BioQControl Order form

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You can send your orders to us by this form. In several countries an distributor is appointed. In those cases you have to order at the local distributor. You can still use this order form, but send it to the distributor. Please fill out the form, print it, sign it and send it by telefax. We also accept external PO forms. More info from This e-mail address is being protected from spambots. You need JavaScript enabled to view it .or the distributor

Cat. nr., price, format and name quantity
Cat. nr., price, format and name quantity
Cat. nr., price, format and name quantity
Name:
Department:
Institute:
Adress:
Postal code:
Customer order number:
Delivery adress (if different):
Postal code:
Billing adress (if different):
Postal code:
City:
Country:


Signature:
Telephone number:
Telefax number:
e-mail:
VAT code (only EU countries)
Print this form and fax it to bioQControl. We will send an proposal within 10 working days. On the order form the mandatory information is marked bold. Although we prepared the price lists carefully errors may occur. After receiving your submission we will send a order confirmation. The mentioned prices are list prices. On the confirmation we will mention also your discounts.
Telephone: ++31-70-340.1670 Telefax: ++31-70-340.1671

 

Product for Nucleic Acid Testing are infectious. Some countries requires import permits for infectious substances (Class 6.2, UN3373). Please check at your customs office about the requirements. Without an import permit we cannot execute your order.