 Conditions  Each laboratory wishing to participate in a PT program MUST complete the order form  Please complete this form electronically, Microbiology save and email as an attachment 2018 to: [email protected]  Order forms must be submitted in .doc or .docx format. Other file formats will not be accepted.

 Additional sample sets will only beProficiency available at a discounted Testing price Program to a laboratory site Proficiencyonce it has Testing enrolled Provider in the full fee program. Order Form Certificate Number 3189-02  Shipping costs vary depending on your location and will be itemised on the order.  All requested PT programs will be recorded and invoiced as per the chosen invoicing option.  Payment options only include Credit Card or Electronic Transfer.  Payment by Cheque will not be accepted.  Payments made via credit card are free of any IFM processing fees.  When paying by International Monetary Transfer or Telegraphic Transfer, ALL sending and receiving bank charges must be included in the payment to ensure the full IFM invoice amount is received.  Unless IFM has issued a foreign currency invoice, payment must be made in Australian Dollars.  Please ensure testing commences such that results are submitted by the due date.  Results submitted after the due date will attract a late entry/assessment fee of up to $250.  PT reports will be withheld if any invoices are past due. IFM’s payment terms are 30 days.  New customers or customers wishing to update their details must complete the Customer Registration/Update form before placing an order: CPF163-01_Customer_Registration_Update_Microbiology.doc

 Laboratories located outside of Australia Are reminded that it is your responsibility to ensure your laboratory has met all local Customs and Health regulations relating to the importation of microbiological proficiency testing materials. This includes:  providing required documentation to local authorities,  where required, obtaining import permits and providing copies to IFM,  promptly paying all importation-related fees, duties, taxes and charges

IFM will make every effort to provide information in order to assist with importation. However, IFM takes no direct responsibility for any delays in importation or importation failures. For each program, please indicate the number of sample sets required in the Order Qty column. For each laboratory site, only the first sample set will be charged at the full program price. Additional sets will be automatically charged at a nominal per sample price. Please refer to the price list for details.

Customer Id and Payment Nomination (Must be competed) IFM Customer Id (Cnnnnn) Laboratory name:

Purchase Order # (optional):

Comment

I would like to receive a 5% early bird discount on all PT items. My invoice will be issued immediately. (For this discount to apply, Full Payment must be received in 2017). Invoicing Please issue a separate invoice as each PT program is dispatched (not available with Early Bird Discount) Unless this option is selected, a single invoice will be issued after the first PT sample dispatch

Payment Method: Electronic Transfer Credit Card

Quotation: Please provide me with a Quotation

IFM Quality Services Pty Ltd  www.ifmqs.com.au  Ph: +61 2 9618 3311 Fax: +61 2 9618 3355

Order Program Order Code (Please refer to the current year’s Schedule for full program details) Qty Food Microbiology 18P1FP 2018 P1 Food Pathogens (Muesli) 18P1NP 2018 P1 Non Pathogens (Strawberry milk mix) 18P3FP 2018 P3 Food Pathogens (Pudding mix) 18P3NP 2018 P3 Non Pathogens (Soup mix) 18P6FP 2018 P6 Food Pathogens (Polenta) 18P6NP 2018 P6 Food Non Pathogens (Infant formula) Issue18P8FP Date : 13 September2018 P8 2017 Food Pathogens (Marinade mix) Authorised by : J. Flemming Page 1 of 1 © IFM Quality Services Pty Ltd Doc18P8NP Name : 2018 P8 Food Non Pathogens (Cassata base) 09e9c3018e1cf4c256f9bc0950e8e818C 2018 Chocolate (Block chocolate) 18MM 2018 Meat Microbiology (Beef mince)