ORDER FORM 2011 VETERINARY DRUG RESIDUES AND MYCOTOXINS
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1 ORDER FORM 2011 VETERINARY DRUG RESIDUES AND MYCOTOXINS COMPANY NAME SHIPPING ADDRESS..... POST CODE:..CITY: COUNTRY.... CONTACT PERSON: TEL.No:.FAX.No.. VAT N. (mandatory for EU companies):.. BILLING ADDRESS (if different from the shipping address)...post CODE:..CITY: COUNTRY.... ATTENTION PLEASE: DO NOT FORGET TO INFORM US IN CASE OF ANY ADDRESS CHANGE AFTER THE ORDER DATE. 1 DI 6
2 I ROUND: SHIPMENT 21 ST MARCH 2011 Steroids U1110A 380,00 U1110B 240,00 RAL s Stilbenes β-agonists Corticosteroids Promazine Nitrofuran metabolites Honey U1111A 380,00 U1111B 240,00 U1112A 380,00 U1112B 240,00 U1113A 380,00 U1113B 240,00 U1114A 380,00 U1114B 240,00 U1115A 300,00 U1115B 200,00 A + B 450,00 H1116A 300,00 H1116B 200,00 A + B 450,00 Additional materials I round: 2 DI 6
3 II ROUND: SHIPMENT 5 TH SEPTEMBER 2011 M1120A 330,00 CAP M1120B 240,00 Quinolones Nitrofuran metabolites Tetracyclines Sulphonamides Sulphonamides Eggs M1121A 330,00 M1121B 240,00 M1122A 330,00 M1122B 240,00 M1123A 330,00 M1123B 240,00 M1124A 330,00 M1124B 240,00 E1125A 330,00 E1125B 240,00 Additional materials II round: 3 DI 6
4 III ROUND: SHIPMENT 14 TH NOVEMBER 2011 L1130A 330,00 β-agonists Liver L1130B 240,00 Corticosteroids Sulphonamides Tetracyclines / Quinolones Histamine Sulphonamides / tylosin Liver Milk Milk Tuna Animal feed L1131A 330,00 L1131B 240,00 MI1132A 330,00 MI1132B 240,00 MI1133A 330,00 MI1133B 240,00 T1134A 250,00 T1134B 150,00 F1136A 250,00 F1136B 150,00 Quinolones Animal feed F1137A 250,00 F1137B 150,00 Additional materials III round: 4 DI 6
5 MYCOTOXINS ROUND: SHIPMENT 13 RD JUNE 2011 MA1140A 250,00 Fumonisins / Aflatoxins Maize MA1140B 150,00 DON / Zearalenone Aflatoxin M 1 DON / T2 toxin DON Ochratoxin Maize Milk Wheat Durum wheat Wine MA1141A 250,00 MA1141B 150,00 MI1142A 250,00 MI1142B 150,00 WH1143A 250,00 WH1143B 150,00 WH1144A 250,00 WH1144B 150,00 W1145A 250,00 W1145B 150,00 Additional materials mycotoxins round: 5 DI 6
6 - All prices are subject to VAT where applicable. - The discount is applied to materials "A", "B" and "A + B" but not to the additional materials. - The price includes the final report in pdf-format; if you wish to receive a hardcopy copy you must request it. TEST MATERIALS (please insert here the total amount for all the codes you want to order) 10% discount for purchasing 3-5 test materials (either A or B ) - 15% discount for purchasing 6 or more test materials (either A or B ) - Discounted total (euro) Additional materials total (euro) Shipping cost (muscle, animal feed, liver, wine, eggs) 85,00 euro for EU countries, 150,00 euro for other destinations in Europe Shipping cost (urine, milk, wheat, honey) 50,00 euro for EU countries, 100,00 euro for other destinations in Europe Hardcopy Final Report, 65,00 euro (Price for each report/round) Order total (euro) Shipping costs for overseas non european destinations will be quoted on request. A fixed bank charge of 15,00 euro will be applied for the orders from non-eu countries. ORDER PLACEMENT DEADLINES 15/01/11 for the I round 15/06/11 for the II round 30/09/11 for the III round 16/05/11 for the mycotoxins round INVOICING, PAYMENT CONDITIONS The performance assessment service will start from the registration to the proficiency program. For this reason the invoice will be issued upon the receipt of your order and has to be paid before the test materials will be shipped. Note: in case your invoice is not paid before the test materials are send, your laboratory would be cancelled from the participant's list. Payment can be made by bank credit transfer. Our bank details will be indicated in the order confirmation and in the invoice. SIGNATURE DATE.. 6 DI 6
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