Script Like Survey Monkey = $400 To Make. Repost.

Hey, I am posting this again to see if I can get better bids. Thank you. I need a script that will do all that has been posted in the attached PDF. My budget for this is $400. Some additional features will come up as we work on the project, so be prepared to add a few features if needed. I will Escrow $100 as we start and release the escrow as well as pay the remaining $400 upon completion of the project. You will also need to be a good designer, as I will need a professional Web 2.0, AJAX based design for the script with unlimitted revisions. The script needs to use AJAX so it is comfortable to use. Please Provide Samples Of Previous Work. Thank you.