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

Standardization & Engineering Division

PAID BY CHECK NO.

AMOUNT

3275 Appling Rd.

Memphis, TN 38133

Telephone: (901) 384-3030

RECEIVED BY

DATE

Fax: (901) 384-3032

E-mail: cotton.standards@ams.usda.gov

HVI Color and Trash Calibration Standard Order Form

ITEM

U.S.

EXPORT

QUANTITY

DOLLAR AMOUNT

L1

Calibration Color Tile Set - 5 Tiles

$XXX.XX

Request Quote for Air Freight Pre-Paid

(Check Colorimeter Type)

$XXX.XX

Incandescent

Xenon

L3

Calibration Color Tile - Single Tile

$XX.XX

Request Quote for Air Freight Pre-Paid

(Check Tile and Colorimeter Type)

Xenon

$XX.XX

Incandescent

L4

Color Check Box (6 assorted cottons)

$XX.XX

Request Quote for Air Freight Pre-Paid

$XX.XX

L5

Universal HVI Cotton Color Standard (12 assorted cottons)

$XX.XX

Request Quote for Air Freight Pre-Paid

$XX.XX

L6

Reassignment of Calibration Color Tile Set

$XX.XX

Request Quote for Air Freight Pre-Paid

(Check Colorimeter Type)

$XX.XX

Incandescent

Xenon

M1

Trash Tile (1)

$XX.XX

Request Quote for Air Freight Pre-Paid

(Check Lighting Type)

$XX.XX

Incandescent

Xenon

M2

Cotton Images Under Glass (6 Trash Levels)

$XXX.XX

Request Quote for Air Freight Pre-Paid

$XXX.XX

M3

Single Cotton Image Under Glass

$XX.XX

Request Quote for Air Freight Pre-Paid

(Check One)

$XX.XX

M4

Leaf Guide Book (Check Type)

$XX.XX

Request Quote for Air Freight Pre-Paid

American Upland

American Pima

$XX.XX

M5

Tile Storage Box (Check Type)

$XX.XX

Request Quote for Air Freight Pre-Paid

Color Tile Box

Cotton Under Glass Box

$XX.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 AND TOBACCO 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.

SHIP TO (print or type)