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, $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.