ANALYSIS REQUEST DO NOT FILL IN
Contact
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Fill mandatory fields marked with *
Coordinates
Confidentiality
Projet leader # 1
Projet leader # 2
Team Leader
First Name & Name
Phone
Fax
Email
specify
specify
specify
specify
specify
specify
specify
specify
specify
specify
specify
specify
Wish to receive the
annual satisfaction
survey
Yes
Yes
Yes
Laboratory adress
Name and laboratory complete address *
Billing adress
(if different)
Laboratory complete billing address *
*
*
*
*
Project title
Yes
*
*
*
*
Confidentiality
Yes
specify *
Description of scientific context
description of the scientific context and precise objectives of the analysis. If there's no place enough in this
document for describing the scientific context, this can be done on a free document. *
Plateforme Protéome – Centre Génomique Fonctionnelle Bordeaux
146 rue Léo Saignat, 33076 Bordeaux Cedex France ; Secretariat : Phone : +33 557 571 683 ; Fax : +33 557 571 684
Formulaire Demande d’Analyse Version EN 09
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Type of service *
Complete services description is available at
http://www.cgfb.u-bordeaux2.fr/en/proteome/performance
Collaborative prestation: The price includes only operating costs. The user agrees to make appear as coauthor the personnel involved Proteomics Platform at work.
Service prestation: The rate includes, in addition to operating costs, costs of expertise. The user is then
sole owner of the results.
Specifications (Do not fill in)
Sample preparation, electrophoresis & chromatography
Monodimensionnal electrophoresis
choice 1 Number specify staining no staining Image analysis yes
choice 2 Number specify staining no staining Image analysis yes
Two-dimensionnal electrophoresis
choice 1 Number specify staining no staining Image analysis yes
choice 2 Number specify staining no staining Image analysis yes
In solution Isoelectrofocalisation
choice 1 Number specify
choice 2 Number specify
Western (primary Ab primaires are supplied by users)
Number specify
Bradforf assay Number specify
Mass spectrometry
LC-MS/MS (normal gradient) on choice (low complexity samples)
Number specify
LC-MS/MS (long gradient) on choice (high complexity samples)
Number specify
LC-MS/MS (ultra long gradient) on choicechoix (very high complexity sample)
Number specify
Label-Free treatment
choice
Exact masse determination by
choice Number specify
Analyse MALDI-TOF² (+8 MS/MS)
Number specify
Analyse ESI-MS² (Orbitrap XL)
Number specify
Plateforme Protéome – Centre Génomique Fonctionnelle Bordeaux
146 rue Léo Saignat, 33076 Bordeaux Cedex France ; Secretariat : Phone : +33 557 571 683 ; Fax : +33 557 571 684
Formulaire Demande d’Analyse Version EN 09
2/4
Sample description
Sample number
specify
Sample type
choice
if other
specify
if solution
concentration
specify
buffer
specify
staining
choice
date
specify
file
file name corresponding to the image of annotated gel
bands / spots to analyze
if gel/band/spot
Specie(s) or
taxon(s)
specify
By default, the Platform will search the SwissProt database restricted to the taxon specified below. If you want to
query a particular database, please specify (name, address download ...) and / or provide a file (format *.txt ou
*.fasta).
Special
database
information regarding the database to query
Sample preparation Protocol
Protocol followed for sample preparation
Remarks and special requirements
Specify any notes or requirements in relation with, for example, sample storage, preservation or recovery.
Specify the potential sample toxicity risks.
N.B. The Plateforme Protéome can back up raw data and input/output samples but preservation cannot be
guaranteed.
Plateforme Protéome – Centre Génomique Fonctionnelle Bordeaux
146 rue Léo Saignat, 33076 Bordeaux Cedex France ; Secretariat : Phone : +33 557 571 683 ; Fax : +33 557 571 684
Formulaire Demande d’Analyse Version EN 09
3/4
Deadline for return of results
Do not fill in
Quotation (These prices are indicative. They do not reflect any rate adjustments. In this case, we will contact
you to keep you informed).
Desc ription
Units
Unitaire pric e
SDS-PAGE gel
0
9.30 €
-
€
Gel staining
0
1.80 €
-
€
Digitization of the gel
0
1.60 €
-
€
LC-MS/MS LTQ Orbitrap XL analysis (gradient 120 min)0
41.40 €
-
€
LC-MS/MS Q-Exactive analysis (gradient 120 min)
85.40 €
-
€
-
€
0
Total
Total
Validation *

I read and accept the Plateforme Proteome “Term of use”
(cf. http://www.cgfb.u-bordeaux2.fr/en/proteome/quality/convention)

I read and accept the Plateforme Proteome “Service description”
(cf. http://www.cgfb.u-bordeaux2.fr/en/proteome/performance)

I validate the request based on the information above
Plateforme Protéome – Centre Génomique Fonctionnelle Bordeaux
146 rue Léo Saignat, 33076 Bordeaux Cedex France ; Secretariat : Phone : +33 557 571 683 ; Fax : +33 557 571 684
Formulaire Demande d’Analyse Version EN 09
4/4