Need a clean conversion from PDF to Excel

Project requires converting the attached PDF document to Excel. Document needs to be reproduced _identically*?*_*?** *with the blank spots having their own cell for me to use as a template that can be filled in. Completed file needs to be perfectly accurate. I have already tried automatic converters and they were unsuccessful, so please only bid if you are willing guarantee that the file is a perfect replicate. It's only 2 pages and the data is not very difficult, more time consuming than anything.