Convert one html page to a J query Mobile Page

Hi, I have a small project I need a website page that I need converted to a j query mobile page. The page can be viewed here [login to view URL] Type Green Street in the Street field and 97420 in the Zip Code Field to access the page. The page has a link that allows a pdf to be downloaded (see Download Report) and also has a Subscribe form. Both page functions access a mysql database and are fully functional, I just need someone to convert the page to a simple mobile page. I also have the mobile page html and css complete, so I just need the two elements implemented. I will not need any other elements or functionality from the existing page implemented into the mobile page. My budget is no more than $100. I may also need to add a couple of additional fields to a fully functional mobile contact form, so please consider this when bidding. Please include samples of your work when bidding. Thanks for your interest.