Custom Packed/Micropacked Column Request Form

Column Parameters

RFQ Number

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Number of columns

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Column Length (including voids)

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Unit

Tubing

Packing Description

Enter up to three liquid phases. Remember to specify the coating percentage for each one.

Coatings >15% may incur additional charges.

liquid phase A

liquid phase B

liquid phase C

Solid Support

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Mesh

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Information on mesh size–micron conversions:

If you do not know your mesh, enter "unknown" and Restek will make a recommendation.

Configuration (One),

Standard Configurations: click the diagram to select

General Configuration

Agilent 5880, 5890, 5987, 6890, 7890, 8890

Varian 3700, Vista Series, FID, Bruker 430

PE 900-3920, Sigma 1,2,3

PE Auto System 8300, 8400, 8700 (not on-column)

For Instrument Types Not Listed Above:

Special Configurations: click the diagram to select

1

2

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15

Contact Information

Restek Account #

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First Name

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Last Name

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Phone Number

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Company Name

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Adresse 1

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Adresse 2

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City

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Pays

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State/Province

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Postal Code

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PLEASE NOTE:

Custom Restek products (i.e., non-stocked, non-catalog items) that meet the requested product specifications are not returnable or refundable. Be sure to check the product specifications in your quote request before submitting. Also, recheck the specifications in your sales quote before placing your order. If you have any questions, contact Restek or your local Restek representative.

Custom packed columns are not returnable or refundable. I understand and agree to these terms.

At Restek, we understand and respect your concerns about the privacy and security of your personal data; for more information, visit www.restek.com/fr/pages/politique-de-confidentialite/