Order Form for Antiviral Toolkit Pro Single / Commercial / Government Central Command Inc. P.O. Box 856, Brunswick, Ohio 44212 216.273.2820 / e-mail: keithap@wariat.org Prices are subject to change without notice We accept U.S. Funds/U.S. Banks Only Site Licenses are for (2) year consecutive terms Single License's are for unlimited terms Single / Site License Single License $ 59.95 Up to 10 $ 369.00 Up tp 25 $ 673.00 Up to 50 $ 1124.00 Up to 100 $ 2084.00 Up to 250 $ 4436.00 Up to 500 $ 7239.00 Up to 1000 $ 9243.00 Up to 1500 $10018.00 Up to 2000 $11370.00 Up to 2500 $12525.00 Up to 3000 $13680.00 Up to 5000 $16094.00 Up to 10000 $21010.00 Up to 15000 $24125.00 For larger quantities please call for assistance Renewel is 25% of the license fee Every 100 user licenses includes 1 FREE NLM module when available and FREE home use for Employees! VIP Update Service (2) two years (Weekly) $ 499.95 Premier Update Service (2) two years (Monthly) $ 199.95 Standard Update Service (2) two years (Quarterly) $ 99.95 Licenses Quantity _______ = $_______________ Government users deduct 15% = $_______________ Update Service, USA ONLY (1) one disk per site, per update = $_______________ Shipping and Handling = $ 9.95 Ohio residents add 5.5% Tax = $_______________ Total = $_______________ Paying by (Circle One): Check Money Order Purchase Order (Terms: Net 30 Days) Upon licensing AVP you will receive the latest version with the latest data base and a registration number. A maximum of 5 disks sets are shipped per site. Full Name __________________________________ Title ________________________ Company ____________________________________________________________________ Shipping Address (No P.O. Boxes) ___________________________________________ City ___________________ State ___________________ Zip Code _____________ Phone __________________________ FAX ____________________ Ext _____________ E-Mail Address _____________________________________________________________ E-Mail Carrier _____________________________________ Company Purchase Order Number (Attach Copy) ___________ Terms: (NET 30 Days) Technical Contact _____________________________ Telephone _________________ Purchasing Contact ____________________________ Telephone _________________ Your Signature ________________________________ Date ______________