Custom Chemical Quote Request Form - Lab Safety Supply®

800-356-0783

Custom Chemical Quote Request Form

Request a quote using our Custom Chemical Quote Request Form: Simply fill out this Quote Request Form with your custom chemical specifications, as completely as possible, and then submit for quote. After receipt of your quote request, you will receive an e-mail confirming our receipt of your quote request. An LSS Technical Representative will then forward your quote request to our custom chemical supplier. Once LSS has heard from our supplier, your Technical Representative will contact you with pricing, including shipping and lead-time information. Only one chemical can be requested on each custom chemical quote form. If you have multiple custom chemical quote requests you will need to complete a form for each chemical. Click here for a listing of chemicals that LSS and its chemical supplier do not provide.

Chemicals ordered through the Custom Chemical Program are not returnable - all sales are final. Shelf life testing to determine expiration date is not performed on custom chemicals unless requested by the customer. The custom chemical supplier will charge an additional cost for shelf life testing which will be included in the product cost. The custom chemicals will not include an expiration date on the product or its packaging. LSS only sells chemicals to businesses, institutions, full-time educators and other professionals in the United States. All chemicals are sold for laboratory or industrial use only and are not intended for drug, food or household use. No orders will be accepted from individuals or for export.

Please verify your information below:

Product Specifications
Product Name
Container Size (max 450L or 400Kg) include units (g,kg,lb,pt,etc)	*
Number of Containers	*
Grade (if other please specify)	*
Concentration: include units (M,N,%,etc)	*
Tolerance Allowed (if any or N/A)	*
CAS Number
Initial Shipment Due Date	*
Special Instructions (ex. Amber Bottle, special testing requirements.)

Customer Information
First Name:	*
Last Name:	*
Title/Position:
Company:	*
Address 1:	*
Address 2:
City:	*
State	*
Zip/Postal Code:	*
Country:	*
No orders will be accepted for export.
Phone:	*
E-Mail Address:	*
Fax:
Customer ID:

Billing Information
	Same as Customer Information
Company:	*
Address 1:	*
Address 2:
City:	*
State	*
Zip/Postal Code:	*
Country:	*
No orders will be accepted for export.
Phone:	*
Fax:

Shipping Information
	Same as Customer Information
Company:	*
Address 1:	*
Address 2:
City:	*
State	*
Zip/Postal Code:	*
Country:	*
No orders will be accepted for export.
Phone:	*
Fax:

* Required Fields

I agree to the terms and conditions specified below.

After submitting this form a representative will contact you to confirm your custom chemical order

Chemicals and Reagents
Lab Safety Supply (LSS) is proud to offer the complete line of chemicals and reagents from LabChem, as well as custom formulations. LabChem offers dry chemicals, solutions and reagents prepared to exact quality standards and certified for use in laboratories performing a variety of analyses. In business since January 1986,LabChem is an ISO 9001:2000 certified company.

Sales Policy

Lab Safety Supply, Inc. (LSS) sells chemicals to businesses, institutions, full-time educators and other professionals. All chemicals are sold for laboratory or industrial use only and are not intended for drug, food or household use. No orders will be accepted from individuals or for export.

Shipping
The shipment of hazardous materials is regulated by the U.S. Department of Transportation (D.O.T.). This regulation covers standards for the construction of containers and maximum volumes that containers may hold. All carriers must comply with D.O.T. standards. Package delivery companies and over-the-road (OTR) carriers may impose additional restrictions and shipping charges for hazardous shipments. UPS will not ship some chemicals and imposes quantity restrictions on others. Every attempt is made to deliver shipments by the most economical means available. To verify whether or not restrictions or additional charges apply to your order, call 1-800-356-0783.

Returns
Chemicals are returnable only with prior authorization from LSS. Custom chemical formulations are not returnable. To arrange the return of an item for exchange, credit or refund, call 1-800-356-0783. Hazardous materials must be packed, labeled and shipped by the buyer in accordance with D.O.T. regulations.

Claims and Damaged Shipments
If you receive items that appear to be damaged, do not accept them from the carrier. If you discover hidden damage after accepting an item, notify the carrier and LSS at 1-800-356-0783 immediately. Do not return damaged items without prior authorization.

Restricted Materials
All sales of restricted chemicals, including drug precursors, are reported to the appropriate local, state and federal law enforcement agencies, including the U.S. Drug Enforcement Agency, Federal Bureau of Investigation and the Bureau of Alcohol, Tobacco, Firearms and Explosives.

Compliance and Liability
LSS sells only to businesses, including institutions, educators and professionals. Knowledge of, and compliance with, all applicable local, state and federal regulations is the sole responsibility of the buyer and/or end user. Liability for the safe use, storage and disposal of chemicals rests entirely with the buyer and/or end user.

Warranty
Chemicals are warranted to meet label specifications. All information and statements listed on the label are believed correct and are given without warranty of any kind. Liability is limited to replacement, a credit or refund of the purchase price. Custom chemical formulations are provided “AS IS” without any warranties. Except as described herein, there are no express warranties or implied warranties, including, but not limited to, merchantability and fitness for a particular purpose. LSS shall not be subject to and disclaims: (1) any other obligations or liabilities arising out of breach of contract or of warranty, (2) any obligations whatsoever arising from tort claims (including negligence and strict liability) or arising under other theories of law with respect to products sold or services rendered by LSS, or any undertakings, acts or omissions relating thereto, and (3) all consequential, incidental, and contingent damages whatsoever. LSS’s liability in all events is limited to, and shall not exceed, the purchase price paid.

Terms of Sale
LSS’s Terms of Sale, which are incorporated herein by reference and may be found on LSS.com, apply to all purchases of chemicals and reagents, except for the above terms and conditions which supplement, or to the extent they are conflicting, supersede any conflicting terms and conditions with respect thereto.

Material Safety Data Sheets
All chemicals are labeled and all labels are marked with lot number and expiration date, except custom chemicals. Material Safety Data Sheets (MSDS) are shipped with each item. Additional MSDSs are available by request. Call 1-800-356-2501.

Certificates of Analysis
Applicable certificates of analysis are available by request with orders. Additional certificates may be requested by calling 1-800-356-2501 and specifying lot number and expiration date.

CAS Numbers
Applicable CAS numbers are listed as an aid to literature searches. LSS lists these numbers with best efforts to ensure accuracy, but complete accuracy cannot be guaranteed; verification is recommended.

APHA/ASTM Notes
Chemicals listed with references to APHA methods are manufactured in accordance with Standard Methods for the Examination of Water and Wastewater, a reference volume published jointly by the American Public Health Association, American Water Works Association, and the Water Environment Federation. Chemicals listed with references to ASTM methods are manufactured in accordance with ASTM International technical standards for materials, products, systems and services. ASTM Standards have been incorporated into or are referred to by many federal regulations.

Form No.: ChemTerms Revised: Oct. 20, 2008

Lab Safety Information
FAQ's
Terms of Access
Terms of Sale
Trademarks

Questions and Orders Call 1-800-356-0783 | Fax 1-800-543-9910