document.write("<form id='sl_banner_md' method='get' onsubmit='return ValidateAndSendBanner(this)' action='')>");
document.write("<table width='180' height='152' border='0' cellpadding='1' cellspacing='1' bordercolor='#CCCCCC' style='background-color:#4383dc;'>");
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.gif' alt='Progressive' width='178' height='83' /></td>");
document.write("</tr>");
document.write("<tr>");
document.write("<td height='65' align='left' valign='top' background='http://www.progressiveagent.com/images/quote_bnr_bkg_md_zip.gif'><table width='178' border='0' cellpadding='0' cellspacing='0'>");
document.write("<tr>");
document.write("<td width='38' height='29' align='right' valign='top'>&nbsp;</td>");
document.write("<td align='left' valign='top'><select id='Product' style='width: 145px'>");
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' valign='top'>&nbsp;</td>");
document.write("<td width='180' align='left' valign='top'><input id='ZIP' type='text' size='5' maxlength='5' />");
document.write("&nbsp;<INPUT type='image' id='button1' src='http://www.progressiveagent.com/images/quote_bnr_btn_getquote_md.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>");