<div class="newApiHead">Carrier Services Quote</div><!-- [et_pb_line_break_holder] --><div id="smallApi" class="clearfix" style="margin-top: 0px;"><!-- [et_pb_line_break_holder] --><div style="padding-top: 10px;" align="center"><form action="http://#/geoquote-plugin-v3/geoquote_step2.php" method="POST" name="Calculate"><input name="RefID" type="hidden" value="$RefID"> <input name="RefererPage" type="hidden" value="$RefererPage"> <input name="version" type="hidden" value="$version"><!-- [et_pb_line_break_holder] --><table border="0" cellspacing="0" cellpadding="3"><!-- [et_pb_line_break_holder] --><tbody><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><select class="pulldownfix" name="service_type"><!-- [et_pb_line_break_holder] --><option selected="selected" value="D">High Speed Internet Access</option><!-- [et_pb_line_break_holder] --><option value="V">Voice (SIP/LD/Local/VoIP/POTS)</option><!-- [et_pb_line_break_holder] --><option value="I">Integ. Accs (Voice/Data/Flex/PRI)</option><!-- [et_pb_line_break_holder] --><option value="M">Networks (MPLS/VPN/WAN/P2P)</option><!-- [et_pb_line_break_holder] --><option value="N">Cloud Svcs. (Firewall/Collocation)</option><!-- [et_pb_line_break_holder] --></select></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><input class="fieldfixA" maxlength="50" name="quoteFirstName" size="17" type="text" value="First Name"> <input class="fieldfixA" maxlength="50" name="quoteLastName" size="17" type="text" value="Last Name"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><input class="fieldfix" maxlength="60" name="quoteCompany" size="41" type="text" value="Business Name"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><input class="fieldfix" name="quoteEmail" size="41" type="text" value="Email Address"></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><!-- [et_pb_line_break_holder] --><table id="installPhone" border="0" width="200" cellspacing="0" cellpadding="0"><!-- [et_pb_line_break_holder] --><tbody><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><!-- [et_pb_line_break_holder] --><div style="margin-right: 0px;" align="left"><span class="standardwhite11">Install Phone</span></div></td><!-- [et_pb_line_break_holder] --><td nowrap="nowrap"><!-- [et_pb_line_break_holder] --><div align="left"><!-- [et_pb_line_break_holder] --><table border="0" width="75" cellspacing="0" cellpadding="0"><!-- [et_pb_line_break_holder] --><tbody><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td><input class="fieldstandard" maxlength="3" name="npa" size="3" type="text" value=""></td><!-- [et_pb_line_break_holder] --><td><input class="fieldstandard" maxlength="3" name="nxx" size="3" type="text" value=""></td><!-- [et_pb_line_break_holder] --><td><input class="fieldstandard" maxlength="4" name="xxxx" size="4" type="text" value=""></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --></tbody><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --></div></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --></tbody><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --><tr><!-- [et_pb_line_break_holder] --><td height="20"><!-- [et_pb_line_break_holder] --><div style="padding-right: 5px; margin-bottom: 0px;" align="right"><input type="submit" value="continue"></div></td><!-- [et_pb_line_break_holder] --></tr><!-- [et_pb_line_break_holder] --></tbody><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --></form></div><!-- [et_pb_line_break_holder] --></div>