CN-383-D HVI Color and Trash Calibration Standard Order Form

REPRODUCE LOCALLY

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
COTTON AND TOBACCO PROGRAM
DATE:

ORDER #

DO NOT WRITE IN THIS SPACE
PAID BY CHECK NO.
AMOUNT

Standardization & Engineering Division
3275 Appling Rd.
Memphis, TN 38133
Telephone: (901) 384-3030
Fax: (901) 384-3032
E-mail: [email protected]

RECEIVED BY

DATE

HVI Color and Trash Calibration Standard Order Form
ITEM

U.S.

Calibration Color Tile Set - 5 Tiles

L1

(Check Colorimeter Type)

Incandescent

Xenon

Calibration Color Tile - Single Tile

L3

FOB Memphis

$XXX.XX

Surface Delivery

$XXX.XX

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

Color Check Box
(6 assorted cottons)

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

Universal HVI Cotton Color Standard
(12 assorted cottons)
Reassignment of Calibration Color Tile Set

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

(Check Tile and Colorimeter Type)
W
B
Y
G
C

L4
L5

EXPORT

L6

Xenon
Incandescent

(Check Colorimeter Type)

Incandescent
Trash Tile (1)

M1

Xenon

M2

FOB Memphis

$XXX.XX

Surface Delivery

$XXX.XX

M3

Single Cotton Image Under Glass
(Check One)

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

FOB Memphis

$XX.XX

Surface Delivery

$XX.XX

M4
M5

Request Quote for
Air Freight Pre-Paid

1

2

3

4

5

6

Leaf Guide Book (Check Type)
American Upland

American Pima

Tile Storage Box (Check Type)
Color Tile Box

Cotton Under Glass Box

$

Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid

(Check Lighting Type)

Incandescent
Xenon
Cotton Images Under Glass
(6 Trash Levels)

DOLLAR
AMOUNT

QUANTITY

Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid
Request Quote for
Air Freight Pre-Paid

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 AND TOBACCO PROGRAM.
CHECK
VISA
MC
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.

SHIP TO (print or type)
CONTACT NAME

COMPANY NAME

STREET ADDRESS (necessary)

POSTAL BOX

STATE, COUNTRY, AND ZIP CODE

E-MAIL ADDRESS

PHONE

CITY
FAX

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CN-383-D (12-06)