Incubator Loaner Agreement - Distributor

Which Incubator model would you like to try?*

Hygiena agrees to loan:

Company Name:*

(referred to as "Company" throughout the rest of this agreement) located at:

Address*

Street Address Address Line 2 City

State / Province*

Zip Code*

Country:*

This Loaner Agreement is for one (1) Hygiena Incubator for evaluation. This Loaner Agreement is for a period of fifteen (15) calendar days from the submission date.

Please return to:

Hygiena
Attn: Evaluation Return
941 Avenida Acaso
Camarillo, CA 93012

In the event the incubator is not returned within fifteen (15) days from the effective date of this agreement or the incubator is damaged or lost while in the possession of “Company ”, then Hygiena will bill “Company” for the full retail price of equipment supplied.

By entering contact information below, I agree to the above terms:

Authorized Person's Name:*

Email*

Phone Number:*

Shipping Address:

Check here if address is the same as above

Yes / On

Company Name:

Address 1

Address 2

City

State / Province

Zip / Postal Code

Country

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PCR ASSAYS

LATERAL FLOW TESTS

ELISA TESTS

GENERAL PROTEIN TESTS

PCR ASSAYS

MONITORING SYSTEMS

SURFACE ATP

WATER ATP

ACCESSORIES

PCR ASSAYS

PCR ASSAYS

INSTRUMENTS

QUANTIFICATION

CHROMOGENIC

MEDIA

PCR ASSAYS

MONITORING SYSTEMS

SURFACE

WATER

ACCESSORIES

Incubator Loaner Agreement – Distributor

PCR ASSAYS

LATERAL FLOW TESTS

ELISA TESTS

GENERAL PROTEIN TESTS

PCR ASSAYS

MONITORING SYSTEMS

SURFACE ATP

WATER ATP

ACCESSORIES

PCR ASSAYS

PCR ASSAYS

INSTRUMENTS

QUANTIFICATION

CHROMOGENIC

MEDIA

PCR ASSAYS

MONITORING SYSTEMS

SURFACE

WATER

ACCESSORIES

Incubator Loaner Agreement – Distributor

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