{# inicio del formulario #}
{# modales #}
{{ form_start(nypform,{ 'attr': {'id': 'form-container'} }) }}
{{form_widget(nypform.courses,{ 'attr': {'class': 'check-change step-6 '} })}}
{{form_widget(nypform.navigation_limit_quote,{ 'attr': {'class': 'form-control check-change step-7'} })}}
{% if subAgentLink is defined and subAgentLink != '' %}
{{ form_widget(nypform.agent_link, {'value': subAgentLink}) }}
{% endif %}
{# servira para ocultar campos que aun no usaremos #}
{% if isAgent == false %}
{% endif %}
{% if isAgent == false %}
Welcome to Novamar’s Yacht quote form
{% else %}Welcome to Our Yacht Insurance quote form
{% endif %}Please introduce yourself
{{ form_label(nypform.firstName, "Name") }}
{{form_widget(nypform.firstName,{ 'attr': {'class': 'check-change step-1'} })}}
{{ form_errors(nypform.firstName) }}
{{ form_label(nypform.lastName, "Last Name") }}
{{form_widget(nypform.lastName,{ 'attr': {'class': 'check-change step-1'} })}}
{{ form_errors(nypform.lastName) }}
{% if isAgent == false %}
{% endif %}
Hi [[firstName]]!
Nice to meet youTell us about your boat:
{{ form_label(nypform.boatName, "Boat name") }}
{{form_widget(nypform.boatName,{ 'attr': {'class': 'check-change step-2'} })}}
{{ form_label(nypform.manufacturer) }}
{{form_widget(nypform.manufacturer,{ 'attr': {'class': 'check-change step-2'} })}}
{{ form_label(nypform.lenght, 'Length') }}
{{form_widget(nypform.lenght,{ 'attr': {'class': 'check-change step-2'} })}}
{{ form_label(nypform.built_year, "Year built") }}
{{form_widget(nypform.built_year,{ 'attr': {'class': 'check-change step-2'} })}}
{{ form_label(nypform.hull_type) }}
{{form_widget(nypform.hull_type,{ 'attr': {'class': 'check-change step-2'} })}}
{{ form_label(nypform.hull_material, "Hull material") }}
{{form_widget(nypform.hull_material,{ 'attr': {'class': 'check-change step-2'} })}}
{% if isAgent == false %}
{% endif %}
Please provide more information
Characteristics of the engine(s):
{{ form_label(nypform.power_type) }}
{{form_widget(nypform.power_type,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.horse_power, "Horsepower per engine") }}
{{form_widget(nypform.horse_power,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.max_speed, "Max vessel speed (knots)") }}
{{form_widget(nypform.max_speed,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.number_engines, "Number of engines") }}
{{form_widget(nypform.number_engines,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.engine_manufacturer) }}
{{form_widget(nypform.engine_manufacturer,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.engine_year) }}
{{form_widget(nypform.engine_year,{ 'attr': {'class': 'check-change step-3'} })}}
{{ form_label(nypform.fuel) }}
{{form_widget(nypform.fuel,{ 'attr': {'class': 'check-change step-3'} })}}
{% if isAgent == false %}
{% endif %}
Let's continue with more details
Purchase and usage:
{{ form_label(nypform.purchase_date, "Boat purchase date") }}
{{form_widget(nypform.purchase_date,{ 'attr': {'class': 'check-change step-4 date-format'} })}}
{{ form_label(nypform.purchase_price, "Boat purchase price") }}
{{form_widget(nypform.purchase_price,{ 'attr': {'class': 'check-change step-4'} })}}
{{ form_label(nypform.boat_use, "Boat usage") }}
{{form_widget(nypform.boat_use,{ 'attr': {'class': 'check-change step-4'} })}}
{{ form_label(nypform.live_aboard, "Liveaboard?") }}
{{form_widget(nypform.live_aboard,{ 'attr': {'class': 'check-change step-4'} })}}
{{ form_label(nypform.currently_insured, "Is your boat currently insured?") }}
{{form_widget(nypform.currently_insured,{ 'attr': {'class': 'check-change step-4'} })}}
{{ form_label(nypform.insurance_company, "Select the insurance company:", { 'label_attr': {'class': 'd-none'} }) }}
{{form_widget(nypform.insurance_company,{ 'attr': {'class': 'check-change step-4 d-none'} })}}
{% if isAgent == false %}
{% endif %}
Great [[firstName]]!
We are halfway thereCoverages Limits:
{{ form_label(nypform.hull_value, "Hull coverage limit") }}
{{form_widget(nypform.hull_value,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.deductible, "Hull deductible") }}
{{form_widget(nypform.deductible,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.liability, "Liability coverage limit") }}
{{form_widget(nypform.liability,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.medical, "Medical payments limit") }}
{{form_widget(nypform.medical,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.personnal_effects, "Personal effects limit") }}
{{form_widget(nypform.personnal_effects,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.towing_limits, "Emergency towing limit") }}
{{form_widget(nypform.towing_limits,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.trailer_value, "Trailer value (optional)") }}
{{form_widget(nypform.trailer_value,{ 'attr': {'class': 'check-change step-5'} })}}
{{ form_label(nypform.paid_creu, "Paid crew (if any)") }}
{{form_widget(nypform.paid_creu,{ 'attr': {'class': 'check-change step-5'} })}}
{% if isAgent == false %}
{% endif %}
We are building a tailor made quote for you,
please help us with more infoBoating Experience/Boat Location:
{{ form_label(nypform.years_experience, "Years of boat ownership") }}
{{form_widget(nypform.years_experience,{ 'attr': {'class': 'check-change step-6'} })}}
{{ form_label(nypform.boats_owned, "Length/Manufacturer of boats owned") }}
{{form_widget(nypform.boats_owned,{ 'attr': {'class': 'check-change step-6'} })}}
{{ form_label(nypform.date_vessel_survey, "Date of most recent vessel survey") }}
{{form_widget(nypform.date_vessel_survey,{ 'attr': {'class': 'check-change step-6 date-format'} })}}
{{ form_label(nypform.list_accidents, "List prior boating losses:") }}
{{form_widget(nypform.list_accidents,{ 'attr': {'class': 'check-change step-6'} })}}
{{ form_label(nypform.mooring_storage_country, "Mooring/Storage country") }}
{{form_widget(nypform.mooring_storage_country,{ 'attr': {'class': 'check-change step-6'} })}}
{{ form_label(nypform.mooring_storage_state, "Mooring/Storage state") }}
{{form_widget(nypform.mooring_storage_state,{ 'attr': {'class': 'check-change step-6'} })}}
{{ form_label(nypform.mooring_storage_zipCode, "Mooring/Storage zip code") }}
{{form_widget(nypform.mooring_storage_zipCode,{ 'attr': {'class': 'check-change step-6'} })}}
{% if isAgent == false %}
{% endif %}
Tell us where you use your vessel:
Navigations Limits
{% if isAgent == false %}
{% endif %}
[[firstName]], tell us more about you
{{ form_label(nypform.birthday, "Date of birth") }}
{{form_widget(nypform.birthday,{ 'attr': {'class': 'check-change step-8 date-format'} })}}
{{ form_label(nypform.occupation) }}
{{form_widget(nypform.occupation,{ 'attr': {'class': 'check-change step-8'} })}}
{{ form_label(nypform.additional_insured, "List additional owners (if any)") }}
{{form_widget(nypform.additional_insured,{ 'attr': {'class': 'check-change step-8'} })}}
{{ form_label(nypform.owner_type, "Vessel ownership (Personal/Company)") }}
{{form_widget(nypform.owner_type,{ 'attr': {'class': 'check-change step-8'} })}}
{{ form_label(nypform.company_name, "Company name (If applicable)", { 'label_attr': {'class': 'd-none'} }) }}
{{form_widget(nypform.company_name,{ 'attr': {'class': 'check-change step-8 d-none'} })}}
{{ form_label(nypform.email, "Email address") }}
{{form_widget(nypform.email,{ 'attr': {'class': 'check-change step-8'} })}}
{{ form_label(nypform.phone, "Primary phone") }}
{{form_widget(nypform.phone,{ 'attr': {'class': 'check-change step-8 phone-format'} })}}
{% if isAgent == false %}
{% endif %}
Almost there, [[firstName]]
{{ form_label(nypform.address, "Street Address") }}
{{form_widget(nypform.address,{ 'attr': {'class': 'check-change step-9'} })}}
{{ form_label(nypform.city) }}
{{form_widget(nypform.city,{ 'attr': {'class': 'check-change step-9'} })}}
{{ form_label(nypform.country) }}
{{form_widget(nypform.country,{ 'attr': {'class': 'check-change step-9'} })}}
{{ form_label(nypform.state) }}
{{form_widget(nypform.state,{ 'attr': {'class': 'check-change step-9'} })}}
{{ form_label(nypform.postalCode, "Zip code") }}
{{form_widget(nypform.postalCode,{ 'attr': {'class': 'check-change step-9'} })}}
{% if isAgent == false %}
{% endif %}
Final step!
{{ form_label(nypform.source, "How did you hear about us?") }}
{{form_widget(nypform.source,{ 'attr': {'class': 'check-change step-10'} })}}
{{ form_label(nypform.desire_effective_date, "Desired coverage effective date") }}
{{form_widget(nypform.desire_effective_date,{ 'attr': {'class': 'check-change step-10 date-format'} })}}
{{ form_label(nypform.comments) }}
{{form_widget(nypform.comments,{ 'attr': {'class': 'check-change step-10'} })}}
You did it, [[firstName]]!
Your request has been forwarded to a licensed Novamar Insurance specialist who will be in contact with you within 48 hours
{{ form_rest(nypform) }}
{{ form_end(nypform) }}