5737 Jenness Hall Orono, ME 04469‐5737 Phone: (207) 581‐2281 Fax: (207) 581‐4174 http://umaine.edu/pdc/ Nanocellulose Request Form Please indicate the type, form and amount of Nanocellulose that you require. Cost is by weight, dry basis, exclusive of shipping charges. Orders will be shipped via Fed Ex two‐day delivery, unless otherwise instructed ‐ subject to available inventory. Date of Request: ________________________ Item Number 1 Material Form
(minimum order size) Cellulose Nanofibrils Number of Pounds
(dry basis) Slurry, 3.0% solids
Cost, USD per pound (dry basis) Cost ‐ USD
S/H will be added $50 $800 $250 $180 $450 $500 Not yet Available
n/a n/a Not yet Available
n/a n/a TOTAL for 1 pound units 2 3 4 5 6 7 8 Cellulose Nanofibrils Spray‐dried Cellulose Nanocrystals, acid hydrolysis LARGE BATCH Cellulose Nanocrystals Dry Cellulose Nanocrystals Freeze‐dried Dry Cellulose Nanocrystals Spray‐dried Dry Cellulose Nanofibrils, TEMPO Cellulose Nanofibrils, TEMPO Slurry, 0.3‐1.0% solids Dry 1/2 pound units Slurry, 11.8% solids
1 pound units Slurry, 11.8% solids 55‐gallon drum ¼ pound units ½ pound units samples Plus Shipping/Handling SHIP TO: BILL TO: if different than Ship To address Company Name: ____________________________ Contact Name: ____________________________ Address: ____________________________ ____________________________ City: ____________________________ State: ____________________________ Zip/Postal Code ____________________________ Country: ____________________________ Company Name: ____________________________ Contact Name: ____________________________ Address: ____________________________ ____________________________ City: ____________________________ State: ____________________________ Zip/Postal Code ____________________________ Country: ____________________________ Telephone: ____________________________ Email: ____________________________ SPECIAL SHIPPING or HANDLING NEEDS: Telephone: ____________________________ INTERNAL NOTES: EMAIL: (if prefer Invoice sent by email) __________________ Purchase Order # ________________ PRE‐PAYMENT REQUIRED FOR OVERSEAS SHIPMENT CREDIT CARDS, WIRE, AND BANK TRANSFERS ACCEPTED