iPad app + Website, Server Side

I need an app with website + payment gateway. For custom form creator for survey / lead generation purpose at trade shows. we should be able to collect the data online and offline. Required Feature Standard Question Types Offline Data Collection Real-Time Survey Results Graphical Reporting Download/Export to Excel Responses by Username Responses by Hour Security (SSL Encryption) Basic Skip Logic/Question Branching Ability to add multiple devices Email Support Role-Based Access Control/User Management Add your own logo Add your own background image Splash Screen Questions Survey Locking for Kiosks Survey Timeout for Kiosks QR Code Scanning Instant Auto-Email Complex Skip Logic Survey Meta-Data PDF Reporting Facebook Like Questions Map Point Questions Multiple Choice - Image Questions Show YouTube Video Terms & Conditions Questions PDF Viewer Photo Capture Signature Capture Swipe To Reveal Instant Prizing Splash Screen Secure Encrypted Data Kiosk Locking Kiosk Timeout User Management CRM Integration : Custom Built ,Infusionsoft, Salesforce, ExactTarget, SQL Databases, Constant Contact, MailChimp, AWeber, iContact, SyncApps, Zapier, Web Forms so total summery : app + web + server side + user management + payment gateway + crm let me know what is the time frame to make it and cost. my deadline is Oct 31st 2013. bid only if you have an experience and you can deliver it Thank You send me the quote. thanks