Maintenance and Support Program Application

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Luminex Multi-Tiered Maintenance and Support Program

Application

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First Name «

Last Name «

Title

Email «

Organization «

Phone Number

Fax Number

Instrument Location

Address 1

Address 2

City

State/Province

Other

Postal Code

Country

Billing Location

Billing Contact

Address 1

Address 2

City

State/Province

Other

Postal Code

Country

Luminex System Covered

Luminex 100 Serial Number

Luminex XY Platform Serial Number (if any)

Luminex SD Serial Number (if any)

Packages

United States, Canada

Platinum $7,250.00 USD

Gold $5,300.00 USD

Silver $2,995.00 USD

Bronze $995.00 USD

European Union, Norway and Switzerland

Platinum $8,995.00 USD

Gold $6,000.00 USD

Silver $3,500.00 USD

Bronze $1,250.00 USD

Payment

Purchase Order

Credit Card Number

Type of Card

Expiration Month

Expiration Year

Contract «

I agree to the contract terms and conditions

Fields marked with "«" are required.

Terms and Conditions

CONTACT INFORMATION: To find out more information about the maintenance and support program please call Janna Magoc (512) 219-8020 x3259.

Questions or concerns regarding services: support@luminexcorp.com