Elementor #4487 – OPTOMICS

Unique ID (Your Initials_Group Leader Intials_ddmmyy_Number)

Your Name (first and last)

Your Email

Group Leader E-Mail

Has your group leader approved of this order?

Yes

Funding (Institute)

Helmholtz Munich (IBMI)

TUM (CBI)

Suggested Funding Source (Project Name)

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

Item Name

Catalog/Article No.

Link to item

Link to Item

Number of Units

Unit Cost

Total Cost

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

Criterion 1 (for purchases >1000 € at Helmholtz)

Criterion 2 (for purchases >1000 € at Helmholtz)

Criterion 3 (for purchases >1000 € at Helmholtz)

Criterion 4 (optional)

Criterion 5 (optional)

Criterion 6 (optional)

Preferred Provider (for purchases >1000 € at Helmholtz)

Justification for the Preferred Provider

Alternative Provider 1 (for purchases >1000 € at Helmholtz)

Alternative Provider 2 (for purchases >1000 € at Helmholtz)

Preferred Provider (for purchases >5000 € at TUM)

Justification for Preferred Provider

Alternative Provider 1 (for purchases >5000 € at TUM)

Alternative Provider 2 (for purchases >5000 € at TUM)