Custom solutions order request form

For a re-quote of an existing custom standard please provide
Part number or Quote number *
No	ANALYTE	CAS NUMBER (for compounds, if available)	CONCENTRATION
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Asterix * denotes mandatory field.

Dettagli del contatto
Solvent*
Volume *
Container , e.g.,CERTAN® capillary bottleAmpoule 1.5mL Bottle with screw cap
Number of units *
We recommend that volatile / organic solutions are packed in CERTAN® capillary bottles.
Minimum expiry period ( 3 months, 6 months, other) *
Validation protocol, e.g., Gravimetric, Quantitative, ISO Guide 34 *
Please provide details of your analytical technique in order that we can as far as possible tailor uncertainty calculations *
Have you purchased from LGC Standards before? *	sìNo
Please enter your LGC Standards account or an old invoice number (if known)*
Paese
Organizzazione*
Titolo *
Nome *
Cognome *
Telephone Number *
Email Address *
Re-type email address *
Invoice Details
Società - Organizzazione *
Company Number
Indirizzo (linea 1) *
Indirizzo (linea 2)
Address Line 3
Address Line 4
Città *
Paese*
Provincia*
State
Post Code*
Telefono *
Shipping details
Tick if shipping same as Invoice Details
Organizzazione *
Indirizzo (linea 1) *
Indirizzo (linea 2)
Address Line 3
Address Line 4
Città *
Paese*
Provincia*
State
Post Code*
Telefono *