One webpage designed

I need one website page designed for a home security company, it will have some text and a logo at the top, a video on the left hand side and a contact form on the right hand side, the video will be provided to you and you dont need to do anything with it just integrate it into the design, its very easy to integrate into the website, please provide samples with your bid, thanks, the programming work for the contact form is already done, we just need you to make a design for us.