Custom Binding Assay Services Quotation Form (SC1485) Instructions 1. Please complete and email this form to bioassay@genscript.com 2. Our service representative will contact you with the quote Customer Information Name: Phone: Institution/Company: Shipping address (needed to determine shipping cost): Email: Compound Screening/Profiling Service (Only For Ready Assays) Ion Channel: hERG (hKv11.1) Number of Compounds: Testing Concentrations: Single conc. screening (at 10 μM in duplicate by default.) 5 concentrations, at n=2, IC50 cure if available. (starting conc. is 50 μM, log dilution series by default.) 11 concentrations, at n=2, IC50 cure. (starting conc. is 50 μM, 1/3 log dilution series by default.) Other special requirements: number of conc.: factor: ; number of replicates: ; starting conc.: . Note: Free negative and positive controls are included. Sample Size: We recommend you to provide the compound(s) at a concentration of 10 mM in 100% DMSO. The quantity of solution per compound: If you provide the compounds in dry powder form: Submit your sample according to the following request: Compound ID M.W. Amount (mg) Comments ; dilution Note: a. If the number of test compounds exceeds the space of the table, you can submit your data in an excel file. b. If the compound(s) are not soluble in 100% DMSO, please offer any useful information concerning the solubility in "Comments" section. c. All pre-solubilized or powder samples will be stored at -20°C, unless otherwise specified in "Comments" section. Project Information Is this project for grant application purpose? When will the project start? Immediately Yes No Within one month Within three months Half a year later Custom Assay Development Services Channel Name: DNA Sequence: Gene Accession Number: Stable Cell Line Development: GenScript provides one-stop services from gene synthesis to assay development Client provides the cDNA, and let GenScript do the rest things Other special requirement, please specify: Type of Assays: FLIPR Assays Note: FLIPR assays are a set of flurometric assay technologies which is compatible for FLIPR Tetra. Molecular Devices Inc. supplies calcium dye and membrane potential dye for ion channel assays. In addition, Invitrogen also supplies similar assay kits. Radioligand Binding Assay Manual Patch Clamp Assay Automated Patch Clamp Assay (QPatch 16) Please specify any special requirements: Project Information Is this project for grant application purpose? When will the project start? Immediately Yes No Within one month Within three months Half a year later