CN-383-K Micronaire Orifice Calibration Material Order Form

REPRODUCE LOCALLY

UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

COTTON AND TOBACCO PROGRAMS

DATE:

ORDER #

DO NOT WRITE IN THIS SPACE

Standardization & Engineering Branch

PAID BY CHECK NO.

AMOUNT

3275 Appling Rd.

Memphis, TN 38133

Telephone: (901) 384-3030

RECEIVED BY

DATE

Fax: (901) 384-3032

E-mail: [email protected]

Micronaire Orifice Calibration Material Order Form

ITEM

U.S.

EXPORT

QUANTITY

DOLLAR AMOUNT

J1

Micronaire Orifice Set

$XXX.XX

Request Quote for Air Freight Pre-Paid

Storage Box, 10 gram brass weight, and Low & High Orifice Plugs

$XXX.XX

J2

Low Micronaire Orifice Plug

$XX.XX

Request Quote for Air Freight Pre-Paid

J3

High Micronaire Orifice Plug

Request Quote for Air Freight Pre-Paid

J4

Reassignment of Micronaire Orifice Set (Requires the return of orifice set)

$XX.XX

Request Quote for Air Freight Pre-Paid

$XX.XX

J5

Micronaire Orifice Storage Box Includes 10 gram brass weight

$XX.XX

Request Quote for Air Freight Pre-Paid

$XX.XX

S1

Micronaire Chamber Calibration Cotton

$XX.XX

Request Quote for Air Freight Pre-Paid

(5 lbs.)

$XXX.XX

Totals

PAYMENT MUST BE SUBMITTED WITH ORDER. WE DO NOT ACCEPT LETTERS OF CREDIT.

CHECK MUST BE DRAWN ON A U.S. BANK PAYABLE TO : USDA, AMS, COTTON PROGRAM.

ACCT. NO.

EXPIRES

SIGNATURE

PRICES: Price of standards includes packaging, handling and delivery where stated. Fumigation (if needed) is a minimum of $XX.XX per order. Phytosanitary Certificate (if needed) is $XX.XX.

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