SAMPLE SHIPMENT FORM
Recipient:Sender:Shipment Information:
[Recipient Person][Sender Person][Quotation Number]
KYMOS Pharma Services, S.L.[Company][Study Number] *
Parc Tecnològic del Vallès. C/ Paletes, 7[Address][Study Director] *
08290 Cerdanyola del Vallès.[Number of Items] Data Logger
Barcelona. Spain[Date]
* Non mandatory fields
Content:
Samples and Materials (reagents, standards, columns or others) / Batch / Expected Quantity / Delivered Quantity / Storage Conditions / Handling Conditions / Safety Data SheetTemperature / No Light
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
No RequirementsRoom Temperature (<25ºC)Climatic ChamberRefrigerator (2 to 8ºC)Frezeer (-20ºC)Ultrafrezeer (-80ºC) / No RequirementsBiologic hazardRadioactive hazardHigh potent drug
Comments(please, justify differences in quantitie, if any) Additional Information:Signature:
Reception schedule:Monday toThursday 8:30 to 16:00 and Friday 8:30 to 14:00.Phone: +34 935 481 848
Disclaimer: A detailed checking of the shipment content will be done within the following 15 days from the reception date.
Formulario: D003-m02e02 (fecha de vigencia: 15/09/2015)