Ajax form and data visualization

I need a two page website that includes a form and data visualization very similar to the ones shown here: [login to view URL] People should be able to select three or four choices out of aproximately 10 (including an optional "suggest your own choice") along with some basic personal data just as in the page shown. Email field should be mandatory but basically as a means to stop duplicate voting. All data should be stored in a database. Respondents will come mainly from one city instead of different cities and countries, still we should have an optional "other country" "other city" to be filled out if necesary as well. The city is divided into large neighbourhoods and the voters must specify in which one they live. Once they cast their votes data should be retrieved from database and shown in a way similar to the page shown. It is important to be able to visualize totals by gender, age group, location (neighborhood) as well as an interactive query (See "people like you") where you can specify a gender, age group and location. Finally an interactive little map of the city (vector map with neighbourhoods would be provided) to see specific results from it. Please specify the cost of the project with real time voting shown over the neighbourhood and without it.