SICRIT® Technology – Qualification Report Page 1 of 5DateInstitution / Company*Name*Position*Decision Maker*Please selectYesNoNamePositionDecision MakerPlease selectYesNoNamePositionDecision MakerPlease selectYesNoNamePositionDecision MakerPlease selectYesNoPlasmion Representative*Please selectKatharina HohenwallnerDivya RameshJan BucekNextSICRIT can be deployed (basic criteria of the technology are met)*YesNoWhat do you expect as the main deliverable from SICRIT technology?*Higher ThroughputIncreased SensitivityBetter Ionization CoverageReduced Sample Preparation TimeHigher Level of Analytical AutomationOtherIf other, please describeBackNextFunded By*Please selectPublic Tender/GrantInvestment FundsSubmission*Please selectImmediately3-6 MonthsNext YearImplementation*Please selectImmediately3-6 MonthsNext YearBudget notes?BackNextWhat are the most important evaluation criteria?I am committed to considering the implementation of SICRIT technology if all deliverables are fully met.*YesNoBackNextIs prospect qualified?*YesNoIf no, why?On-site demo necessary?*YesNoIf yes, why?If no, why?BackSendThis field should be left blank