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, $110 (quantity) 1-liter 10X LB, $30.28 (quantity) 4-liter 10X LB, $85.60 (quantity) 1-liter 20X LB, $48.36 (quantity) 4-liter 20X LB, $141.18 (quantity) 10-liter 20X LB, $263.85 (quantity) 20-liter 20X LB, $472.88 (quantity) 8-Pack, LB loading medium, $28.77 (quantity) 50-Pack, LB loading medium, $119.89 (quantity) 4-liter 20X LA, $122.60 (quantity) 8-Pack, LA loading medium, $28.77 (quantity) 1-liter 10X SB, $28.70 (quantity) 4-liter 10X SB, $79.34 (quantity) 1-liter 20X SB, $45.78 (quantity) 4-liter 20X SB, $132.72 (quantity) 10-liter 20X SB, $248.07 (quantity) 20-liter 20X SB, $445.92 (quantity) 8-Pack, SB loading medium, $27.05 (quantity) 40-Pack, SB loading medium, $112.71 (quantity) Subtotal ($) Sales tax (Maryland non-tax exemt 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.