Procurement request for IARMA-010 CRM

K-40 and Cs-137 in Hay

Price: 300 GBP (£) plus VAT (where applicable) including shipment within the EU (Outside EU, shipping is made at cost)

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Quantity (Bottle)

Number of bottles to be ordered

Institute/Laboratory or Business Name *

Title *

Ms.

Mr.

Eng.

Dr.

Contact Name *

First

Last *

Last

Email *

Phone *

Will be used by the forwarding company

Company Invoicing Address: *

VAT as noted on your purchase order (if applicable):

City *

Postal Code *

Country *

Delivery Address: (If different from above) :

This is the address to which the samples will be delivered to.

City

Country

Postal Code

We request:

Quotation

Proforma Invoice

VAT Invoice– note this will be sent upon material dispatch

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Invoicing or shipment requirements.

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