Thanks for sharing your requirements with us as i have gone through your requirements i understood that you are looking for a single html page as you have attached in example [login to view URL]
Relevant Skills and Experience
HTML 5 ,CSS3, BOOTSTRAP, JAVA SCRIPT, J QUERY, Ajax, PHP, MYSQL, LARAVEL, CAKE PHP,
Codeigniter, WORDPRESS, Drupal, Joomla, Custom CMS, Magento, Prestashop, Woo Commerce, AND .NET TECHNOLOGIES.
Proposed Milestones
£200 GBP - needs to be discussed
Do you want exactly as you mentioned in Example [login to view URL] ?