Quick php, jquery, bootstrap one page

I am looking for quick php, jquery, bootstrap page. Attaching my requirement in image. This needs to be done today, so please do bid accordingly. Also, key aspect here is good, simple, crisp design & minimal code with best practices used. No ready components of data tables to be used please. This has to be simple, clear and minimal custom code used. Please confirm in bid that you can do this today & final quote.