Joomla Ajax contact form with autoresponder

Looking for Joomla expert, create a submit form inside the custom html module and it is loaded in the leftside of an ariticle. Need a ajax form submission were the page should not be refreshed and the submission message has to show with the name provided in the name box. Fields: Name: Email: Phone: Dealers Name: Invoice Number: Product Details. all field are required validation for malicious entries. Captcha code is required. On Submission show a message if the mail is sent. Form content has to be delivered to two email ids, 1. Company email id, 2. the email id which is provided in the form. A custom message has to append to the emails.