AccuTrac ORDER FORM

SHIPPING INFORMATION

BILLING INFORMATION

Name: ___________________________

Address: _________________________

_________________________________

_________________________________

Phone: _______________

Fax: _________________

Email: ___________________________

Name: ___________________________

Address: _________________________

_________________________________

_________________________________

Phone: __________________

Fax: ____________________

P.O. #: __________________

Sequencing Method:

AccuTrac for DYE-TERMINATOR

CAT # SIZE QUANTITY COST (Each)* TOTAL
AT-3 3ml   $70  
AT-10 10ml   $200  
AT-50 50ml   $800  
AT-100 100ml   $1,400  


AccuTrac-P for DYE-PRIMER

CAT # SIZE QUANTITY COST (Each)* TOTAL
ATP-3 3ml   $70  
ATP-10 10ml   $200  
ATP-50 50ml   $800  
ATP-100 100ml   $1,400  


      Total: _________________

CBI will waive all shipping handling fees for orders that exceed $1,000.
Volume discounts are also available, please inquire.
*Prices do not reflect tax or shipping and handling fees.