small google api map with mileage calculator = courier cost

Avg Bid (GBP)
Project Budget (GBP)
£20 - £100

Project Description:
I need A google API map with quote option for a new courier website hosted on a unix server account, this should include a small google map, a field for collection postcode, delivery postcode, a dropdown menu listing available vehicles, once details added customer should be able to click get quote and it shows the estimated quote just below the google map, another version of this can be seen in action at [url removed, login to view] about half way down on the left side.
once the calculations have been made and the estimated cost shows they then should have the option to click a book now button which goes to a form with the postcode fields they used already populated, the vehicle they chose selected and then the rest of the form can be filled out, this would then be emailed to a specific email address, more details are in the attached document along with graphics, I have already made a form (not working) so you can see how the form should be laid out, there is a vehicle dropdown menu which when the vehicle type is chosen it shows a graphic of the vehicle along with costs per mile (these cost can be used for the calculations to get quote estimates as above.
I would also need the ability to add vehicle text, add new vehicles to dropdown menu along with a graphic for any I add, also be able to change mileage cost which would automatically be represented in the form on the site for the initial estimated quote.
New website url, cpanel and all login details will be supplied when they are available, please read the attached document before making any bids for this project as it needs to be fully understood, thank you for looking at my project.

Skills required:
HTML, jQuery / Prototype, MySQL, PHP
Additional Files: Requirements.doc
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