Taxi Transfer Site Help

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hi, i need help to build a website on pw, i need a search & booking request form, the logic is

 choose a pick up location (predefined locations from pages) then pick a drop of location again (predefined locations from pages) then choose how many passengers (1-4, 5-8, 9-12. etc) and then show the price which is based on the previous selections, example, pick up from point a, drop of on point b, 5 passengers, the price is 15 euro. And then the customer send the form thru email to administrator and the confirmation email is send to client automatic.

Wait for suggestion of the cost, thank you!

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