Convert a Template to a Website - Single Landing Page

Need a simple design translated into a landing page. The page should be centered with white bars on the side. Resizes to fit the screen. There is a basic background with a mail form on the left (code from MailChimps) and video on the right (embedded Youtube). Photo attached for quote, will provide the following to developer 1. PSD file 2. Logo file 3. Link to Youtube video 4. MailChimp code to implement 5. Background image 6. Address for the links to point to (about us page on bottom)