ࡱ> 8bjbj}}BB4#( """""""$^%(B#u"#BBx#{{{B8"{"{{z0a"#0#B(B(B({###B( : INCLUDEPICTURE "https://scontent-fra3-1.xx.fbcdn.net/v/t1.0-1/c0.0.200.200/p200x200/15578820_1212122765538568_3223797989647699565_n.jpg?oh=f37094704ddfe9c1405fd9a8e2172094&oe=58E8F6F8" \* MERGEFORMATINET  CUMHUR0YET N0VERS0TES0 0LER0 TEKNOLOJ0 UYGULAMA VE ARA^TIRMA MERKEZ0 Cumhuriyet niversitesi, Kamps 58140 S0VAS  HYPERLINK "mailto:cutam@cumhuriyet.edu.tr" cutam@cumhuriyet.edu.tr http://cutam.cumhuriyet.edu.trQ-TOF LC-MS ANAL0Z TALEP FORMUTalep Edilen Analiz Bilgileri0stenen Analizler % MALDI-TOF MS % ESI-TOF MSNumune BilgileriNumune Kodu: % Saf % Kar1_1mNumunenin Miktar1:  % Kat1 % S1v1 % zeltiSaf Numune ise Kapal1 Forml ve Mol Ktlesi:znrlkleri:Dier Ko_ullar: Numune zellikleri: % Bozunma S1cakl11 % Toksik (& & & & & & & ..) % I_1a duyarl1 % Dier (& & & & & & ..& ..) % Numune ve analizi ile ilgili 0_ Sal11 ve Gvenlii a1s1ndan al1nmas1 gereken nlemler var m1? Varsa a1klay1n1z. (& & & & & & & & & & & & & & & & & & & & & & & & & .................................................................)Analizi Talep Eden Ki_i veya Kuruma Ait BilgilerAd1-Soyad1: Adres: Telefon ve Fax: E-mail: 0MZAAnaliz creti deme Bilgilerideme yapacak ki_i veya kurulu_un ad1: Varsa Proje No: Adres-Tel: Analiz cretinin yat1r1laca1 hesap no: TR63 0001 0015 0739 8770 6050 35Raporun ve Faturan1n Al1c1ya Gnderilme ^ekli % Elden %Posta* % Kargo* *Raporun ve/veya faturan1n posta veya kargoya verilmesi durumunda deme al1c1ya aittir. -Gnderilen numune cam, plastik veya metal bir kaba konulmal1d1r. Po_et, torba, vb _ekilde konularak gnderilen numune iade edilecektir. Dklmeye kar_1 gerekli tedbirler al1narak gnderilmelidir. -Kullan1c1ya ve cihaza zarar verme ols1l11 olan rnekler kabul edilmeyecektir.AdetBirim Fiyat (TL)Toplam Fiyat (TL)Analizi Gerekle_tirilen Numune Toplam 0ndirim Miktar1 Ara Toplam %18 KDV Genel Toplam 0leri Teknoloji Uygulama ve Ara_t1rma Merkezi Taraf1ndan DoldurulacakKay1t No.Geli_ TarihiBiti_ TarihiAnaliz Tutar1Analizi Yapan1n 0mzas1 Laboratuvar Mdrnn 0mzas1 Prof.Dr. Mehmet ^0M^0R CTAM Hizmet Szle_mesi Bu szle_me CTAM Laboratuvar1 ile M_teri aras1ndaki Hizmet Szle_mesidir CTAM dan hizmet talebinde bulunan tm ki_i ve kurulu_lar  M^TER0 olarak, Merkez Laboratuvar1 ise  CTAM olarak adland1r1lm1_t1r. Deney _artlar1na uygun _ekilde numune gnderme i_lemi m_teriye aittir. Numune ald1rma talebinde bulunabilir. Numuneler, ilgili laboratuvar ile konu_ulduktan sonra istenilen miktarda gnderilmelidir. Numunenin CTAM a kabulne kadar geen sre zarf1nda uygun ko_ullarda ta_1nmas1, ambalajlanmas1 ve muhaf 0 2 4 f t    V X Z \ ^ < > R X d tmih+QG hOAhihmhiCJ$aJ$ h+QG56hwhi56hmhi5 hi5hMhiCJaJ"jhiCJUaJmHnHu h hi h3hihukhi0J h@ 3hih@ 3hi5hmhi5CJaJ h(hihijhiU' 4  X \ $dh$Ifa$gdW $$Ifa$gdW\ ^ ]Q $$Ifa$gdmkd+$$IfFF!(=H t0{(    44 lapyt)- $Ifgd5qkd,$$IfF({( t0{(44 lap yt.  $Ifgdf{okd%-$$IfF({( t0{(44 lap yt.d    & ( * R X Z \ r t v ~ <| hi56 hu56hCH+h&hCH+56 hCH+56hQhCH+56h|hi5huhi5 huhi hi5hQhi56hmhi5h+QGhi56h+QGhmhiCJ$aJ$hiCJ$aJ$hih{,  $IfgdOokd-$$IfF({( t0{(44 lap ytw (  $IfgdU okdI.$$IfF({( t0{(44 lap yt.( * R wjj  $IfgdU kd.$$IfF0:( t0{(44 lapytI wj  $IfgdOkd/$$IfF0:( t0{(44 lapytI <>uu  $IfgdO  $Ifgduokd?0$$IfF({( t0{(44 lap ytW<>@h$<>FPr>@B@򫜍wowhCJ aJ hu4hiCJ aJ hmhiB*phh'hiB*CJaJphh'hiB*CJaJphh'hiCJaJhv h],hmhi5h@hiCJaJh@CJaJh@hmSCJaJh@hi56CJaJhih&hu56(>@h2wnhh$If $Ifgdm kd0$$IfF0(<? t0{(44 lapytu<$Ifqkd1$$IfFo({( t0{(44 lap yt@<>Vd~ $Ifgd;s$Ifokd!2$$IfF({( t0{(44 lap yt.~$Ifqkd2$$IfF~({( t0{(44 lap yt.@$Ifokd=3$$IfF({( t0{(44 lap yt.@B $Ifgdzqkd3$$IfF\({( t0{(44 lap yt.B $$Ifa$gdmqkdY4$$IfF({( t0{(44 lap yt'@D68x~024FHJLJxz|~÷βޝޙމޅo+hbwh[6CJOJPJQJaJnH tH hShhChi5ht}h hi5hmh'5hmh@5 h'5h'h'5CJaJh'h@CJaJh@h'h@5CJaJhihmhiCJaJhu4hiCJ aJ hiCJ aJ )6 $$Ifa$gdmqkd4$$IfF_({( t0{(44 lap yt.68xz|~G;/// $$Ifa$gd], $$Ifa$gd@kdy5$$IfF\(3N t0{(44 lap(yt@~G; $$Ifa$gd],kde6$$IfF\(3N t0{(44 lap(yt@ $$Ifa$gd],qkdQ7$$IfFq({( t0{(44 lap yt'wkk $$Ifa$gd],kd7$$IfF0a( t0{(44 lapyt@02wkk $$Ifa$gd],kd8$$IfF0a( t0{(44 lapyt@24wkk $$Ifa$gd],kd99$$IfF0a( t0{(44 lapyt@FHwkk $$Ifa$gd],kd9$$IfF0a( t0{(44 lapyt@HJLwkk $$Ifa$gdmkd:$$IfF0a( t0{(44 lapyt@">$Ifokd=;$$IfF({( t0{(44 lap yt.>@BDFHGAAAA$Ifkd;$$IfF\ j( cl t0{(44 lap(yt.HJx|~G>5>>> $Ifgd $Ifgdu4kd<$$IfF\ j( cl t0{(44 lap(yt. lcPPAA$$*$1$Ifa$gdW$d<$Ifa$gdW  gd6cCkd=$$IfF0(j t0{(44 lapyt. $Ifgdu4 X *!hn*qPy~$Z ɶɴɣɘɆvdOdOdOdO> hbwh[5B* CJaJph `(hbwh[5B* CJOJQJaJph `"h[5B* CJOJQJaJph `hbwh[5CJOJQJaJ#hbwh[5CJKHOJQJaJhbwh[CJaJ!hbwh[B*CJPJaJphU%hbwh[CJaJfHq hbwh[CJPJaJ+hbwh[6CJOJPJQJaJnH tH %h[6CJOJPJQJaJnH tH Z ii@k\mn*qqhrtuv.xPy~!$ & F Vd$*$1$If^`Va$gd[azas1 m_terinin sorumluluundad1r. Bu etkenlerden dolay1 deney sonular1nda olu_acak olumsuzluklardan CTAM sorumlu tutulamaz. M_teri, numuneleri kodlamal1 ve s1ralamal1d1r. Kodlama silinmeyecek _ekilde numunelerin zerine yaz1lmal1d1r. Ba_vurular1n kabul edilebilmesi iin Ba_vuru Formu ve ilgili Deney 0stek Formlar1 eksiksiz olarak doldurulmas1 ve imzalar1n yetkili ki_iler taraf1ndan at1lmas1 gerekmektedir. Ba_vuru Formu ve ilgili Deney 0stek Formlar1n1n doldurulup imzalanmas1yla m_teri, deneye gnderilen numunenin (varsa) insan ve evre sal11na olan zararl1 etkilerini beyan ettiini, etmedii takdirde olu_acak uygunsuzluklardan KEND0S0N0N sorumlu olaca1n1 kabul eder. Deneyler ve cretleri, numune kabul kriterleri ve deme _artlar1, deneyi gerekle_tirecek uzman/retim yesi kabul ve Merkez Mdr onay1 ile belirlenir. M_teri taraf1ndan iadesi talep edilen numuneler de analiz sonras1nda orijinal veya modifikasyonlar yap1lm1_ numune artm1_ ise gnderi masraflar1n1 m_terinin kar_1lamas1 suretiyle iade edilir. Numunelerin iadesi deney raporunun teslimi ile birlikte yap1l1r. Bu numuneler bir hafta iinde teslim al1nmad11 takdirde imha edilir. Her trl posta/kargo masraf1 m_teriye aittir. Deney ve hizmet cretinin dendiine dair belge CTAM a ibraz edilmeden deney ba_lamaz ve rapor dzenlenmez. Birden ok ayn1 analiz numunesi ba_vurusunda ilk numunenin uygunsuzluu durumunda dier numunelerin analizi iin m_teriyle ileti_ime geilir. M_terinin istei dorultusunda analiz i_lemlerinin sreci belirlenir. Dier numunelerin analizinin iptal edilmesi durumunda ilk analiz bedeli al1narak kalan bedel iade edilir. Tek analiz ba_vurular1nda, analiz sonucu elde edilemese dahi analiz bedeli iade edilmez. Her deney sonucunda, oklu numune bile olsa, tek deney raporu dzenlenir. 0lave raporlar, sonular1 yorumlama ve farkl1 sonu formatlar1n1n her biri %50 ek crete tabidir. M_terinin deney sonular1na itiraz1 durumunda yap1lan deney tekrarlar1nda ayn1 sonular1n bulunmas1 durumunda m_teriden tam hizmet bedeli tahsil edilir. Analiz cretlerinde niversiteler ve kamu kurum ve kurulu_lara 0ND0R0M yap1ld11 durumlarda ilgili kurumdan CTAM gerekli belgeleri isteyebilir. Analiz sonular1n1n bilimsel bir yay1nda kullan1lmas1 halinde bu analiz(ler)in yap1ld11 yerin Cumhuriyet niversitesi 0leri Teknoloji Uygulama ve Ara_t1rma Merkez i olduunun yap1lan yay1n(lar)da/tez(ler)de belirtilmesi gerekmektedir. Sunduunuz yaz1l1/szl, ulusal/uluslararas1 al1_malar1n1z1n bir kopyas1n1 da merkezimize vermeniz gerekmektedir. Analiz talep eden ki_i/kurum, deney sonular1n1n sadece deneyi yap1lan numuneye ait olduunu, ticari bir amala kullan1lmayaca1n1 ve reklamlarda CTAM 1n ad1n1n zikredilerek ve/veya sz konusu rnn CTAM, Cumhuriyet niversitesi Laboratuvarlar1 vb. taraf1ndan onayland11 anlam1na gelecek _ekilde kullan1lmayaca1n1 taahht eder. Anla_mazl1k durumunda S0VAS mahkemeleri yetkilidir. BU FORMDA BEL0RTM0^ OLDUUM B0LG0LER0N DORULUUNU VE CTAM H0ZMET SZLE^MES0 NDEK0 HKMLER0 AYNEN KABUL ETT00M0 BEYAN EDER0M. 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