New Client Form - Murray Brown Labs

NEW CUSTOMER FORM

Welcome to Murray-Brown Laboratories! We believe that analyzing your product goes beyond producing test results. We go to great lengths to operate in a manner which is approachable, thereby promoting an open partnership which allows you, our Customer, to have complete confidence in our expertise and ethics, as well as the analytical results that we provide.

We are appreciative of the opportunity to serve you and we look forward to a long and mutually rewarding partnership in business. If you have any questions regarding our processes, please do not hesitate to ask.

CUSTOMER INFORMATION
Business Name*
Business Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
DELIVERABLES
- MBL delivers results via E mail (MBLTestResults@mb-labs.com) in the form of a PDF Certificate of Analysis.
- MBL will only report to a third-party at the consent of Customer.
- For multiple recipients of results, we recommend establishing an internal distribution list (i.e. labresults@yourcompany.com).
List all individuals to receive results; add more lines using ⊕
Results List*
First Name Last Name Email
List all individuals to receive invoices; add more lines using ⊕
Invoice List*
First Name Last Name Email
PAYMENT TERMS & CONDITIONS
- Customer must maintain a valid credit card on file with MBL which MBL may charge prior to proceeding with sample analysis or reporting results.
- Contact MBL for self-payment approval via check, credit card, wire or ACH transfer.
- Samples are as submitted by Customer; MBL will not invoice a third party unless agreed upon by MBL, at MBLs' sole discretion.
Credit Card on File*
Credit Card on File Expiration Month Expiration Year
MBL TERMS AND CONDITIONS
ACCEPTANCE OF MBL TERMS AND CONDITIONS*
Sample submission to MBL signifies Customers’ acceptance of MBL Terms and Conditions. MBL and Customer named herein concur that, as acknowledged by the signature of a Customer Representative, MBL Terms and Conditions will be binding upon and will ensure to the benefit of the two parties and their respective representatives, including but not limited to, their officers, directors, managers, employees, including their heirs, executors, administrators, personal representatives, successors, assigns or otherwise affiliates, and is applicable to all dealings transpiring between the two parties. By signing below, Customer Representative asserts that he/she is in receipt of and has actual and/or apparent authority to bind Customer named herein to MBL Terms and Conditions.
- I have read and accept MBL TERMS AND CONDITIONS
Name*
First Last
Email*
Signature*
View the Terms and Conditions

Save and Continue Later

NEW CUSTOMER FORM

CUSTOMER INFORMATION

DELIVERABLES

List all individuals to receive results; add more lines using ⊕

List all individuals to receive invoices; add more lines using ⊕

PAYMENT TERMS & CONDITIONS

MBL TERMS AND CONDITIONS

Accredited to ISO/IEC 17025:2017

for Biological and Chemical Testing

Lets Get Started

First Name	Last Name	Email

First Name	Last Name	Email