Peptide pdf order form

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Peptide order form : Peptide synthesis , Peptide Production ,Peptide Sequence ,Multiple
Antigenic Peptide(MAP) System ,Protein Carrier Conjugation,Fluorescence/Dye labeling

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Peptide pdf order form

  1. 1. Peptide Order Form4150 Tuller Rd, Suite 228Dublin, Ohio 43017Fax: 614-792-8685Phone: 614-792-8680Toll Free: 800-860-9729e-mail: save@bio-world.com l abor at or y ser - w w w . bi o- w or l d. c omPlease fill out form as completely as possible. BILL TO: PO#________________ Customer#________ SHIP TO: Name_________________________________________ Name_______________________________________ Institution______________________________________ Institution____________________________________ Department_____________________________________ Department__________________________________ Address________________________________________ Address_____________________________________ ______________________________________________ City, State, Zip________________________________ City, State, Zip__________________________________ Phone_______________________________________ Phone_________________________________________ Fax_________________________________________ PEPTIDE 1 Peptide Name__________________________ Write Sequence N to C INDEX A-Ala ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 C-Cys d-Asp e-Glu ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 F-Phe g-Gly Purification __Unpurified (15-40mg) __>70%pure (5-25mg) __>80%pure (5-15mg) __>95%pure (5-10mg) H-His I-Ile Conjugation __KLH (Keyhole Limpet Hemocyanin) __BSA(Bovine Serum Albumin) K-Lys Conjugation Terminal End __ N-terminal __C-terminal L-Leu M-Met Modifications___________________________________________________________________________________________________ N-Asn ______________________________________________________________________________________________________________ P-Pro Q-Gln ____________________________________________________________________ Setup (MAPONLY) $__________ R-Arg AA Bases ≤80# ___ $__________ Comments___________________________________________________________ S-Ser AA Bases >80# ___ $__________ T-Thr ____________________________________________________________________ Modifications $__________ V-Val ____________________________________________________________________ Purification $__________ W-Trp TOTAL $__________ Y-TyrModification Succinylation $60.00 Multiple Antigenic Peptide (MAP) SystemAcetylation $65.50 Sulfonation $485.00 Set-Up Fee (ALL MAPPEPTIDES) $75.00Amidation(C-terminal) $50.00 Fluorescence/Dye labeling Asymmetric 4 branches $275.00Benzyloxycarbonylation $48.00 Aminocoumarin $200.00 Symmetric 4 branches $285.00Biotin $150.00 Biodipy $350.00 Asymmetric 8 branches $295.00Dansylation $60.00 Fluorescein $200.00 Symmetric 8 branches $295.00Dinitrobenzoylation(DNP) $60.00 Lissamine $250.00Fatty Acid $48.00 Rhodamine $195.00 PurificationFormylation $160.00 NBD $250.00 Unpurified (Greater than 60% Pure) $0.00Nitronation $120.00 Tetramethylrhodamine $200.00 Greater than 70% Pure $170.00Phosphorylation-Serine $160.00 Protein Carrier Conjugation Greater than 80% Pure $210.00Phosphorylation-Threonine $160.00 KLH(Keyhole Limpet Hemocyanin $245.00 Greater than 95% Pure $260.00Phosphorylation-Tyrosine $160.00 BSA(Bovine Serum Albumin) $245.00 ORDERING AND CREDIT CARD INFORMATION ___VISA ___Mastercard Amount $__________ + Shipping $____________= TOTAL $____________ Card Number_______________________________________ Expiration Date__________ Cardholder Name (as it appears on card) _________________________ Signature__________________________________________
  2. 2. Peptide Order Form continued Use this form for additional peptide sequences. I A-Ala F-Phe K-Lys P-Pro T-Thr I N C-Cys g-Gly L-Leu Q-Gln V-Val N D D d-Asp H-His M-Met R-Arg W-Trp E E lab or at ory se r - X e-Glu I-Ile N-Asn S-Ser Y-Tyr X w w w.bio- PEPTIDE 2 Peptide Name__________________________ Write Sequence N to C ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Purification __Unpurified (15-40mg) __>70%pure (5-25mg) __>80%pure (5-15mg) __>95%pure (5-10mg) Conjugation __KLH (Keyhole Limpet Hemocyanin) __BSA (Bovine Serum Albumin) Conjugation Terminal End __ N-terminal __C-terminal Modifications/Comments:_________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ PEPTIDE 3 Peptide Name__________________________ Write Sequence N to C ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Purification __Unpurified (15-40mg) __>70%pure (5-25mg) __>80%pure (5-15mg) __>95%pure (5-10mg) Conjugation __KLH (Keyhole Limpet Hemocyanin) __BSA (Bovine Serum Albumin) Conjugation Terminal End __ N-terminal __C-terminal Modifications/Comments:_________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ PEPTIDE 4 Peptide Name__________________________ Write Sequence N to C ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Purification __Unpurified (15-40mg) __>70%pure (5-25mg) __>80%pure (5-15mg) __>95%pure (5-10mg) Conjugation __KLH (Keyhole Limpet Hemocyanin) __BSA (Bovine Serum Albumin) Conjugation Terminal End __ N-terminal __C-terminal Modifications/Comments:_________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________4150 Tuller Rd, Suite 228 • Dublin, Ohio 43017 • Phone: 614-792-8680 • Toll Free: 800-860-9729 • Fax: 614-792-8685 • save@bio-world.com

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