Sterilization Processing Order Form

We’re ready to provide you with the fastest sterilization services possible.

Contact us if you require immediate assistance: 303-531-1238
sterilization@boulderiq.com.

1Place your order

2Checkout

Service Requested

Cycle Type

Production - Validated cycle, sterilizer, load configuration required. BIs included. Add Cycle Spec ID below. Cycle spec ID must be provided for production sterilization.

Non-Production - R&D/engineering cycles. Indicate 1x or 2x. BIs can be added by request. Standard cycle parameters are listed on Page 2. Custom parameters are available by request.

Non-Production: please indicate 1x or 2x

2x (adds another business day of processing)

Cycle spec. ID

(Can be found in your product's Sterilization Validation Report.)

Sterilization Method

Ethylene Oxide (EO)

Chlorine Dioxide (CD)

Ethylene Oxide (EO) Sterilization

Production sterilization and engineering run - $850 (4-5 business days)

Standard expedite sterilization $1,100 (2 business days)

RUSH expedited sterilization - $1,450 (1 business day)

Chlorine Dioxide Sterilization

Standard sterilization run = $3,500 (5 business days)

Ethylene Oxide (EO) Sterilization

Production sterilization and engineering run - $850 (4-5 business days)

Standard expedite sterilization $1,100 (2 business days)

RUSH expedited sterilization - $1,450 (1 business day)

Chlorine Dioxide Sterilization

Standard sterilization run = $1,500 (5 business days)

Ethylene Oxide (EO) Sterilization

Production sterilization and engineering run - $1,700 2X (5-6 business days)

Standard expedite sterilization $2,200 2X (3 business days)

RUSH expedited sterilization - $2,900 2X (2 business day)

Chlorine Dioxide Sterilization

Standard sterilization run = $3,000 2X (6 business days)

Items to be Sterilized

Product Details

Description

Part Number

Revision

Quantity

Lot Number

(Note: Large-item volume may incur additional cycle charges if all items do not fit into a single run.)

Product Testing

For product testing, specify the Sample Quantity and ID for the specific tests below.

No Testing Required

Testing Required (will incur an additional fee)

Bls/PCDs

Sample Quantity

Sample ID

Test of Sterility

Sample Quantity

Sample ID

Endotoxin (LAL)

Sample Quantity

Sample ID

Bioburden

Sample Quantity

Sample ID

EO/CD Residuals

Sample Quantity

Sample ID

Other

Sample Quantity

Sample ID

Processing Parameters

Cycle Parameters

I accept the standard cycle parameters

I would like to use custom cycle parameters (add below)

Cycle Temp (°C) | Standard Cycle=60

Preheat Time (mins) | Standard Cycle=60

Max Vacuum Pressure (mbars) | Standard Cycle=160

Relative Humidity (%) | Standard Cycle=60

EO Dwell Time (mins) | Standard Cycle=240

Aeration (hour:mins) | Standard Cycle=1:00

Concentration (mg/L) | Standard Cycle=759

Additional Info | Special Instructions

Conditioning Time (mins) | Standard Cycle=120

Vacuum Pressure (kPa) | Standard Cycle=25

(Conditioning / CD Charge / Exposure)

Relative Humidity (%) | Standard Cycle=65

(Conditioning / Exposure)

Charge Concentration (mg/L) | Standard Cycle=3.0

PPM Hrs (ppm hours) | Standard Cycle=10,000

Aeration Flushes (#) | Standard Cycle=35

Additional Info | Special Instructions

Company Name

Address

Street Address City State ZIP Code

Contact Name

First Last

Phone

Email for Certificate of Processing and shipment tracking (if different)

Shipping

Return Shipping Method

Pick-up

FedEx

UPS

Note: If a shipping account number is not included, you will be billed for the additional shipping charges once the job is complete. There is an 18% mark-up on shipping provided by Boulder Sterilization.

FedEx Service

First Overnight (by 8am)

Priority Overnight (by 10:30am)

Standard Overnight (by 5pm)

2Day

Express Saver

Ground

UPS Service

Next Day Air A.M. (by 8am)

Next Day Air (by 10:30am)

Next Day Air Saver (by 3pm)

2nd Day Air

3-Day Select

Ground

Account Number

Ship to

Address provided

Different address

Different Shipping Address

Contact Address City State ZIP Code

Desired return-by date

MM slash DD slash YYYY

PO Number (optional)

Processing Agreement & Disclaimer

By placing an Order for Sterilization Services, you agree to be bound by the terms and conditions of the Sterilization Processing Agreement. This Agreement includes the following Disclaimer: The client acknowledges and agrees that it is solely and exclusively responsible for (i) ensuring that the process and specifications are appropriate for the products, (ii) the validation of the EO/CD cycle, (iii) product sterility, (iv) the integrity of the product packaging, (v) the adequacy of product labeling and (vi) compliance with any and all FDA or other regulatory requirements.

Yes, I have read and agree to the terms of the Sterilization Processing Agreement, including the above disclaimer.

Authorized Representative

Title

Date

MM slash DD slash YYYY

Total

Pay by Credit Card

Pay by Purchase Order (PO)

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 50 MB.

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