document.write("</form><form id='bt_banner_sm' method='get' onsubmit='return ValidateAndSendBanner(this)' action='')>");
document.write("<table width='125' height='120' border='0' cellpadding='0' cellspacing='0' bordercolor='#CCCCCC'>");
document.write("<tr>");
document.write("<td align='left' valign='top'><table width='123' 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_bt_sm_head_n.gif' alt='Progressive' width='123' height='97' /></td>");
document.write("</tr>");
document.write("<tr>");
document.write("<td bgcolor='#FFFFFF' height='35' align='left' valign='top' style='border-right: 1px solid #CCC; border-left: 1px solid #CCC; border-bottom: 1px solid #CCC;'><div align='center'>");
document.write("<input id='ZIP' type='text' size='5' maxlength='5' />");
document.write("<INPUT type='hidden' id='Product' value='BT'>");
document.write("&nbsp;<INPUT type='image' id='button1' src='http://www.progressiveagent.com/images/quote_bnr_btn_quote_sm.gif' alt='go' align='absmiddle'>");
document.write("</tr>");
document.write("</table></td>");
document.write("</tr>");
document.write("</table>");
document.write("</form><form>");