8/9/2019 Simple Letter Agreement

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Simple Letter Agreement Instructions

The one-page form that follows is the NIH-recommended Simple Letter Agreement for material

transfers between academic/non-profit institutions. This form should only be used for the transfer of

research material owned by Tufts to academic/non-profit institutions.

Please ! N!T use this form if"

#a$ a commercial entit% wishes to recei&e the material' or 

#b$ the material contains cre or lo( NA' or #c$ the material is the sub)ect of a pending patent application or an issued patent' or 

#d$ the material resulted from a pro)ect funded b%' or using materials recei&ed from' industr%.

If an% of the abo&e is true' please refer the matter to the !ffice for Technolog% Licensing and Industr%*ollaboration #!TL+I*$ as detailed below.

INSTRUCTIONS FOR TUFTS IN!STI"#TOR $%ROI&!R SCI!NTIST'

Please print and sign two copies of the attached material transfer agreement #,TA$' and mail them to

the academic scientist who reuested the material. Please be sure to fill out %our contact information#under Pro&ider Information$ so that the recipient can return a full% e(ecuted ,TA to %ou. Send the

material to the recipient scientist only upon receipt of a fully si(ned) unaltered *T#. 0ou can

accept a fa(ed cop% of the ,TA to speed the transfer.

Please 1eep a record of the ,TA and the shipment.

The attached form cannot be altered other than to fill in the blan1s. If the recipient reuests changes orhas uestions about the ,TA' please as1 that person to contact !TL+I* directl%.

If %ou prefer' %ou can email this form directl% to the reuesting scientist and ha&e him/her begin thesignature process. If %ou choose this option' please wait to send the material until %ou ha&e recei&ed an

unaltered ,TA signed b% both the recipient scientist and an institutional official' and be sure to return a

full% e(ecuted cop% of the ,TA to the recipient at the address the% pro&ide.

INSTRUCTIONS FOR R!CI%I!NT SCI!NTIST/INSTITUTION

Please sign two copies of this agreement' and ha&e both copies signed b% an authori2ed official of %ourinstitution. !nce the recipient scientist and authori2ed official ha&e both signed this form' please return

the *T# to the pro+ider scientist at Tufts 3ni&ersit% b% fa( or mail. If the pro&ider scientist needs to

co-sign and return a full% e(ecuted cop% of the agreement' please clearl% indicate the address to whichhe/she should return the full% e(ecuted cop%.

,U!STIONS OR C#N"!S. %!#S! CONT#CT OT0IC1

 Nina 4reen' irector 

Tufts 3ni&ersit% - !ffice for Technolog% Licensing and Industr% *ollaboration

nina.green5tufts.edu#678$ 696-:96:

8/9/2019 Simple Letter Agreement

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Simple etter #(reement for the Transfer of *aterials

In response to ;<*IPI<NT=s reuest for the ,AT<;IAL ' including an% progen% and unmodified deri&ati&es thereof'the P;!>I<; as1s that the ;<*IPI<NT and the ;<*IPI<NT S*I<NTIST agree to the following before the ;<*IPI<NT

recei&es the ,AT<;IAL"

7. The abo&e ,AT<;IAL is the propert% of the P;!>I<; and is made a&ailable as a ser&ice to the research communit%.?. THIS ,AT<;IAL IS N!T @!; 3S< IN H3,AN S3B<*TS.

9. The ,AT<;IAL will be used for teaching or non-profit research purposes onl%.

C. The ,AT<;IAL will not be further distributed to others without the P;!>I<;Ds written consent. The ;<*IPI<NT

shall refer an% reuest for the ,AT<;IAL to the P;!>I<;. To the e(tent supplies are a&ailable' the P;!>I<; orthe P;!>I<; S*I<NTIST agree to ma1e the ,AT<;IAL a&ailable' under a separate Simple Letter Agreement' to

other scientists for teaching or not-for-profit research purposes onl%.

E. The ;<*IPI<NT agrees to ac1nowledge the source of the ,AT<;IAL in an% publications reporting use of it.

6. An% ,AT<;IAL deli&ered pursuant to this ,aterial Transfer Agreement is understood to be e(perimental in nature andma% ha&e ha2ardous properties. The P;!>I<; ,AF<S N! ;<P;<S<NTATI!NS AN <GT<NS N!

A;;ANTI<S !@ AN0 FIN' <ITH<; <GP;<SS< !; I,PLI<. TH<;< A;< N! <GP;<SS !; I,PLI<

A;;ANTI<S !@ ,<;*HANTAILIT0 !; @ITN<SS @!; A PA;TI*3LA; P3;P!S<' !; THAT TH< 3S< !@

TH< I!L!4I*AL ,AT<;IAL ILL N!T IN@;IN4< AN0 PAT<NT' *!P0;I4HT' T;A<,A;F' !; !TH<;

P;!P;I<TA;0 ;I4HTS. 3nless prohibited b% law' ;<*IPI<NT assumes all liabilit% for claims or damages against it b% third parties which ma% arise from the use' storage or disposal of the ,AT<;IAL e(cept that' to the e(tent permitted

 b% law' the Pro&ider shall be liable to the ;<*IPI<NT when the damage is caused b% the gross negligence or willful

misconduct of the P;!>I<;.8. The ;<*IPI<NT agrees to use the ,AT<;IAL in compliance with all applicable statutes and regulations.

. The ,AT<;IAL is pro&ided at no cost' or with an optional transmittal fee solel% to reimburse the P;!>I<; for its

 preparation and distribution costs. If a fee is reuested' the amount will be indicated here"

The PROVIDER SCIENTIST, RECIPIENT and RECIPIENT SCIENTIST must sign both copies of this letter and return one

 signed cop to the PROVIDER! The PROVIDER "ill then send the #$TERI$%! This &N#ODI'IED Simple %etter

 $greement for transfer of materials to NON(PRO'IT institutions does not re)uire signature b an official of Tufts &ni*ersit!

P;!>I<; IN@!;,ATI!N"

 Name of Pro&ider Scientist"Title of Pro&ider Scientist"

Pro&ider !rgani2ation" Tufts 3ni&ersit%Address"

 JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJJJJJJJJJJJJJJJ Signature of Pro&ider Scientist ate

;<*IPI<NT IN@!;,ATI!N and A3TH!;IK< SI4NAT3;<"

;ecipient Scientist";ecipient !rgani2ation"

Address"

 Name of Authori2ed !fficial"

Title of Authori2ed !fficial"

 JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJJJJJJJJJJJJJJJ 

Signature of Authori2ed !fficial ate

*ertification of ;ecipient Scientist" I ha&e read and understood the conditions outlined in this Agreement and I agree to

abide b% them in the receipt and use of the ,AT<;IAL.

 JJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJJJJJJJJJJJJJJJ ;ecipient Scientist ate