Convert mockup to HTML/CSS

I need you to convert a mockup (1 page) to clean, validating and structured HTML/CSS. Please see the attached wireframe. The page contains several panels, dropdowns, input fields, checkboxes and textareas. Please see the attached file (it's a wireframe, I will send you the actual PSD once the design is ready). For privacy reasons I can't provide you with the full-resolution file right now, but will do so once the project is awarded to you. Please provide examples of your work when you apply for the job.