Elementor #4487 – OPTOMICS

Order Request Form

Unique ID: _061024

First Name

Last Name

Your Email

Group Leader E-Mail

Has your group leader approved of this order?

Yes

Suggested Funding (please select one)

Short description of the work for which the requested items will be used

Please use the table below to list your items. Alternatively, please attach a file with a quote (e.g. Thorlabs) below.

It is recommended that if your order is from multiple vendors and exceeds 1.000 € to instead submit more than one request (e.g. one request per vendor/supplier)

Attach Quote

Item Name

Article No.

URL

Number of Units

Cost per Unit (€)

Total Cost (€)

The total cost of my order (before taxes) are:

You may now submit your form. Make sure you have attached any required documents (e.g. PDF quote for single-supplier orders in case the table was not used).

Criterion 1

Criterion 2

Criterion 3

Criterion 4 (optional)

Criterion 5 (optional)

Criterion 6 (optional)

Preferred Supplier

Justification for the Preferred Supplier

Quote 1 (preferred supplier)

Is the preferred supplier the only possible supplier (e.g. no other company makes the item you need)?

Yes

Please give a justification as to why the preferred supplier is the only option for purchasing your requested item(s):

Alternative Supplier 1

Alternative Supplier 2