分子科学公共实验平台 样品检测委托协议单.pdf

!"#$%&'()*++,-./012345 Sample Analysis Request Form @ ISCMS 编号 Serial NO.： 1．客户信息 Client Information 委托单位名称 Company Name 委托单位地址 （请填写邮寄地址） Company Address 委托人 Client Info. 姓名 Name 电话 Tel. 电子邮箱 Email 2．样品信息 Sample Information 样品名称 Sample Name 检测要求 Analysis Requirements & Considerations： 样品保存条件 Sample Storage Conditions 样品数量 Quantity □ 常温 Room Temperature □ 低温 Low Temperature ( ______°C) □ 防潮 Moisture-sensitive □ 避光 Light-sensitive □ 特殊要求 Other Special Requirements ______________________________ 余样处理 Remaining Samples： □ 保留（自取或到付寄回）Keep the remaining samples (Self Pick-up or Mail Back) □ 授权受托方处理 Disposal by ISCMS 3．委托日期 Date Requested 4．检测费总额 Analysis Fee (￥) 收取检测结果前需付清所有检测费用，费用请转账到下列账号。 单位名称：西湖大学； 银行账号：19000101040026821； 开户银行：中国农业银行杭州市西湖支行。 付款条件、 方式及日期 转账时请备注： 收款项目编码 201074172001 或 分子科学公共实验平台 样品检测费 Payment Information The sample analysis report won’t be provided until the payment is completed. Please make the transaction to the following account. Organization Name: Westlake University; Bank Account #: 19000101040026821; Deposit Bank Info: Agricultural Bank of China, Hangzhou Xihu Sub-branch. Please add the following notes during transaction: Corresponding Project NO. 201074172001 or ISCMS sample analysis fee 委托方 开票信息 Invoice Information of Client 发票类型 Invoice Type：□普票 Plain Invoice □专票 Special Invoice □其他 Others 发票抬头 Invoice Title： 识别号 Identity Number： 开户银行 Deposit Bank： 银行账户 Bank Account #： 联系地址及电话 Address & Tel ： 6．备注 Remarks 委托人签字 Client Signature： 日期 Date： 受托人签字 Accepted By： 日期 Date： 注： 1. 样品保存期限一般为 10 天，特殊情况由委托人与受托人协商确定；若样品回寄，平台不负责样 品在运输中是否完好。 2. 检测报告发出之日算起，本平台受理检测质量申诉的有效期限为 5 天；对存在失效期限的样品， 检测质量申诉有效期不超过样品可保存期限。 3. 本委托检测结果仅对来样负责，且仅反映对所测样品的评价。检测结果仅用于科学研究、数据分 析、性能评价、质量分析，对于检测结果的使用及用途、使用所产生的直接或间接损失及一切法 律后果，平台不承担任何经济和法律责任。 4. 委托单位须对样品的合法性、代表性和所提供的样品信息、资料的真实性负全部责任。 5. 平台业务联系电话：0571-86790737；付清检测费后请将“转账凭证”邮件发送至分子科学公共 实验平台，邮箱：wuweiwei@westlake.edu.cn；邮件主题：【转账凭证】【单位-委托人-日期】。 6. 平台网址 https://iscms.westlake.edu.cn；平台快递地址：浙江省杭州市西湖区三墩镇墩余路 600 号，西湖大学分子科学公共实验平台 E10-308。 Attention: 1.The storage period of the sample is 10 days by default. For special analysis requirements and/or considerations, please contact corresponding technician directly before sending the samples. If the client chooses to mail the remaining/used samples back, the ISCMS is not responsible for potential damage during sample transportation. 2. Quality complaints will be accepted within 5 days from the date of receiving the analysis report. For samples with expiration date, any quality complaint must be reported within 5 days or before the expiration date of the samples, whichever comes first. 3. The sample analysis report represents only the experimental result of received/analyzed samples. It can only be used for scientific research, data analysis, sample performance evaluation and quality analysis. The ISCMS will not bear any economic or legal responsibility for any losses and consequences caused by the use of the analysis results. 4. The client/the company should be fully responsible for the legality and representativeness of the samples as well as the authenticity of the sample information and data provided. 5. ISCMS contact number is 0571-86790737. ISCMS website is https://iscms.westlake.edu.cn. Once the payment is completed, please email the digital receipt to the ISCMS (Email address: wuweiwei@westlake.edu.cn). Make sure you have the subject in the following format: [Digital Receipt] [Company Name - Client Name - Date]. 6. The mailing address of the ISCMS is: Room E10-308, No. 600 Dunyu Road, Sandun Town, Xihu District 310030, Hangzhou, Zhejiang, PR China