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<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Et / And</span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le Mandataire / The Agent :</span></p> <table border="0" cellpadding="1" cellspacing="2" style="width:100%;"> <tbody> <tr> <td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Siège <span style="font-weight:600;">Headquarters</span> :</span></td> </tr> <tr> <td>{% textinput_tag name="9eaebd25" data_label="Dénomination société" data_map_field="societe" data_help="Dénomination sociale" maxlength="100" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="1" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="width: 68%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">dont le siège social est domicilié <span style="font-weight:600;">whose head office is domiciled</span> :</span></td> </tr> <tr> <td style="width: 68%;">{% textinput_tag name="4bf2a398" data_label="Adresse postale du siège social" data_map_field="adresse" data_help="Adresse postale du siège social" maxlength="100" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Représentée par <span style="font-weight:600;">Represented by </span>:</span> </p> <table border="0" cellpadding="1" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><strong> </strong></span>{% select_tag name="e591f3e8" data_label="Civilité" data_map_field="civilite" data_help="Choisissez la civilité" data_choices="Civilité|civilite; Monsieur / Mr|monsieur; Madame / Ms|madame;" data_required_field="false" data_bold_text="false" %} <span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Nom<span style="font-weight:600;"> Last name</span> :</span></td> <td style="vertical-align: bottom; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Prénom <span style="font-weight:600;">First name</span> :</span></td> </tr> <tr> <td style="vertical-align: middle; width: 50%;">{% textinput_tag name="b73a7b8a" data_label="Nom " data_map_field="nom" data_help="Nom du signataire " maxlength="50" data_required_field="false" data_bold_text="false" %}</td> <td style="vertical-align: middle; width: 50%;">{% textinput_tag name="997dd310" data_label="Prénom " data_map_field="prenom" data_help="Prénom du signataire" maxlength="50" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="1" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="vertical-align: middle; width: 70%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">E-mail <span style="font-weight:600;">Email </span>: </span></td> <td style="vertical-align: middle; width: 30%;"> <span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Tél <span style="font-weight:600;">Phone number</span> : </span></td> </tr> <tr> <td style="vertical-align: middle; width: 70%;">{% textinput_tag name="b8aeae93" data_label="Email du signataire" data_map_field="email" data_help="Email du signataire" maxlength="50" data_required_field="false" data_bold_text="false" %}</td> <td style="vertical-align: middle; width: 30%;">{% textinput_tag name="cd81f022" data_label="Tél du signataire" data_map_field="tel" data_help="Tél du signataire" maxlength="25" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="2" cellspacing="2" style="width:100%;"> <tbody> <tr> <td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Agissant en qualité de <span style="font-weight:600;">Acting in the capacity of </span>:</span> </td> </tr> <tr> <td>{% textinput_tag name="e43d897a" data_label="qualité du mandataire" data_map_field="nomap" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="1" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Immatriculée au RCS de <span style="font-weight:600;">Place of RCS registration</span> :</span></td> <td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Sous le numéro <span style="font-weight:600;">RCS Number</span> :</span></td> </tr> <tr> <td style="vertical-align: middle; width: 50%;">{% textinput_tag name="8bb8f323" data_label="Lieu d'immatriculation RCS" data_map_field="rcs_place" data_help="Lieu RCS" maxlength="50" data_required_field="false" data_bold_text="false" %}</td> <td style="vertical-align: middle; width: 50%;">{% textinput_tag name="6703ac8d" data_label="Numéro RCS" data_map_field="rcs_num" data_help="Numéro RCS" maxlength="50" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="2" cellspacing="2" style="width:100%;"> <tbody> <tr> <td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Titulaire de la CPI Transactions sur immeubles et fonds de commerce n° <span style="font-weight:600;">Holder of the Transaction licence n° :</span></span></td> </tr> <tr> <td>{% textinput_tag name="91dbde68" data_label="n° de la CPI du mandataire" data_map_field="nomap" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="2" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="width: 60%; vertical-align: bottom;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Délivrée par la CCI de <span style="font-weight:600;">Registrade in the Trade and Companies of :</span></span></td> <td>{% textinput_tag name="da78f596" data_label="CPI délivrée par la préfecture de" data_map_field="nomap" data_help="capital" maxlength="70" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="2" cellspacing="2" style="width:100%;"> <tbody> <tr> <td style="vertical-align: bottom; width: 65%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Titulaire d'une garantie financière auprès de <span style="font-weight:600;">Holder of a financial guarantee from :</span></span></td> </tr> <tr> <td style="vertical-align: bottom; width: 65%;">{% textinput_tag name="161c4a44" data_label="Titulaire de la garantie financière auprès de" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="2" cellspacing="2" style="width:100%;"> <tbody> <tr> <td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Et d'une assurance en responsabilité civile professionnelle auprès de <span style="font-weight:600;">And professionnal liability insurance from :</span></span></td> </tr> <tr> <td>{% textinput_tag name="4c06012a" data_label="Nom de l'assurance RCP" data_map_field="nomap" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table> <table border="0" cellpadding="1" cellspacing="2" style="width: 100%;"> <tbody> <tr> <td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Autres informations utiles <span style="font-weight:600;">Other useful information</span> : </span></td> </tr> <tr> <td>{% textarea_tag name="2342f91b" data_width="100" rows="1" data_label="Autres informations utiles" data_map_field="nomap" data_help="Autres informations utiles" data_required_field="false" data_bold_text="false" %}</td> </tr> </tbody> </table>
Mode Simplifié
<p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Et / And</span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Le Mandataire / The Agent :</span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;"><strong>{{9eaebd25}} </strong><br /> dont le siège social est domicilié /whose head office is domiciled <strong>{{4bf2a398}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Représentée par/Represented by : <strong>{{e591f3e8}} {{b73a7b8a}} {{997dd310}}</strong><br /> • E-mail : <strong>{{b8aeae93}}</strong>, • Téléphone/Phone number : <strong>{{cd81f022}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Agissant en qualité de/Acting in the capacity of <strong>{{e43d897a}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">immatriculée au RCS de/Place of RCS registration <strong>{{8bb8f323}}</strong> sous le numéro/RCS Number <strong>{{6703ac8d}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Titulaire de la CPI Transactions sur immeubles et fonds de commerce n° Holder of the Transaction licence n° <strong>{{91dbde68}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Délivrée par la CCI de Registrade in the Trade and Companies of <strong>{{da78f596}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Titulaire d'une garantie financière auprès de Holder of a financial guarantee from <strong>{{161c4a44}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Et d'une assurance en responsabilité civile professionnelle auprès de And professionnal liability insurance from <strong>{{4c06012a}}</strong></span></p> <p><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Autres informations utiles/Other useful information : <strong>{{2342f91b}}</strong></span></p>
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