Auto Insurance

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" background="066fd5a3.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Statewide Agency</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="Statewide Agency"><B>home</B></A></div> <div> <B>Auto Insurance</B>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Homeowners Insurance">Homeowners Insurance</A>   |   <A HREF="id24.htm" TARGET="_top" TITLE="Other Insurance Products">Other Insurance Products</A>   |   <A HREF="id25.htm" TARGET="_top" TITLE="License Service">License Service</A></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="067d2b03.jpg"> <div> <A HREF="home.htm" TARGET="_top" TITLE="Statewide Agency">Statewide Agency</A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="About Us">About Us</A></div> <div> <A HREF="id18.htm" TARGET="_top" TITLE="News">News</A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Contact Us">Contact Us</A></div> <div> <A HREF="id20.htm" TARGET="_top" TITLE="Our Products and Services">Our Products and Services</A></div> </td> <td valign="top" height=390 width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Auto Insurance</I></div> <div> <FONT SIZE="3" COLOR="#000000" FACE="Arial" >We now offer basic liability rates with monthly payments as low as $86.00 in Philadelphia and</FONT> <B>NO LATE FEES</B><FONT SIZE="3" COLOR="#000000" FACE="Arial" >!!!!!!!!</FONT></div> <bR> <div> CHOICE CHOICE CHOICE</div> <div> We represent no fewer than 10 major Pennsylvania insurance companies.  We actively shop all companies to locate the lowest rate for all customers. As a customer at Statewide Agency there is no need to search for the lowest rate as we do that for you automatically at every renewal.</div> <div>  <A NAME="auto_insurance"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></div> <div> Call us now at <B>215-634-1700</B> for a quick quote or fill out the form below and hit <send>:</div> <bR> <div>  <form method="post" action="http://www.emailmeform.com/fid.php?formid=100730" enctype="multipart/form-data" accept-charset="UTF-8"> <table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"> <tr> <td> <font face="Verdana" size="2" color="#000000">Auto Insurance Quote</font> <div style="" id="mainmsg"> </div> </td> </tr> </table> <br> <table cellpadding="2" cellspacing="0" border="0" bgcolor="#FFFFFF"> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Name</font></td> <td> <input type="text" name="FieldData0" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Your Email Address</font></td> <td> <input type="text" name="FieldData1" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Street Address</font></td> <td> <input type="text" name="FieldData2" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Zip Code</font></td> <td> <input type="text" name="FieldData3" value="" maxlength="100" size="60"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Phone Number</font></td> <td> <input type="text" name="FieldData4" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Age</font></td> <td> <input type="text" name="FieldData5" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Vehicle Year Make and Model</font></td> <td> <input type="text" name="FieldData6" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Number of Years Licensed</font></td> <td> <input type="text" name="FieldData7" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Number of Violations</font></td> <td> <input type="text" name="FieldData8" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Number of Accidents</font></td> <td> <input type="text" name="FieldData9" value="" maxlength="100" size="30"> </td> </tr> <tr valign="top"> <td nowrap><font face="Verdana" size="2" color="#000000">Describe Violations/Accidents</font></td> <td> <textarea name="FieldData10" cols="60" rows="10"></textarea><br> </td> </tr> <tr> <td colspan="2"> <table cellpadding=5 cellspacing=0 bgcolor="#E4F8E4" width="100%"> <tr bgcolor="#AAD6AA"> <td colspan="2"><font color="#FFFFFF" face="Verdana" size="2"><b>Image Verification</b></font></td> </tr> <tr> <td style="padding: 2px;" width="10"><img src="http://www.emailmeform.com/turing.php" id="captcha"></td> <td valign="top"><font color="#000000">Please enter the text from the image</font> <br><input type="text" name="Turing" value="" maxlength="100" size="10"> [ <a href="#" onclick=" document.getElementById('captcha').src = document.getElementById('captcha').src + '?' + (new Date()).getMilliseconds()">Refresh Image</a> ] [ <a href="http://www.emailmeform.com/?v=turing&pt=popup" onClick="window.open('http://www.emailmeform.com/?v=turing&pt=popup','_blank','width=400, height=300, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a> ] </td> </tr> </table> </td> </tr> <tr> <td> </td> <td align="right"> <input type="text" name="hida2" value="" maxlength="100" size="3" style="display : none;"> <input type="submit" class="btn" value="Send" name="Submit"></td> </tr> <tr> <td colspan=2 align="center"> <br> </td> </tr> </table> </form>  </div> </td> </tr></table></body>