making prototype

For a customer-project we´re looking for an interface developer (html, javascript, css, jquery, ajax, php) who will implement a calculator based on [login to view URL] (script will be delievered by us). The principle function should look like this (a visual of this concept can be found here: [login to view URL] ): (A) customer enters a zip-code or name of a city (B) this vaules is used to do an REST call to our existing API. based on this results two sliders habe to be displayed (price, radius). depending on this values our api delievers a json-return with websites and price (per time unit, standard is day) (C) this values should be used to calculate a final price If this form is submit this values should be sent by POST to the next order step. Please add working examples of you work (similar project prefered) and an educated guess of the time you need to realize.