document.write("<form id='sl_banner_md' method='get' onsubmit='return ValidateAndSendBanner(this)' action='')>");
document.write("<table width='180' height='152' border='0' cellpadding='0' cellspacing='0'>");
document.write("<tr>");
document.write("<td align='left' valign='top'><table width='178' border='0' cellspacing='0' cellpadding='0'>");
document.write("<tr>");
document.write("<td align='left' valign='top'><img src='http://www.progressiveagent.com/images/quote_bnr_sl_md_head_n.gif' alt='Progressive' width='178' height='89' /></td>");
document.write("</tr>");
document.write("<tr>");
document.write("<td align='left' valign='top'><table bgcolor='#FFFFFF' width='178' border='0' cellpadding='0' cellspacing='0' style='border-left: 1px solid #CCC; border-right: 1px solid #CCC; border-bottom: 1px solid #CCC;'>");
document.write("<tr>");
document.write("<td align='right' valign='top'>&nbsp;</td>");
document.write("<td style='padding-left: 17px;'><select id='Product' style='width: 135px'>");
document.write("<option selected value='AU'>Auto</option>");
document.write("<option value='MC-M'>Motorcycle</option>");
document.write("<option value='MC-A'>ATV</option>");
document.write("<option value='BT'>Boat/PWC</option>");
document.write("</select></td>");
document.write("</tr>");
document.write("<tr>");
document.write("<td align='right'>&nbsp;</td>");
document.write("<td style='padding-left: 17px; padding-top:6px; padding-bottom:0px;'><img src='http://www.progressiveagent.com/images/quote_bnr_sl_md_zip.gif'><br><input id='ZIP' type='text' size='6' maxlength='5' />");
document.write("&nbsp;<INPUT type='image' id='button1' src='http://www.progressiveagent.com/images/quote_bnr_btn_getquote_md_n.gif' alt='Get a Quote' align='absmiddle' vspace='4'>");
document.write("</tr>");
document.write("</table></td>");
document.write("</tr>");
document.write("</table></td>");
document.write("</tr>");
document.write("</table>");
document.write("</form>");