Autoclave Testing Service, Inc. Order Form

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Type of sterilizer:

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CONTACT US: Toll Free: 877/287-1199 Call: 604/850-3016 Fax: 888/789-6555 Email: info@sterilizermonitoring.ca www.SterilizerMonitoring.ca

Stock No. Description / Packing Unit PRICE 1 PRICE 5 PRICE 10+ Quantity TOTAL In

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SC3525 SterileCheck Biological Indicators, 24 Hour Results 25/box Box $64.95 (1 box)

$59.95 (2 boxes)

$54.95 (3+ boxes)

SC35100 SterileCheck Biological Indicators, 24 Hour Results 100/box Box $179.00 (1 box)

$169.00 (2 boxes)

$159.00 (3+ boxes)

BSH100 10-24 Digital Incubator for EZTest BIs & SterileCheck BIs Each $269.00 $259.00 $249.00

SCSSK25 Start-Up Kit: 25 BI tests, Incubator, Log Book, 500 Class 4’s Kit $295.00 $285.00 $275.00

SCSSK100 Start-Up Kit: 100 BI tests, Incubator, Log Book, 500 Class 4’s Kit $375.00 $360.00 $350.00

SCSSK300 Start-Up Kit: 300 BI tests, Incubator, Log Book, 500 Class 4’s Kit $675.00 $660.00 $645.00

SEZ5/S EZ Test Log 5 Biological Indicators, 10 Hour Results 100/box Box $349.00 (1 box)

$329.00 (2 boxes)

$299.00 (3+ boxes)

EZTSK100 EZ Test Start-Up Kit: 100 EZTest BIs, Log Book, Incubator Kit $499.00 $489.00 $479.00

EZTSK300 EZ Test Start-Up Kit: 300 EZTest BIs, Log Book, Incubator Kit $1,099.00 $1,079.00 $1,059.00

CWB+ Economy-Plus Weekly Mail-to-Lab Kit, 52 Tests/year Kit $349.00 per sterilizer (annual cost)

CWB Economy Weekly Mail-to-Lab Kit, 52 Tests/year Kit $249.00 per sterilizer (annual cost)

CBWB+ Economy-Plus Bi-Weekly Mail-to-Lab Kit, 26 Tests/year Kit $239.00 per sterilizer (annual cost)

CBWB Economy Bi-Weekly Mail-to-Lab Kit, 26 Tests/year Kit $199.00 per sterilizer (annual cost)

CMB+ Economy-Plus Monthly Mail-to-Lab Kit, 12 Tests/year Kit $139.00 per sterilizer (annual cost)

CMB Economy Weekly Mail-to-Lab Kit, 12 Tests/year Kit $109.00 per sterilizer (annual cost)

LRB20 Sterilizer Log Record Book – 20 Pages Each $15.00 $12.00 $10.00

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CI-PEN Chemical Indicator Pen, Class 5 Grade Ink 1/box Box $20.00 $18.00 $15.00

CI-III-C4 Class 4 Chemical Indicators 250/bag Bag $20.00 $18.00 $15.00

CI-SINT Class 4 chemical Indicators (Split to equal 500 tests) 250/bag Bag $25.00 $23.00 $20.00

CI-EXT Raven Extended-timing Class 5 Steam Integrators 250/box Box $35.00 $32.00 $30.00

SC5 SterileCheck5, Class 5 Moving Front Steam Integrator 250/bag Bag $50.00 $45.00 $40.00

PSI-250 Propper Vaporline® Class 5 Moving Front Integrator 250/bag Bag $60.00 $55.00 $50.00

BD134 Bowie-Dick Green Card Tests (requires holder) 120/cs. Case $395.00 (1 case)

$375.00 (2 cases)

$358.00 (3+ cases)

BD134-SK Bowie-Dick Green Card Start-up Kit: 30 tests with test holder Kit $130.00

(1 kit) $125.00

(2 kits) $120.00 (3+ kits)

BD134-TH Bowie-Dick Green Card Test Holder Each $75.00 $70.00 $65.00

CI-BDTLF80 Bowie-Dick Test Packs (pre-assembled test packs) 80/cs. Case $419.00 (1 case)

$409.00 (2 cases)

$399.00 (3+ cases)

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es 442089 2.25”x4” Sterilizer Pouches 200/box 12/cs. Case $90.00 $78.00 $66.00

442090 2.75”x10” Sterilizer Pouches 200/box 6/cs. Case $45.30 $40.50 $34.50

442100 3.5”x6.5” Class 4 Sterilizer Pouches 200/box 6/cs. Case $45.60 $40.80 $34.80

442101 3.5”x9” Class 4 Sterilizer Pouches 200/box 6/cs. Case $56.40 $50.40 $44.40

442102 5.25”x11”Class 4 Sterilizer Pouches 200/box 6/cs. Case $75.00 $69.00 $63.00

442103 7.5”x13” Class 4 Sterilizer Pouches 200/box 5/cs. Case $134.50 $129.50 $124.50

GS1016 10”x16” Sterilizer Pouches 100/box 1/cs. Case $49.00 $44.00 $39.00

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e CI-STP12 Steam/CV Indicator Tape, 12mm x 55M (½” x 180’ long) 72/cs. Roll

$4.25 (5 rolls)

$3.95 (15 rolls)

$2.95 (1 case)

CI-STP18 Steam/CV Indicator Tape, 18mm x 55M (¾” x 180’ long) 48/cs. Roll $5.25

(5 rolls) $4.75

(15 rolls) $4.10

(1 case)

CI-STP24 Steam/CV Indicator Tape, 24mm x 55M (1” x 180’ long) 36/cs. Roll $5.95

(5 rolls) $5.50

(15 rolls) $5.00

(1 case)

CI-T-DISP Indicator Tape Dispenser, for use with all size tape Each $40.00 $35.00 $30.00

SMS012 12”x 12” SMS Autoclave Wrap, non-woven, Blue 500/box Box $52.00 $48.00 $44.00

SMS015 15”x15” SMS Autoclave Wrap, non-woven, Blue 500/box Box $66.00 $62.00 $58.00

SMS018 18”x18” SMS Autoclave Wrap, non-woven, Blue 500/box Box $74.00 $70.00 $66.00

SMS020 20”x20” SMS Autoclave Wrap, non-woven, Blue 500/box Box $80.00 $76.00 $72.00

SMS024 24”x24” SMS Autoclave Wrap, non-woven, Blue 500/box Box $66.00 $62.00 $58.00

SMS030 30”x30” SMS Autoclave Wrap, non-woven, Blue 250/box Box $104.00 $100.00 $96.00

SMS036 36”x36” SMS Autoclave Wrap, non-woven, Blue 250/box Box $147.00 $140.00 $132.00

SUBTOTAL

O: www.SterilizerMonitoring.ca E: info@sterilizermonitoring.ca T: 877/287-1199 T: 604/850-3016 F: 888/789-6555

CheckMoney Order: OffVisa: OffMasterCard: OffAmerican Express: OffPayPal: OffContact Name: Facility Name: Ship-to Street Name: Bill-to Street Name: Ship-to Suite/Unit/Bldg: No:

Ship-to City/Province/Postal Code: Bill-to Suite/Unit/Bldg: No:

Bill-to City/Province/Postal Code: Email Address: Fax Number: Type of Sterilizer(s): Phone Number: Sterilizer Brand/Model/Serial No: Credit Card Number: Expiry Date: STOCK NO 1: STOCK NO 2: Unit: Price 1: Price 5: Price 10+: Product 1: Product 2: QSC35100: QSC3525: QBSH100: QSCSSK25: QSCSSK100: QSCSSK300: QSEZ5/S: QEZTSK100: QEZTSK300: QCWB+: QCWB: QCBWB+: QCMB+: QCMB: QLRB20: QCI-PEN: QCI-111-C4: QCI-SINT: QCI-EXT: QSC5: QPSI-250: QBD134: QBD134-SK: QBD134-TH: QCI-BDTLF80: Q442089: Q442090: Q442100: Q442101: Q442102: Q442103: QGS1016: QCI-STP12: QCI-STP18: QCI-STP24: QCI-T-DISP: QSMS012: QSMS015: QSMS018: QSMS020: QSMS024: QSMS030: QSMS036: QProduct1: QProduct2: Total SC3525: Total SC35100: Total BSH100: Total SCSSK25: Total SCSSK100: Total SCSSK300: Total SEZ5/S: Total EZTSK100: Total EZTSK300: Total CWB+: Total CWB: Total CBWB+: Total CBWB: QCBWB: Total CMB+: Total CMB: Total LRB20: Total CI-PEN: Total CI-111-C4: Total CI-SINT: Total CI-EXT: Total SC5: Total PSI-250: Total BD134: Total BD134-SK: Total BD134-TH: Total CI-BDTLF80: Total 442089: Total 442090: Total 442101: Total 442102: Total 442103: Total GS1016: Total CI-STP12: Total CI-STP18: Total CI-STP24: Total CI-T-DISP: Total SMS012: Total SMS015: Total SMS018: Total SMS020: Total SMS024: Total SMS030: Total SMS036: Total Product 1: Total Product 2: SUBTOTAL: 0Promotion/Discount: -0.00HST Tax: 0S&H: TOTAL: 0PRINT FORM: RESET FORM: Sales Tax: [.15]Subtotal-Discount: 0