Sequencing Sample Submission Form (Please contact genesequin@gccbiotech.co.in for your sequencing queries) Customer Information Company/ University Name: Customer Name: Company /University Address: Country : India State /Province Zip : This Order Form is filled by: Date of Order: Contact Number: Email Id: Date: PLEASE SEND THIS FORM WITH PROPER SAMPLE INFORMATION AS WRITTEN BELOW ALONG WITH YOUR SAMPLES TO OUR GENOMIC STATION ADDRESS. Plasmids: Plasmids must be purified and enclose the gel photograph of the same. Minimum template conc. should be150ng/µl and minimum volume should be 10µl. Provide 0.5µg of more DNA for every additional reaction. Please mention your sample eluting/dissolving media (buffer or water) in REMARKS section of the data sheet. PCR Products: PCR product must be purified. If purification is needed please mention in the REMARKS section of the data sheet. Provide 20ng more DNA per 100bp product length for every additional reaction. Enclose the gel photograph of the samples. Primer: Primer conc. should be10pmol/µl, and minimum volume of 10 µl. Provide 5µl additional primer for every additional reaction. Enclose the sequence of your specific/nonstandard primers for synthesis. Special Instructions: Please do not use Tris EDTA buffer for eluting/dissolving your samples, preferably use water or 10mM Tris.Cl (pH8). Please submit samples in 0.5/1.5ml micro centrifuge tubes. Please indicate the DNA concentration. Please indicate, if known, your samples have high GC content, repeats. Required Information: Primer synthesis required PCR Purification required Plasmid preparation required PCR amplification required DNA purification method Yes No Yes No Yes No Yes No _____________________________ Genomic station: Patharberia Road, Joychandipur, Bakrahat 24 Prg.(S) Kolkata- 743377. Phone: -91-33-24951044/0004 & 40608482, Email:- genesequin@gccbiotech.co.in Regd. Office: 351, BMK, Giri Nagar, Kalkaji, New Delhi- 110019 (INDIA), Ph-91-11-26440301/32558879, Fax- 91-11-26418606, info@gccbiotech.co.in SEQUENCING ORDER DATA SHEET PLEASE STRICTLY FOLLOW THE SAMPLE REQUIREMENT FOR BEST QUALITY SEQUENCING DATA TEMPLATE # DNA/ Plasmid Name PCR Product Name Product Concentration PRIMER Size of product Primer Name FORWARD REVERSE Primer Concentratio n Preferred Annealing TºC REMARKS PRIMER INFORMATION # Primer Name Primer Sequence Primers to be synthesized (Yes/No) **TERMS AND CONDITIONS Samples not meeting the quality standards in terms of the concentrations &purity, after they are received at our facility, will be intimated to the customer and further process will be based on the instructions of the customers thereafter. All Payment should be made only by A/c Payee Cheque/Draft in the name of GCC BIOTECH (INDIA) PVT. LTD., should be made within 15 to 30 days from the data delivery date. All the orders shall be accompanied with the complete billing address including the pin code, contact person name, contact number & email to avoid delay in dispatch of report & invoice. All disputes are subject to jurisdiction of New Delhi court only. SUBMIT