Data Entry Form

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I need a web based data entry form developed for an existing mysql database.

The database currently has no web based forms so an initial setup will need to be created such as an admin page to manage users and user rights.

The tables and form layout are already planned / developed.

I would expect all code and rights to be provided to me for future use and development of our site. I would require any information required so you or another developer could edit / update your work.

Tables to be used in the form (actual table names are different, just listing descriptive name here):
Main Tables:
clients table
tickets table
address table
contacts table
vendors table
accounting table
equipment table

Actual number & name of tables may vary.

We currently have this form designed and working in MS Access. This can be provided to you as a template to work from.
The data entry person will need to be able to do the following:
Select a Client Company Name from a drop down list (which pulls from our Clients Table)
Enter the Clients Ticket Number
Select the repair type from a drop down list
Enter the ticket location information:
- Enter the address of the ticket
- Enter the zip code which will then pull from our zip code table to automatically enter the city and state
Select the vendor id from a drop down list linked to our vendors table
Select the vendor profile (will default to vendor selected above but allow for edits from a drop down list)
Select the Timeframe Type for the Ticket from a drop down list
Enter the service date and have the pay period date auto entered based on our pay period table and the related service date
Enter the end date of the ticket (we use this if the ticket spans multiple days)
Date received (this field will default to current date but allow edits in the event data entry is behind)
Enter the time we are required to start the ticket and the time we are required to finish the ticket
Show a field at the end of the data entry which allows the data entry clerk to copy and paste to create calendar events and will pull information from the above fields to show: Client Company Name, Ticket Number, Timeframe Type, and Repair Type
Show another field at the end of data entry that allows for copy/paste of the location information.

An option button to allow more detailed data entry for advanced tickets to include:
Item code
Rate Amount
Rate Type
End User Name
Site Company Name

In the background, there will be the following items:
Date entered (enters actual date of data entry)
Internal ticket number (auto counting field from our tickets table)
Ticket status (defaults to active)
Client ID (auto entered based on the client name selected by the data entry clerk)(pulled from our clients table)
Followup By: default field to indicate the next person responsible for the ticket
Followup Required: default to new ticket status

Your bid should be a flat rate amount to develop this form to completion. I have tried to list all relative items to make your bid easier but I cannot guarantee that I have listed all fields, tables, drop-down lists, etc.

I can provide a copy of our Microsoft Access database for reference and all login information for the mysql database.

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