University of Maryland, Analytical Services for NMR, EPR & Mass Spec. Analyses
New Account Application for Non-Chemistry Department Clients (Rev. 7/21/2008)
For more information, please visit http://www.chem.umd.edu/Shared_Instrumentation/
Please send request to corresponding facility manager for processing. Thank you!
I.
Client Information (please print or type):
Name of Company (or University): ______________________________ Department: ________________
Billing Address: _________________________________________________________________
_____________________________________________________ Zip_________
FAX number: (_____) __________________ Phone: (_____) _____________________
Name (user) for contact: __________________ Phone: (_____) __________ Email: ________________
Purchase Order (PO) or FRS number: _____________________________
Authorization name: _____________________________ Title: __________________
Signature: _____________________________ Date: _________________
II.
Source of funding (select a or b):
a) The analyses with this PO are not funded by Federal Grant.
b) The analyses with this PO are funded by federal sources.
Federal Grant Number(s): _____________________ (Must be included)
III.
Terms of service: The USER (with authorized signature in this form) agrees on the following conditions for the
analysis to be carried out by the Analytical Services Facilities at the University of Maryland, College Park:
a)
b)
c)
d)
e)
f)
The facility's staff and the Department are not liable for loss, damage, or decomposition of sample(s), spectra, or any
structural implications therein.
The user has made his or her best effort to utilize other commercial analytical resources, but decided it is to his (hers) best
interests to apply the service to the facility at U. of Maryland.
The facility reserves the right to accept the analysis (pending on the resources available).
No samples of radioactive or explosive nature can be submitted.
The following rates will be applied for the corresponding analyses. Rates are subjected to change with 30 days notice.
The period of services is good for twelve months from the date of this application. Renewal is required to continue the
services.
Analyses
Charge Rate (Industrial clients)
Charge Rate (Academic Clients)
NMR or EPR
$100.00 per hour
$66.60 per hour
Overnight analyses NMR
$180.00 per sample
$100.00 per sample
Mass Spec Analyses
$120.00 per sample
$90.00 per hour