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NEW PRICING TO START APRIL 01, 2008
Prices
subject to change without notice.
*International orders require USD $100.00 minimum product order.
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PAGE 2
WE
(THE UNDERSIGNED) ASSUME RESPONSIBILITY FOR THE PROFESSIONAL APPLICATION
OF THESE PRODUCTS FOR RESEARCH OR SERVICE LABORATORY USE:
CONTACT
PERSON___________________________________________
(Please print name, sign and date)
___________________________________________
(signature)
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Date:___________________________ Purchase Order
NO:______________
Billing Address:
Company Name_________________________
Attn To________________________________
Address_______________________________
______________________________
______________________________
City, State,
Zip_________________________
Country_______________________________
Phone/Fax_____________________________ |
Date:___________________________
Shipping Address:
(If different from Billing Address)
Company
Name_________________________
Attn
To________________________________
Address_______________________________
______________________________
______________________________
City, State,
Zip_________________________
Country_______________________________
Phone/Fax_____________________________ |
