For credit card purchases, print and fax a pdf form.   ONLINE ORDER FORM Ship Attn To: Institution/Company 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, $180 (quantity) 1-liter 10X LB, $76.28 (quantity) 4-liter 10X LB, $215.66 (quantity) 1-liter 20X LB, $121.83 (quantity) 4-liter 20X LB, $355.71 (quantity) 10-liter 20X LB, $664.75 (quantity) 20-liter 20X LB, $1191.35 (quantity) 8-Pack, LB loading medium, $72.45 (quantity) 50-Pack, LB loading medium, $302.06 (quantity) 4-liter 20X LA, $196.96 (quantity) 8-Pack, LA loading medium, $72.45 (quantity) 1-liter 10X SB, $76.28 (quantity) 4-liter 10X SB, $215.66 (quantity) 1-liter 20X SB, $121.83 (quantity) 4-liter 20X SB, $355.71 (quantity) 10-liter 20X SB, $664.75 (quantity) 20-liter 20X SB, $1191.35 (quantity) 8-Pack, SB loading medium, $72.45 (quantity) 40-Pack, SB loading medium, $302.06 (quantity) Subtotal ($) 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.