For credit card purchases,
print and fax a pdf form.


Ship Attn To:
Full Shipping Address
Ship-To E-mail Address
Ordered by (name)
Phone (for questions)() -
Bill-To Department
Full Bill-To Address
Payment Dept Phone or E-mail
Purchase Order Number
100g Tap-Out agarose, $170 (quantity)
1-liter 10X LB, $66.33 (quantity)
4-liter 10X LB, $187.53 (quantity)
1-liter 20X LB, $105.94 (quantity)
4-liter 20X LB, $309.31 (quantity)
10-liter 20X LB, $578.04 (quantity)
20-liter 20X LB, $1035.96 (quantity)
8-Pack, LB loading medium, $63.00 (quantity)
50-Pack, LB loading medium, $262.66 (quantity)
4-liter 20X LA, $171.27 (quantity)
8-Pack, LA loading medium, $63.00 (quantity)
1-liter 10X SB, $66.33 (quantity)
4-liter 10X SB, $187.53 (quantity)
1-liter 20X SB, $105.94 (quantity)
4-liter 20X SB, $309.31 (quantity)
10-liter 20X SB, $578.04 (quantity)
20-liter 20X SB, $1035.96 (quantity)
8-Pack, SB loading medium, $63.00 (quantity)
40-Pack, SB loading medium, $262.66 (quantity)
Subtotal ($)

Sales tax (Maryland non-tax exempt buyers only - 6%) and freight charges (ground) will be added at time of invoicing.

Tax exempt status for Maryland non-profits and governmental agencies can be declared using the separate one-time form.

For Canada and other countries outside NAFTA, any duty/tax will be billed separately to you by the courier.