-js-reload=\"field_7_33\" ><label class='gfield_label gform-field-label' for='input_7_33'>Previous\/Current Insurance Company<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_7_33' type='text' value='' class='small'   tabindex='56'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_34\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_34\" ><label class='gfield_label gform-field-label' for='input_7_34'>Premium<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_7_34' type='text' value='' class='small'   tabindex='57'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_35\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_quarter gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_35\" ><legend class='gfield_label gform-field-label' >Has owner ever had insurance canceled, non-renewed, or declined?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_35'>\n\t\t\t<div class='gchoice gchoice_7_35_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='Yes'  id='choice_7_35_0' onchange='gformToggleRadioOther( this )'  tabindex='58'  \/>\n\t\t\t\t\t<label for='choice_7_35_0' id='label_7_35_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_35_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_35' type='radio' value='No'  id='choice_7_35_1' onchange='gformToggleRadioOther( this )'  tabindex='59'  \/>\n\t\t\t\t\t<label for='choice_7_35_1' id='label_7_35_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_36\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_36\" ><label class='gfield_label gform-field-label' for='input_7_36'>Company Name<\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_7_36' type='text' value='' class='small'   tabindex='60'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_37\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_37\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Date<\/legend><div id='input_7_37' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_37_1_container'>\n                                            <input type='number' maxlength='2' name='input_37[]' id='input_7_37_1' value='' tabindex='61'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_37_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_37_2_container'>\n                                            <input type='number' maxlength='2' name='input_37[]' id='input_7_37_2' value='' tabindex='62'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_37_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_37_3_container'>\n                                            <input type='number' maxlength='4' name='input_37[]' id='input_7_37_3' value='' tabindex='63'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_37_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_38\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_38\" ><label class='gfield_label gform-field-label' for='input_7_38'>Reasons<\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_7_38' type='text' value='' class='small'   tabindex='64'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_39\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_quarter gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_39\" ><legend class='gfield_label gform-field-label' >Has any owner or operator sustained any marine claims or losses?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_39'>\n\t\t\t<div class='gchoice gchoice_7_39_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='Yes'  id='choice_7_39_0' onchange='gformToggleRadioOther( this )'  tabindex='65'  \/>\n\t\t\t\t\t<label for='choice_7_39_0' id='label_7_39_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_39_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_39' type='radio' value='No'  id='choice_7_39_1' onchange='gformToggleRadioOther( this )'  tabindex='66'  \/>\n\t\t\t\t\t<label for='choice_7_39_1' id='label_7_39_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_40\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_40\" ><label class='gfield_label gform-field-label' for='input_7_40'>Company Name<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_7_40' type='text' value='' class='small'   tabindex='67'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_41\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_41\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Date<\/legend><div id='input_7_41' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_41_1_container'>\n                                            <input type='number' maxlength='2' name='input_41[]' id='input_7_41_1' value='' tabindex='68'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_41_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_41_2_container'>\n                                            <input type='number' maxlength='2' name='input_41[]' id='input_7_41_2' value='' tabindex='69'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_41_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_41_3_container'>\n                                            <input type='number' maxlength='4' name='input_41[]' id='input_7_41_3' value='' tabindex='70'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_41_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_43\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_43\" ><label class='gfield_label gform-field-label' for='input_7_43'>Amount Paid<\/label><div class='ginput_container ginput_container_number'><input name='input_43' id='input_7_43' type='text' step='any'   value='' class='small' tabindex='71'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_42\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible o_medium\"  data-field-class=\"o_medium\" data-js-reload=\"field_7_42\" ><label class='gfield_label gform-field-label' for='input_7_42'>Cause<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_7_42' type='text' value='' class='small'   tabindex='72'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_44\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_quarter gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_44\" ><legend class='gfield_label gform-field-label' >Does vessel have unrepaired damage or was it purchased as salvage?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_44'>\n\t\t\t<div class='gchoice gchoice_7_44_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='Yes'  id='choice_7_44_0' onchange='gformToggleRadioOther( this )'  tabindex='73'  \/>\n\t\t\t\t\t<label for='choice_7_44_0' id='label_7_44_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_44_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_44' type='radio' value='No'  id='choice_7_44_1' onchange='gformToggleRadioOther( this )'  tabindex='74'  \/>\n\t\t\t\t\t<label for='choice_7_44_1' id='label_7_44_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_45\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right o_medium\"  data-field-class=\"gf_half gf_right o_medium\" data-js-reload=\"field_7_45\" ><label class='gfield_label gform-field-label' for='input_7_45'>Provide Details<\/label><div class='ginput_container ginput_container_text'><input name='input_45' id='input_7_45' type='text' value='' class='small'   tabindex='75'   aria-invalid=\"false\"   \/> <\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_47' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous' tabindex='76' onclick='jQuery(\"#gform_target_page_number_7\").val(\"1\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"1\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_7_47' class='gform_next_button gform-theme-button button' value='Next' tabindex='77' onclick='jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_3' class='gform_page' data-js='page-field-id-47' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_3' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_7_49\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_49\" ><h3 class=\"gsection_title\">Vessel &amp; Equipment Information<\/h3><\/div><fieldset id=\"field_7_177\" class=\"gfield gfield--type-list field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_177\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Previously Owned Vessels<\/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\">Years Owned TO-FROM<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Year<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Make<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Model<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Length<\/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_177_cell1 gform-grid-col' data-label='Years Owned TO-FROM'><input aria-invalid='false'   aria-label='Years Owned TO-FROM, Row 1' data-aria-label-template='Years Owned TO-FROM, Row {0}' type='text' name='input_177[]' value='' tabindex='78'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_177_cell2 gform-grid-col' data-label='Year'><input aria-invalid='false'   aria-label='Year, Row 1' data-aria-label-template='Year, Row {0}' type='text' name='input_177[]' value='' tabindex='79'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_177_cell3 gform-grid-col' data-label='Make'><input aria-invalid='false'   aria-label='Make, Row 1' data-aria-label-template='Make, Row {0}' type='text' name='input_177[]' value='' tabindex='80'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_177_cell4 gform-grid-col' data-label='Model'><input aria-invalid='false'   aria-label='Model, Row 1' data-aria-label-template='Model, Row {0}' type='text' name='input_177[]' value='' tabindex='81'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_177_cell5 gform-grid-col' data-label='Length'><input aria-invalid='false'   aria-label='Length, Row 1' data-aria-label-template='Length, Row {0}' type='text' name='input_177[]' value='' tabindex='82'  \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type=\"button\"  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_7_179\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_179\" ><h3 class=\"gsection_title\">Vessel to be quoted<\/h3><\/div><div id=\"field_7_48\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_48\" ><label class='gfield_label gform-field-label' for='input_7_48'>Year Built<\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_7_48' type='text' value='' class='small'   tabindex='83'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_50\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_50\" ><label class='gfield_label gform-field-label' for='input_7_50'>Length (Feet)<\/label><div class='ginput_container ginput_container_number'><input name='input_50' id='input_7_50' type='number' step='any'   value='' class='small' tabindex='84'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_51\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_51\" ><label class='gfield_label gform-field-label' for='input_7_51'>Builder\/Manufacturer<\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_7_51' type='text' value='' class='small'   tabindex='85'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_52\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_52\" ><label class='gfield_label gform-field-label' for='input_7_52'>Model Name<\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_7_52' type='text' value='' class='small'   tabindex='86'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_53\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_53\" ><label class='gfield_label gform-field-label' for='input_7_53'>Vessel Type (Power\/Sail; Single\/Multi-Hull)<\/label><div class='ginput_container ginput_container_text'><input name='input_53' id='input_7_53' type='text' value='' class='small'   tabindex='87'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_54\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_54\" ><label class='gfield_label gform-field-label' for='input_7_54'>Purchase Price $<\/label><div class='ginput_container ginput_container_number'><input name='input_54' id='input_7_54' type='text' step='any'   value='' class='small' tabindex='88'     aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_7_55\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_55\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Purchase Date<\/legend><div id='input_7_55' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_55_1_container'>\n                                            <input type='number' maxlength='2' name='input_55[]' id='input_7_55_1' value='' tabindex='89'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_55_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_55_2_container'>\n                                            <input type='number' maxlength='2' name='input_55[]' id='input_7_55_2' value='' tabindex='90'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_55_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_55_3_container'>\n                                            <input type='number' maxlength='4' name='input_55[]' id='input_7_55_3' value='' tabindex='91'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_55_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_57\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_57\" ><label class='gfield_label gform-field-label' for='input_7_57'>Hull ID\/Documentation Number<\/label><div class='ginput_container ginput_container_text'><input name='input_57' id='input_7_57' type='text' value='' class='small'   tabindex='92'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_58\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_left o_medium\"  data-field-class=\"gf_half gf_left o_medium\" data-js-reload=\"field_7_58\" ><label class='gfield_label gform-field-label' for='input_7_58'>Vessel&#039;s Name<\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_7_58' type='text' value='' class='small'   tabindex='93'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_59\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right o_medium\"  data-field-class=\"gf_half gf_right o_medium\" data-js-reload=\"field_7_59\" ><label class='gfield_label gform-field-label' for='input_7_59'>Maximum Speed (MPH)<\/label><div class='ginput_container ginput_container_number'><input name='input_59' id='input_7_59' type='number' step='any'   value='' class='small' tabindex='94'     aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_7_60\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_left gf_list_inline gfsp_dot o_small\"  data-field-class=\"gf_half gf_left gf_list_inline gfsp_dot o_small\" data-js-reload=\"field_7_60\" ><legend class='gfield_label gform-field-label' >Hull Material<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_60'>\n\t\t\t<div class='gchoice gchoice_7_60_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Fiberglass'  id='choice_7_60_0' onchange='gformToggleRadioOther( this )'  tabindex='95'  \/>\n\t\t\t\t\t<label for='choice_7_60_0' id='label_7_60_0' class='gform-field-label gform-field-label--type-inline'>Fiberglass<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_60_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Wood'  id='choice_7_60_1' onchange='gformToggleRadioOther( this )'  tabindex='96'  \/>\n\t\t\t\t\t<label for='choice_7_60_1' id='label_7_60_1' class='gform-field-label gform-field-label--type-inline'>Wood<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_60_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Steel'  id='choice_7_60_2' onchange='gformToggleRadioOther( this )'  tabindex='97'  \/>\n\t\t\t\t\t<label for='choice_7_60_2' id='label_7_60_2' class='gform-field-label gform-field-label--type-inline'>Steel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_60_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='Aluminum'  id='choice_7_60_3' onchange='gformToggleRadioOther( this )'  tabindex='98'  \/>\n\t\t\t\t\t<label for='choice_7_60_3' id='label_7_60_3' class='gform-field-label gform-field-label--type-inline'>Aluminum<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_60_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_60' type='radio' value='gf_other_choice'  id='choice_7_60_4' onchange='gformToggleRadioOther( this )'  tabindex='99'  \/>\n\t\t\t\t\t<label for='choice_7_60_4' id='label_7_60_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_7_60_other' class='gchoice_other_control' name='input_60_other' type='text' value='Other' aria-label='Other Choice, please specify' tabindex='99' disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_61\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_61\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Last Marine Survey Date<\/legend><div id='input_7_61' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_61_1_container'>\n                                            <input type='number' maxlength='2' name='input_61[]' id='input_7_61_1' value='' tabindex='100'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_61_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_61_2_container'>\n                                            <input type='number' maxlength='2' name='input_61[]' id='input_7_61_2' value='' tabindex='101'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_61_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_61_3_container'>\n                                            <input type='number' maxlength='4' name='input_61[]' id='input_7_61_3' value='' tabindex='102'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_61_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_62\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_62\" ><label class='gfield_label gform-field-label' for='input_7_62'>Mast Material (If Sailboat)<\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_7_62' type='text' value='' class='small'   tabindex='103'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_63\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_inline gfsp_dot o_medium\"  data-field-class=\"gf_list_inline gfsp_dot o_medium\" data-js-reload=\"field_7_63\" ><legend class='gfield_label gform-field-label' >Engine\/Propulsion Drive System<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_63'>\n\t\t\t<div class='gchoice gchoice_7_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Outboard'  id='choice_7_63_0' onchange='gformToggleRadioOther( this )'  tabindex='104'  \/>\n\t\t\t\t\t<label for='choice_7_63_0' id='label_7_63_0' class='gform-field-label gform-field-label--type-inline'>Outboard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Inboard'  id='choice_7_63_1' onchange='gformToggleRadioOther( this )'  tabindex='105'  \/>\n\t\t\t\t\t<label for='choice_7_63_1' id='label_7_63_1' class='gform-field-label gform-field-label--type-inline'>Inboard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='I\/O'  id='choice_7_63_2' onchange='gformToggleRadioOther( this )'  tabindex='106'  \/>\n\t\t\t\t\t<label for='choice_7_63_2' id='label_7_63_2' class='gform-field-label gform-field-label--type-inline'>I\/O<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Inboard\/POD'  id='choice_7_63_3' onchange='gformToggleRadioOther( this )'  tabindex='107'  \/>\n\t\t\t\t\t<label for='choice_7_63_3' id='label_7_63_3' class='gform-field-label gform-field-label--type-inline'>Inboard\/POD<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Inboard\/Jet'  id='choice_7_63_4' onchange='gformToggleRadioOther( this )'  tabindex='108'  \/>\n\t\t\t\t\t<label for='choice_7_63_4' id='label_7_63_4' class='gform-field-label gform-field-label--type-inline'>Inboard\/Jet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Inboard\/Surface Piercing'  id='choice_7_63_5' onchange='gformToggleRadioOther( this )'  tabindex='109'  \/>\n\t\t\t\t\t<label for='choice_7_63_5' id='label_7_63_5' class='gform-field-label gform-field-label--type-inline'>Inboard\/Surface Piercing<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_63_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='None'  id='choice_7_63_6' onchange='gformToggleRadioOther( this )'  tabindex='110'  \/>\n\t\t\t\t\t<label for='choice_7_63_6' id='label_7_63_6' class='gform-field-label gform-field-label--type-inline'>None<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_64\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_64\" ><label class='gfield_label gform-field-label' for='input_7_64'>Number of Engines<\/label><div class='ginput_container ginput_container_number'><input name='input_64' id='input_7_64' type='number' step='any'   value='' class='small' tabindex='111'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_69\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_69\" ><label class='gfield_label gform-field-label' for='input_7_69'>Total H.P.<\/label><div class='ginput_container ginput_container_number'><input name='input_69' id='input_7_69' type='number' step='any'   value='' class='small' tabindex='112'     aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_7_66\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right gf_list_4col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_right gf_list_4col gfsp_dot o_medium\" data-js-reload=\"field_7_66\" ><legend class='gfield_label gform-field-label' >Fuel Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_66'>\n\t\t\t<div class='gchoice gchoice_7_66_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Gas w\/ No Fume Detector'  id='choice_7_66_0' onchange='gformToggleRadioOther( this )'  tabindex='113'  \/>\n\t\t\t\t\t<label for='choice_7_66_0' id='label_7_66_0' class='gform-field-label gform-field-label--type-inline'>Gas w\/ No Fume Detector<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_66_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Gas w\/ Fume Detector'  id='choice_7_66_1' onchange='gformToggleRadioOther( this )'  tabindex='114'  \/>\n\t\t\t\t\t<label for='choice_7_66_1' id='label_7_66_1' class='gform-field-label gform-field-label--type-inline'>Gas w\/ Fume Detector<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_66_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Hybrid\/Electric'  id='choice_7_66_2' onchange='gformToggleRadioOther( this )'  tabindex='115'  \/>\n\t\t\t\t\t<label for='choice_7_66_2' id='label_7_66_2' class='gform-field-label gform-field-label--type-inline'>Hybrid\/Electric<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_66_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Diesel'  id='choice_7_66_3' onchange='gformToggleRadioOther( this )'  tabindex='116'  \/>\n\t\t\t\t\t<label for='choice_7_66_3' id='label_7_66_3' class='gform-field-label gform-field-label--type-inline'>Diesel<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_142\" class=\"gfield gfield--type-list field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible o_medium\"  data-field-class=\"o_medium\" data-js-reload=\"field_7_142\" ><legend class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><\/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\">Engine Manufacturer<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Year Built<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">H.P. Each<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Engine Serial Numbers (Outboard Only<\/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_142_cell1 gform-grid-col' data-label='Engine Manufacturer'><input aria-invalid='false'   aria-label='Engine Manufacturer, Row 1' data-aria-label-template='Engine Manufacturer, Row {0}' type='text' name='input_142[]' value='' tabindex='117'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_142_cell2 gform-grid-col' data-label='Year Built'><input aria-invalid='false'   aria-label='Year Built, Row 1' data-aria-label-template='Year Built, Row {0}' type='text' name='input_142[]' value='' tabindex='118'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_142_cell3 gform-grid-col' data-label='H.P. Each'><input aria-invalid='false'   aria-label='H.P. Each, Row 1' data-aria-label-template='H.P. Each, Row {0}' type='text' name='input_142[]' value='' tabindex='119'  \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_142_cell4 gform-grid-col' data-label='Engine Serial Numbers (Outboard Only'><input aria-invalid='false'   aria-label='Engine Serial Numbers (Outboard Only, Row 1' data-aria-label-template='Engine Serial Numbers (Outboard Only, Row {0}' type='text' name='input_142[]' value='' tabindex='120'  \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type=\"button\"  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 6)'>Add<\/button>   <button type=\"button\"  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 6)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_72\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_inline gfsp_dot o_medium\"  data-field-class=\"gf_list_inline gfsp_dot o_medium\" data-js-reload=\"field_7_72\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Equipment (Check all that apply)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_72'><div class='gchoice gchoice_7_72_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.1' type='checkbox'  value='Built-in Auto Fire Extinguishing System'  id='choice_7_72_1' tabindex='121'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_72_1' id='label_7_72_1' class='gform-field-label gform-field-label--type-inline'>Built-in Auto Fire Extinguishing System<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_72_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.2' type='checkbox'  value='Fume Detector'  id='choice_7_72_2' tabindex='122'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_72_2' id='label_7_72_2' class='gform-field-label gform-field-label--type-inline'>Fume Detector<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_72_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.3' type='checkbox'  value='Carbon Monoxide Detector'  id='choice_7_72_3' tabindex='123'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_72_3' id='label_7_72_3' class='gform-field-label gform-field-label--type-inline'>Carbon Monoxide Detector<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_72_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_72.4' type='checkbox'  value='Alarm\/ Monitoring System'  id='choice_7_72_4' tabindex='124'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_72_4' id='label_7_72_4' class='gform-field-label gform-field-label--type-inline'>Alarm\/ Monitoring System<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_73\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left o_medium\"  data-field-class=\"gf_third gf_left o_medium\" data-js-reload=\"field_7_73\" ><label class='gfield_label gform-field-label' for='input_7_73'>Alarm Manufacturer<\/label><div class='ginput_container ginput_container_text'><input name='input_73' id='input_7_73' type='text' value='' class='small'   tabindex='125'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_74\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_74\" ><label class='gfield_label gform-field-label' for='input_7_74'>Alarm Model<\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_7_74' type='text' value='' class='small'   tabindex='126'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_75\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_right o_medium\"  data-field-class=\"gf_third gf_right o_medium\" data-js-reload=\"field_7_75\" ><label class='gfield_label gform-field-label' for='input_7_75'>Alarm Type<\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_7_75' type='text' value='' class='small'   tabindex='127'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_76\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left o_medium\"  data-field-class=\"gf_third gf_left o_medium\" data-js-reload=\"field_7_76\" ><label class='gfield_label gform-field-label' for='input_7_76'>Trailer Manufacturer<\/label><div class='ginput_container ginput_container_text'><input name='input_76' id='input_7_76' type='text' value='' class='small'   tabindex='128'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_77\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_77\" ><label class='gfield_label gform-field-label' for='input_7_77'>Year Built<\/label><div class='ginput_container ginput_container_text'><input name='input_77' id='input_7_77' type='text' value='' class='small'   tabindex='129'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_78\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_right o_medium\"  data-field-class=\"gf_third gf_right o_medium\" data-js-reload=\"field_7_78\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Purchase Date<\/legend><div id='input_7_78' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_78_1_container'>\n                                            <input type='number' maxlength='2' name='input_78[]' id='input_7_78_1' value='' tabindex='130'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_78_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_78_2_container'>\n                                            <input type='number' maxlength='2' name='input_78[]' id='input_7_78_2' value='' tabindex='131'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_78_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_78_3_container'>\n                                            <input type='number' maxlength='4' name='input_78[]' id='input_7_78_3' value='' tabindex='132'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_78_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_79\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left o_medium\"  data-field-class=\"gf_third gf_left o_medium\" data-js-reload=\"field_7_79\" ><label class='gfield_label gform-field-label' for='input_7_79'>Trailer Value<\/label><div class='ginput_container ginput_container_number'><input name='input_79' id='input_7_79' type='text' step='any'   value='' class='small' tabindex='133'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_80\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_right o_medium\"  data-field-class=\"gf_third gf_right o_medium\" data-js-reload=\"field_7_80\" ><label class='gfield_label gform-field-label' for='input_7_80'>Trailer Serial Number<\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_7_80' type='text' value='' class='small'   tabindex='134'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_81\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_81\" ><legend class='gfield_label gform-field-label' >Tender\/Dinghy Coverage Options<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_81'>\n\t\t\t<div class='gchoice gchoice_7_81_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Tender\/Dinghy Not Scheduled (No Charge)'  id='choice_7_81_0' onchange='gformToggleRadioOther( this )'  tabindex='135'  \/>\n\t\t\t\t\t<label for='choice_7_81_0' id='label_7_81_0' class='gform-field-label gform-field-label--type-inline'>Tender\/Dinghy Not Scheduled (No Charge)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_81_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_81' type='radio' value='Tender\/Dinghy Scheduled (Charge)'  id='choice_7_81_1' onchange='gformToggleRadioOther( this )'  tabindex='136'  \/>\n\t\t\t\t\t<label for='choice_7_81_1' id='label_7_81_1' class='gform-field-label gform-field-label--type-inline'>Tender\/Dinghy Scheduled (Charge)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_143\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_left o_medium\"  data-field-class=\"gf_left o_medium\" data-js-reload=\"field_7_143\" ><b>Actual Cash Value and Vessel Hull Deductible Amount applies (Not Scheduled)<\/b>\n\n<p>However, if policy type is Yachtsman or Boatsman, then tenders 17 ft or less in length with motor 40 hp or less are subject to $250 deductible <\/p><\/div><fieldset id=\"field_7_82\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_third gf_left gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_82\" ><legend class='gfield_label gform-field-label' >Deductible Option<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_82'>\n\t\t\t<div class='gchoice gchoice_7_82_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='$250'  id='choice_7_82_0' onchange='gformToggleRadioOther( this )'  tabindex='137'  \/>\n\t\t\t\t\t<label for='choice_7_82_0' id='label_7_82_0' class='gform-field-label gform-field-label--type-inline'>$250<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_82_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_82' type='radio' value='$500'  id='choice_7_82_1' onchange='gformToggleRadioOther( this )'  tabindex='138'  \/>\n\t\t\t\t\t<label for='choice_7_82_1' id='label_7_82_1' class='gform-field-label gform-field-label--type-inline'>$500<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_83\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_third gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_83\" ><legend class='gfield_label gform-field-label' >Loss Settlement Option<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_83'>\n\t\t\t<div class='gchoice gchoice_7_83_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='Agreed Value'  id='choice_7_83_0' onchange='gformToggleRadioOther( this )'  tabindex='139'  \/>\n\t\t\t\t\t<label for='choice_7_83_0' id='label_7_83_0' class='gform-field-label gform-field-label--type-inline'>Agreed Value<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_83_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_83' type='radio' value='Actual Cash Value'  id='choice_7_83_1' onchange='gformToggleRadioOther( this )'  tabindex='140'  \/>\n\t\t\t\t\t<label for='choice_7_83_1' id='label_7_83_1' class='gform-field-label gform-field-label--type-inline'>Actual Cash Value<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_84\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_right gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_third gf_right gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_84\" ><legend class='gfield_label gform-field-label' >Tender Value<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_84'>\n\t\t\t<div class='gchoice gchoice_7_84_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='Included (In vessel hull limit)'  id='choice_7_84_0' onchange='gformToggleRadioOther( this )'  tabindex='141'  \/>\n\t\t\t\t\t<label for='choice_7_84_0' id='label_7_84_0' class='gform-field-label gform-field-label--type-inline'>Included (In vessel hull limit)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_84_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_84' type='radio' value='Not included (in vessel hull limit)'  id='choice_7_84_1' onchange='gformToggleRadioOther( this )'  tabindex='142'  \/>\n\t\t\t\t\t<label for='choice_7_84_1' id='label_7_84_1' class='gform-field-label gform-field-label--type-inline'>Not included (in vessel hull limit)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_85' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous' tabindex='143' onclick='jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"2\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_7_85' class='gform_next_button gform-theme-button button' value='Next' tabindex='144' onclick='jQuery(\"#gform_target_page_number_7\").val(\"4\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"4\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_4' class='gform_page' data-js='page-field-id-85' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_4' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_7_86\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_86\" ><label class='gfield_label gform-field-label' for='input_7_86'>Tender Year<\/label><div class='ginput_container ginput_container_text'><input name='input_86' id='input_7_86' type='text' value='' class='small'   tabindex='145'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_87\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" data-js-reload=\"field_7_87\" ><label class='gfield_label gform-field-label' for='input_7_87'>Manufacturer<\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_7_87' type='text' value='' class='small'   tabindex='146'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_89\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_89\" ><label class='gfield_label gform-field-label' for='input_7_89'>Model<\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_7_89' type='text' value='' class='small'   tabindex='147'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_90\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_90\" ><label class='gfield_label gform-field-label' for='input_7_90'>Tender Value<\/label><div class='ginput_container ginput_container_number'><input name='input_90' id='input_7_90' type='text' step='any'   value='' class='small' tabindex='148'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_91\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_91\" ><label class='gfield_label gform-field-label' for='input_7_91'>Length (ft)<\/label><div class='ginput_container ginput_container_number'><input name='input_91' id='input_7_91' type='number' step='any'   value='' class='small' tabindex='149'     aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_7_92\" class=\"gfield gfield--type-date gfield--input-type-datefield field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_92\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Purchase Date<\/legend><div id='input_7_92' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_7_92_1_container'>\n                                            <input type='number' maxlength='2' name='input_92[]' id='input_7_92_1' value='' tabindex='150'  aria-required='false'   placeholder='MM' min='1' max='12' step='1'\/>\n                                            <label for='input_7_92_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                        <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_7_92_2_container'>\n                                            <input type='number' maxlength='2' name='input_92[]' id='input_7_92_2' value='' tabindex='151'  aria-required='false'   placeholder='DD' min='1' max='31' step='1'\/>\n                                            <label for='input_7_92_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                        <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_7_92_3_container'>\n                                            <input type='number' maxlength='4' name='input_92[]' id='input_7_92_3' value='' tabindex='152'  aria-required='false'   placeholder='YYYY' min='1920' max='2025' step='1'\/>\n                                            <label for='input_7_92_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                       <\/div>\n                                   <\/div><\/fieldset><div id=\"field_7_93\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_93\" ><label class='gfield_label gform-field-label' for='input_7_93'>Serial Number<\/label><div class='ginput_container ginput_container_text'><input name='input_93' id='input_7_93' type='text' value='' class='small'   tabindex='153'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_94\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_94\" ><label class='gfield_label gform-field-label' for='input_7_94'>Motor Year<\/label><div class='ginput_container ginput_container_text'><input name='input_94' id='input_7_94' type='text' value='' class='small'   tabindex='154'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_95\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half o_medium\"  data-field-class=\"gf_half o_medium\" data-js-reload=\"field_7_95\" ><label class='gfield_label gform-field-label' for='input_7_95'>Motor Manufacturer<\/label><div class='ginput_container ginput_container_text'><input name='input_95' id='input_7_95' type='text' value='' class='small'   tabindex='155'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_96\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_right o_medium\"  data-field-class=\"gf_quarter gf_right o_medium\" data-js-reload=\"field_7_96\" ><label class='gfield_label gform-field-label' for='input_7_96'>Serial Number<\/label><div class='ginput_container ginput_container_text'><input name='input_96' id='input_7_96' type='text' value='' class='small'   tabindex='156'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_97\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter gf_left o_medium\"  data-field-class=\"gf_quarter gf_left o_medium\" data-js-reload=\"field_7_97\" ><label class='gfield_label gform-field-label' for='input_7_97'>Motor H.P.<\/label><div class='ginput_container ginput_container_number'><input name='input_97' id='input_7_97' type='number' step='any'   value='' class='small' tabindex='157'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_98\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_98\" ><label class='gfield_label gform-field-label' for='input_7_98'>Motor Value (Outboards Only)<\/label><div class='ginput_container ginput_container_number'><input name='input_98' id='input_7_98' type='text' step='any'   value='' class='small' tabindex='158'     aria-invalid=\"false\"  \/><\/div><\/div><fieldset id=\"field_7_99\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right gf_list_3col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_right gf_list_3col gfsp_dot o_medium\" data-js-reload=\"field_7_99\" ><legend class='gfield_label gform-field-label' >Motor Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_99'>\n\t\t\t<div class='gchoice gchoice_7_99_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_99' type='radio' value='Outboard'  id='choice_7_99_0' onchange='gformToggleRadioOther( this )'  tabindex='159'  \/>\n\t\t\t\t\t<label for='choice_7_99_0' id='label_7_99_0' class='gform-field-label gform-field-label--type-inline'>Outboard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_99_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_99' type='radio' value='Inboard'  id='choice_7_99_1' onchange='gformToggleRadioOther( this )'  tabindex='160'  \/>\n\t\t\t\t\t<label for='choice_7_99_1' id='label_7_99_1' class='gform-field-label gform-field-label--type-inline'>Inboard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_99_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_99' type='radio' value='Inboard\/Outdrive'  id='choice_7_99_2' onchange='gformToggleRadioOther( this )'  tabindex='161'  \/>\n\t\t\t\t\t<label for='choice_7_99_2' id='label_7_99_2' class='gform-field-label gform-field-label--type-inline'>Inboard\/Outdrive<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_100' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous' tabindex='162' onclick='jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"3\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_7_100' class='gform_next_button gform-theme-button button' value='Next' tabindex='163' onclick='jQuery(\"#gform_target_page_number_7\").val(\"5\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"5\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_5' class='gform_page' data-js='page-field-id-100' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_5' class='gform_fields top_label form_sublabel_below description_below'><div id=\"field_7_102\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_102\" ><h3 class=\"gsection_title\">Operation of Vessel<\/h3><\/div><div id=\"field_7_101\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_101\" ><label class='gfield_label gform-field-label' for='input_7_101'>Waters to be navigated<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_101' id='input_7_101' class='textarea medium' tabindex='164'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_7_103\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_left o_medium\"  data-field-class=\"gf_half gf_left o_medium\" data-js-reload=\"field_7_103\" ><label class='gfield_label gform-field-label' for='input_7_103'>Lay up period (From MM\/DD to MM\/DD)<\/label><div class='ginput_container ginput_container_text'><input name='input_103' id='input_7_103' type='text' value='' class='small'   tabindex='165'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_104\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_right gf_list_3col gfsp_dot o_medium\"  data-field-class=\"gf_half gf_right gf_list_3col gfsp_dot o_medium\" data-js-reload=\"field_7_104\" ><legend class='gfield_label gform-field-label' >If laid up, vessel is decommissioned<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_104'>\n\t\t\t<div class='gchoice gchoice_7_104_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Ashore'  id='choice_7_104_0' onchange='gformToggleRadioOther( this )'  tabindex='166'  \/>\n\t\t\t\t\t<label for='choice_7_104_0' id='label_7_104_0' class='gform-field-label gform-field-label--type-inline'>Ashore<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_104_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Afloat'  id='choice_7_104_1' onchange='gformToggleRadioOther( this )'  tabindex='167'  \/>\n\t\t\t\t\t<label for='choice_7_104_1' id='label_7_104_1' class='gform-field-label gform-field-label--type-inline'>Afloat<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_104_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Afloat w\/Bubbler'  id='choice_7_104_2' onchange='gformToggleRadioOther( this )'  tabindex='168'  \/>\n\t\t\t\t\t<label for='choice_7_104_2' id='label_7_104_2' class='gform-field-label gform-field-label--type-inline'>Afloat w\/Bubbler<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_105\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_half gf_left o_medium\"  data-field-class=\"gf_half gf_left o_medium\" data-js-reload=\"field_7_105\" ><h3 class=\"gsection_title\">Berth\/Mooring Location of Vessel<\/h3><\/div><div id=\"field_7_106\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_106\" ><label class='gfield_label gform-field-label' for='input_7_106'>Marina Name<\/label><div class='ginput_container ginput_container_text'><input name='input_106' id='input_7_106' type='text' value='' class='small'   tabindex='169'   aria-invalid=\"false\"   \/> <\/div><\/div><fieldset id=\"field_7_107\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_107\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mooring Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_7_107' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_107_1_container' >\n                                        <input type='text' name='input_107.1' id='input_7_107_1' value='' tabindex='170'   aria-required='false'    \/>\n                                        <label for='input_7_107_1' id='input_7_107_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_107_3_container' >\n                                    <input type='text' name='input_107.3' id='input_7_107_3' value='' tabindex='171'   aria-required='false'    \/>\n                                    <label for='input_7_107_3' id='input_7_107_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_107_4_container' >\n                                        <input type='text' name='input_107.4' id='input_7_107_4' value='' tabindex='173'     aria-required='false'    \/>\n                                        <label for='input_7_107_4' id='input_7_107_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_107_5_container' >\n                                    <input type='text' name='input_107.5' id='input_7_107_5' value='' tabindex='174'   aria-required='false'    \/>\n                                    <label for='input_7_107_5' id='input_7_107_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_7_107_6_container' >\n                                        <select name='input_107.6' id='input_7_107_6' tabindex='175'  aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_7_107_6' id='input_7_107_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_7_108\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_inline gfsp_dot o_medium\"  data-field-class=\"gf_list_inline gfsp_dot o_medium\" data-js-reload=\"field_7_108\" ><legend class='gfield_label gform-field-label' >Berth\/Mooring Type<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_108'>\n\t\t\t<div class='gchoice gchoice_7_108_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Afloat at Dock\/Slip'  id='choice_7_108_0' onchange='gformToggleRadioOther( this )'  tabindex='176'  \/>\n\t\t\t\t\t<label for='choice_7_108_0' id='label_7_108_0' class='gform-field-label gform-field-label--type-inline'>Afloat at Dock\/Slip<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Afloat at Mooring'  id='choice_7_108_1' onchange='gformToggleRadioOther( this )'  tabindex='177'  \/>\n\t\t\t\t\t<label for='choice_7_108_1' id='label_7_108_1' class='gform-field-label gform-field-label--type-inline'>Afloat at Mooring<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='On Hydraulic Lift'  id='choice_7_108_2' onchange='gformToggleRadioOther( this )'  tabindex='178'  \/>\n\t\t\t\t\t<label for='choice_7_108_2' id='label_7_108_2' class='gform-field-label gform-field-label--type-inline'>On Hydraulic Lift<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='On Trailer'  id='choice_7_108_3' onchange='gformToggleRadioOther( this )'  tabindex='179'  \/>\n\t\t\t\t\t<label for='choice_7_108_3' id='label_7_108_3' class='gform-field-label gform-field-label--type-inline'>On Trailer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Rack Storage (Inside)'  id='choice_7_108_4' onchange='gformToggleRadioOther( this )'  tabindex='180'  \/>\n\t\t\t\t\t<label for='choice_7_108_4' id='label_7_108_4' class='gform-field-label gform-field-label--type-inline'>Rack Storage (Inside)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='Rack Storage (Outside)'  id='choice_7_108_5' onchange='gformToggleRadioOther( this )'  tabindex='181'  \/>\n\t\t\t\t\t<label for='choice_7_108_5' id='label_7_108_5' class='gform-field-label gform-field-label--type-inline'>Rack Storage (Outside)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='On Jack Stands or Stilts'  id='choice_7_108_6' onchange='gformToggleRadioOther( this )'  tabindex='182'  \/>\n\t\t\t\t\t<label for='choice_7_108_6' id='label_7_108_6' class='gform-field-label gform-field-label--type-inline'>On Jack Stands or Stilts<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_108_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_108' type='radio' value='gf_other_choice'  id='choice_7_108_7' onchange='gformToggleRadioOther( this )'  tabindex='183'  \/>\n\t\t\t\t\t<label for='choice_7_108_7' id='label_7_108_7' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_7_108_other' class='gchoice_other_control' name='input_108_other' type='text' value='Other' aria-label='Other Choice, please specify' tabindex='183' disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_109\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_inline gfsp_dot o_medium\"  data-field-class=\"gf_list_inline gfsp_dot o_medium\" data-js-reload=\"field_7_109\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Vessel is (Check all that apply)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_109'><div class='gchoice gchoice_7_109_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.1' type='checkbox'  value='Raced in other than club races'  id='choice_7_109_1' tabindex='184'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_1' id='label_7_109_1' class='gform-field-label gform-field-label--type-inline'>Raced in other than club races<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_109_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.2' type='checkbox'  value='Lived aboard on a permanent\/semi-permanent basis'  id='choice_7_109_2' tabindex='185'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_2' id='label_7_109_2' class='gform-field-label gform-field-label--type-inline'>Lived aboard on a permanent\/semi-permanent basis<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_109_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.3' type='checkbox'  value='Bareboat Chartered'  id='choice_7_109_3' tabindex='186'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_3' id='label_7_109_3' class='gform-field-label gform-field-label--type-inline'>Bareboat Chartered<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_109_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.4' type='checkbox'  value='Chartered with Captain\/Crew'  id='choice_7_109_4' tabindex='187'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_4' id='label_7_109_4' class='gform-field-label gform-field-label--type-inline'>Chartered with Captain\/Crew<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_109_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.5' type='checkbox'  value='Stored on trailer at apartment\/condominium'  id='choice_7_109_5' tabindex='188'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_5' id='label_7_109_5' class='gform-field-label gform-field-label--type-inline'>Stored on trailer at apartment\/condominium<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_7_109_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_109.6' type='checkbox'  value='Used for other commercial purposes'  id='choice_7_109_6' tabindex='189'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_109_6' id='label_7_109_6' class='gform-field-label gform-field-label--type-inline'>Used for other commercial purposes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_7_110\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_110\" ><label class='gfield_label gform-field-label' for='input_7_110'>Days\/year vessel is bareboat chartered<\/label><div class='ginput_container ginput_container_text'><input name='input_110' id='input_7_110' type='text' value='' class='small'   tabindex='190'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_111\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_111\" ><label class='gfield_label gform-field-label' for='input_7_111'>Days\/year vessel is chartered with captain\/crew<\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_7_111' type='text' value='' class='small'   tabindex='191'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_112\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_112\" ><label class='gfield_label gform-field-label' for='input_7_112'>Max passengers on vessel when chartered<\/label><div class='ginput_container ginput_container_number'><input name='input_112' id='input_7_112' type='number' step='any'   value='' class='small' tabindex='192'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_113\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_quarter o_medium\"  data-field-class=\"gf_quarter o_medium\" data-js-reload=\"field_7_113\" ><label class='gfield_label gform-field-label' for='input_7_113'>Other commercial purposes (details)<\/label><div class='ginput_container ginput_container_text'><input name='input_113' id='input_7_113' type='text' value='' class='small'   tabindex='193'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_150\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_inline gf_left o_medium\"  data-field-class=\"gf_inline gf_left o_medium\" data-js-reload=\"field_7_150\" ><h3 class=\"gsection_title\">Insurance Coverage Requested<\/h3><\/div><div id=\"field_7_144\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_144\" ><b>Property Damage<\/b><\/div><div id=\"field_7_145\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_145\" ><label class='gfield_label gform-field-label' for='input_7_145'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_145' id='input_7_145' type='text' step='any'   value='' class='small' tabindex='194'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_146\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_146\" ><label class='gfield_label gform-field-label' for='input_7_146'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_146' id='input_7_146' type='text' value='' class='small'   tabindex='195'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_147\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_147\" ><b>Liability Coverage (Including Pollution)<\/b><\/div><div id=\"field_7_148\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_148\" ><label class='gfield_label gform-field-label' for='input_7_148'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_148' id='input_7_148' type='text' step='any'   value='' class='small' tabindex='196'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_149\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_149\" ><label class='gfield_label gform-field-label' for='input_7_149'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_7_149' type='text' value='' class='small'   tabindex='197'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_151\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_151\" ><b>Medical Payments (per person)<\/b><\/div><div id=\"field_7_152\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_152\" ><label class='gfield_label gform-field-label' for='input_7_152'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_152' id='input_7_152' type='text' step='any'   value='' class='small' tabindex='198'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_153\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_153\" ><label class='gfield_label gform-field-label' for='input_7_153'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_153' id='input_7_153' type='text' value='' class='small'   tabindex='199'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_154\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_154\" ><b>Uninsured Boater<\/b><\/div><div id=\"field_7_155\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_155\" ><label class='gfield_label gform-field-label' for='input_7_155'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_155' id='input_7_155' type='text' step='any'   value='' class='small' tabindex='200'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_156\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_156\" ><label class='gfield_label gform-field-label' for='input_7_156'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_156' id='input_7_156' type='text' value='' class='small'   tabindex='201'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_157\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_157\" ><b>L&HCA<\/b><\/div><div id=\"field_7_158\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_158\" ><label class='gfield_label gform-field-label' for='input_7_158'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_158' id='input_7_158' type='text' step='any'   value='' class='small' tabindex='202'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_159\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_159\" ><label class='gfield_label gform-field-label' for='input_7_159'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_159' id='input_7_159' type='text' value='' class='small'   tabindex='203'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_160\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_160\" ><b>Trailer<\/b><\/div><div id=\"field_7_161\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_161\" ><label class='gfield_label gform-field-label' for='input_7_161'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_161' id='input_7_161' type='text' step='any'   value='' class='small' tabindex='204'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_162\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_162\" ><label class='gfield_label gform-field-label' for='input_7_162'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_162' id='input_7_162' type='text' value='' class='small'   tabindex='205'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_163\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_163\" ><b>Unscheduled Personal Property<\/b><\/div><div id=\"field_7_164\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_164\" ><label class='gfield_label gform-field-label' for='input_7_164'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_164' id='input_7_164' type='text' step='any'   value='' class='small' tabindex='206'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_165\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_165\" ><label class='gfield_label gform-field-label' for='input_7_165'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_165' id='input_7_165' type='text' value='' class='small'   tabindex='207'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_166\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_166\" ><b>Towing and Assistance<\/b><\/div><div id=\"field_7_167\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_167\" ><label class='gfield_label gform-field-label' for='input_7_167'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_167' id='input_7_167' type='text' step='any'   value='' class='small' tabindex='208'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_168\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_168\" ><label class='gfield_label gform-field-label' for='input_7_168'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_168' id='input_7_168' type='text' value='' class='small'   tabindex='209'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_169\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_169\" ><b>Tender\/Dinghy<\/b><\/div><div id=\"field_7_170\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_170\" ><label class='gfield_label gform-field-label' for='input_7_170'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_170' id='input_7_170' type='text' step='any'   value='' class='small' tabindex='210'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_171\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_171\" ><label class='gfield_label gform-field-label' for='input_7_171'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_171' id='input_7_171' type='text' value='' class='small'   tabindex='211'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_172\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_third gf_left gf_label_inline o_medium\"  data-field-class=\"gf_third gf_left gf_label_inline o_medium\" data-js-reload=\"field_7_172\" ><b>Owner's Liability to Paid Crew<\/b><\/div><div id=\"field_7_173\" class=\"gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_173\" ><label class='gfield_label gform-field-label' for='input_7_173'>Limit<\/label><div class='ginput_container ginput_container_number'><input name='input_173' id='input_7_173' type='text' step='any'   value='' class='small' tabindex='212'     aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_7_174\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible gf_third o_medium\"  data-field-class=\"gf_third o_medium\" data-js-reload=\"field_7_174\" ><label class='gfield_label gform-field-label' for='input_7_174'>Deductible<\/label><div class='ginput_container ginput_container_text'><input name='input_174' id='input_7_174' type='text' value='' class='small'   tabindex='213'   aria-invalid=\"false\"   \/> <\/div><\/div><div id=\"field_7_115\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_115\" ><label class='gfield_label gform-field-label' for='input_7_115'>Special Conditions\/Other Coverages<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_115' id='input_7_115' class='textarea medium' tabindex='214'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform_page_footer top_label'>\n                        <input type='button' id='gform_previous_button_7_116' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' value='Previous' tabindex='215' onclick='jQuery(\"#gform_target_page_number_7\").val(\"4\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"4\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_7_116' class='gform_next_button gform-theme-button button' value='Next' tabindex='216' onclick='jQuery(\"#gform_target_page_number_7\").val(\"6\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_7\").val(\"6\");  jQuery(\"#gform_7\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_7_6' class='gform_page' data-js='page-field-id-116' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_7_6' class='gform_fields top_label form_sublabel_below description_below'><fieldset id=\"field_7_117\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible gf_list_2col gfsp_dot o_medium\"  data-field-class=\"gf_list_2col gfsp_dot o_medium\" data-js-reload=\"field_7_117\" ><legend class='gfield_label gform-field-label' >Loss Payee\/Additional Insured Information<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_7_117'>\n\t\t\t<div class='gchoice gchoice_7_117_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_117' type='radio' value='Loss Payee'  id='choice_7_117_0' onchange='gformToggleRadioOther( this )'  tabindex='217'  \/>\n\t\t\t\t\t<label for='choice_7_117_0' id='label_7_117_0' class='gform-field-label gform-field-label--type-inline'>Loss Payee<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_7_117_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_117' type='radio' value='Additional Insured'  id='choice_7_117_1' onchange='gformToggleRadioOther( this )'  tabindex='218'  \/>\n\t\t\t\t\t<label for='choice_7_117_1' id='label_7_117_1' class='gform-field-label gform-field-label--type-inline'>Additional Insured<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_7_118\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible o_medium\"  data-field-class=\"o_medium\" data-js-reload=\"field_7_118\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name has_middle_name has_last_name no_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_7_118'>\n                            \n                            <span id='input_7_118_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_118.3' id='input_7_118_3' value='' tabindex='220'  aria-required='false'     \/>\n                                                    <label for='input_7_118_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            <span id='input_7_118_4_container' class='name_middle gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_118.4' id='input_7_118_4' value='' tabindex='221'  aria-required='false'     \/>\n                                                    <label for='input_7_118_4' class='gform-field-label gform-field-label--type-sub '>Middle<\/label>\n                                                <\/span>\n                            <span id='input_7_118_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_118.6' id='input_7_118_6' value='' tabindex='222'  aria-required='false'     \/>\n                                                    <label for='input_7_118_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_7_119\" class=\"gfield gfield--type-address field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_7_119\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_7_119' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_7_119_1_container' >\n                                        <input type='text' name='input_119.1' id='input_7_119_1' value='' tabindex='224'   aria-required='false'    \/>\n                                        <label for='input_7_119_1' id='input_7_119_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_7_119_3_container' >\n                                    <input type='text' name='input_119.3' id='input_7_119_3' value='' tabindex='225'   aria-required='false'    \/>\n                                    <label for='input_7_119_3' id='input_7_119_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_7_119_4_container' >\n                                        <input type='text' name='input_119.4' id='input_7_119_4' value='' tabindex='227'     aria-required='false'    \/>\n                                        <label for='input_7_119_4' id='input_7_119_4_label' class='gform-field-label gform-field-label--type-sub '>State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_7_119_5_container' >\n                                    <input type='text' name='input_119.5' id='input_7_119_5' value='' tabindex='228'   aria-required='false'    \/>\n                                    <label for='input_7_119_5' id='input_7_119_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_7_119_6_container' >\n                                        <select name='input_119.6' id='input_7_119_6' tabindex='229'  aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albania' >Albania<\/option><option value='Algeria' >Algeria<\/option><option value='American Samoa' >American Samoa<\/option><option value='Andorra' >Andorra<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctica' >Antarctica<\/option><option value='Antigua and Barbuda' >Antigua and Barbuda<\/option><option value='Argentina' >Argentina<\/option><option value='Armenia' >Armenia<\/option><option value='Aruba' >Aruba<\/option><option value='Australia' >Australia<\/option><option value='Austria' >Austria<\/option><option value='Azerbaijan' >Azerbaijan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahrain' >Bahrain<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Barbados' >Barbados<\/option><option value='Belarus' >Belarus<\/option><option value='Belgium' >Belgium<\/option><option value='Belize' >Belize<\/option><option value='Benin' >Benin<\/option><option value='Bermuda' >Bermuda<\/option><option value='Bhutan' >Bhutan<\/option><option value='Bolivia' >Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina' >Bosnia and Herzegovina<\/option><option value='Botswana' >Botswana<\/option><option value='Bouvet Island' >Bouvet Island<\/option><option value='Brazil' >Brazil<\/option><option value='British Indian Ocean Territory' >British Indian Ocean Territory<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Bulgaria' >Bulgaria<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cabo Verde' >Cabo Verde<\/option><option value='Cambodia' >Cambodia<\/option><option value='Cameroon' >Cameroon<\/option><option value='Canada' >Canada<\/option><option value='Cayman Islands' >Cayman Islands<\/option><option value='Central African Republic' >Central African Republic<\/option><option value='Chad' >Chad<\/option><option value='Chile' >Chile<\/option><option value='China' >China<\/option><option value='Christmas Island' >Christmas Island<\/option><option value='Cocos Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo' >Congo<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czechia' >Czechia<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/option><option value='Denmark' >Denmark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominica' >Dominica<\/option><option value='Dominican Republic' >Dominican Republic<\/option><option value='Ecuador' >Ecuador<\/option><option value='Egypt' >Egypt<\/option><option value='El Salvador' >El Salvador<\/option><option value='Equatorial Guinea' >Equatorial Guinea<\/option><option value='Eritrea' >Eritrea<\/option><option value='Estonia' >Estonia<\/option><option value='Eswatini' >Eswatini<\/option><option value='Ethiopia' >Ethiopia<\/option><option value='Falkland Islands' >Falkland Islands<\/option><option value='Faroe Islands' >Faroe Islands<\/option><option value='Fiji' >Fiji<\/option><option value='Finland' >Finland<\/option><option value='France' >France<\/option><option value='French Guiana' >French Guiana<\/option><option value='French Polynesia' >French Polynesia<\/option><option value='French Southern Territories' >French Southern Territories<\/option><option value='Gabon' >Gabon<\/option><option value='Gambia' >Gambia<\/option><option value='Georgia' >Georgia<\/option><option value='Germany' >Germany<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Greece' >Greece<\/option><option value='Greenland' >Greenland<\/option><option value='Grenada' >Grenada<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guinea' >Guinea<\/option><option value='Guinea-Bissau' >Guinea-Bissau<\/option><option value='Guyana' >Guyana<\/option><option value='Haiti' >Haiti<\/option><option value='Heard Island and McDonald Islands' >Heard Island and McDonald Islands<\/option><option value='Holy See' >Holy See<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hungary' >Hungary<\/option><option value='Iceland' >Iceland<\/option><option value='India' >India<\/option><option value='Indonesia' >Indonesia<\/option><option value='Iran' >Iran<\/option><option value='Iraq' >Iraq<\/option><option value='Ireland' >Ireland<\/option><option value='Isle of Man' >Isle of Man<\/option><option value='Israel' >Israel<\/option><option value='Italy' >Italy<\/option><option value='Jamaica' >Jamaica<\/option><option value='Japan' >Japan<\/option><option value='Jersey' >Jersey<\/option><option value='Jordan' >Jordan<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Korea, Democratic People&#039;s Republic of' >Korea, Democratic People&#039;s Republic of<\/option><option value='Korea, Republic of' >Korea, Republic of<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/option><option value='Latvia' >Latvia<\/option><option value='Lebanon' >Lebanon<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libya' >Libya<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lithuania' >Lithuania<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaysia' >Malaysia<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malta' >Malta<\/option><option value='Marshall Islands' >Marshall Islands<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritania' >Mauritania<\/option><option value='Mauritius' >Mauritius<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexico' >Mexico<\/option><option value='Micronesia' >Micronesia<\/option><option value='Moldova' >Moldova<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolia' >Mongolia<\/option><option value='Montenegro' >Montenegro<\/option><option value='Montserrat' >Montserrat<\/option><option value='Morocco' >Morocco<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibia' >Namibia<\/option><option value='Nauru' >Nauru<\/option><option value='Nepal' >Nepal<\/option><option value='Netherlands' >Netherlands<\/option><option value='New Caledonia' >New Caledonia<\/option><option value='New Zealand' >New Zealand<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nigeria' >Nigeria<\/option><option value='Niue' >Niue<\/option><option value='Norfolk Island' >Norfolk Island<\/option><option value='North Macedonia' >North Macedonia<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Norway' >Norway<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Palestine, State of' >Palestine, State of<\/option><option value='Panama' >Panama<\/option><option value='Papua New Guinea' >Papua New Guinea<\/option><option value='Paraguay' >Paraguay<\/option><option value='Peru' >Peru<\/option><option value='Philippines' >Philippines<\/option><option value='Pitcairn' >Pitcairn<\/option><option value='Poland' >Poland<\/option><option value='Portugal' >Portugal<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Romania' >Romania<\/option><option value='Russian Federation' >Russian Federation<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena, Ascension and Tristan da Cunha' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' >Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines' >Saint Vincent and the Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='San Marino' >San Marino<\/option><option value='Sao Tome and Principe' >Sao Tome and Principe<\/option><option value='Saudi Arabia' >Saudi Arabia<\/option><option value='Senegal' >Senegal<\/option><option value='Serbia' >Serbia<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapore' >Singapore<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovakia' >Slovakia<\/option><option value='Slovenia' >Slovenia<\/option><option value='Solomon Islands' >Solomon Islands<\/option><option value='Somalia' >Somalia<\/option><option value='South Africa' >South Africa<\/option><option value='South Georgia and the South Sandwich Islands' >South Georgia and the South Sandwich Islands<\/option><option value='South Sudan' >South Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen' >Svalbard and Jan Mayen<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria Arab Republic' >Syria Arab Republic<\/option><option value='Taiwan' >Taiwan<\/option><option value='Tajikistan' >Tajikistan<\/option><option value='Tanzania, the United Republic of' >Tanzania, the United Republic of<\/option><option value='Thailand' >Thailand<\/option><option value='Timor-Leste' >Timor-Leste<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad and Tobago' >Trinidad and Tobago<\/option><option value='Tunisia' >Tunisia<\/option><option value='Turkmenistan' >Turkmenistan<\/option><option value='Turks and Caicos Islands' >Turks and Caicos Islands<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='T\u00fcrkiye' >T\u00fcrkiye<\/option><option value='US Minor Outlying Islands' >US Minor Outlying Islands<\/option><option value='Uganda' >Uganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='United Arab Emirates' >United Arab Emirates<\/option><option value='United Kingdom' >United Kingdom<\/option><option value='United States' selected='selected'>United States<\/option><option value='Uruguay' >Uruguay<\/option><option value='Uzbekistan' >Uzbekistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Viet Nam' >Viet Nam<\/option><option value='Virgin Islands, British' >Virgin Islands, British<\/option><option value='Virgin Islands, U.S.' >Virgin Islands, U.S.<\/option><option value='Wallis and Futuna' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c5land Islands' >\u00c5land Islands<\/option><\/select>\n                                        <label for='input_7_119_6' id='input_7_119_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_7_180\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible\"  data-js-reload=\"field_7_180\" ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Privacy Policy<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox' id='input_7_180'><div class='gchoice gchoice_7_180_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_180.1' type='checkbox'  value='By submitting my phone number, I hereby authorize Lighthouse Insurance Agency LLC to communicate with me through text messaging. View our &lt;a href=&quot;https:\/\/marcusagent.com\/privacy-policy\/&quot; target=&quot;_blank&quot;&gt;Privacy Policy here&lt;\/a&gt;.'  id='choice_7_180_1' tabindex='230'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_7_180_1' id='label_7_180_1' class='gform-field-label gform-field-label--type-inline'>By submitting my phone number, I hereby authorize Lighthouse Insurance Agency LLC to communicate with me through text messaging. 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