MICROBIOLOGICAL GROWTH MEDIA /

TISSUE CELL CULTURE MEDIA

Note:  Please fill in the form for each type of growth media to be provided in the contract and attach to the application form.  If space is not sufficient, attach additional pages.

LINE ITEM NUMBER

(as it corresponds to the number in the Excel attachment to the application form)

Type of tissue cell culture medium / microbial growth medium

                   (broth / agar / concentrate / powder)

Manufacturer

Purity / grade

For growth of

Pre-package size (litre or Kg)

Intended use