[quote request] ASP Coding

I have this order form that I need to modify to do the following:

A customer that has already been added to a database is able to automatically fill out the contact form by entering his customer ID.

The order is sent via Jmail. (you dont have to worry about that)

Details:
Access database table setup (customer id, name, company, address, zip, city, e-mail, telephone)

Password protected/hidden admin page with the following functions:
- Add contacts
- View existing contacts
- Delete contacts

Integration with the existing order form.
- Pull out customer contact data by entering a customer ID

Link to a test version of the order form

Please post your quote and the amount of time you think it will take for you to make this.

Thanks.