Microbiology Material Release Form

MICROBIOLOGY MATERIAL RELEASE FORM

Provider Name:    Recipient Name:

WHEREAS

WHEREAS, Provider is the lawful possessor of microbiological materials described herein and has authority to disclose or transfer such materials for the purposes and subject to the terms set forth in this Agreement; and

WHEREAS, Recipient desires to receive certain microbiological materials from Provider for the limited purpose stated below and agrees to comply with applicable biosafety, biosecurity, and regulatory requirements and the terms of this Agreement; and

NOW, THEREFORE, in consideration of the mutual covenants and agreements contained herein, the parties agree as follows:

SCOPE OF MATERIAL RELEASE

BIOSAFETY, HANDLING AND TRANSPORT

Biosafety Level required: BSL‑1 BSL‑2 BSL‑3 BSL‑4

CHAIN OF CUSTODY

Date of Transfer:    Lot / Sample ID:

CERTIFICATIONS, COMPLIANCE AND INDEMNIFICATION

Recipient certifies that it has the requisite facilities, trained personnel, institutional approvals, and regulatory authorizations to receive, store, handle, and dispose of the materials described. Recipient will not transfer, share, sublicense, or otherwise distribute the materials to third parties without prior written consent of Provider.

Recipient agrees to comply with all applicable laws, regulations, institutional biosafety committee (IBC) approvals, and shipping and hazardous materials laws. Recipient shall notify Provider promptly of any unauthorized release, exposure, or regulatory inquiry related to the materials.

Recipient shall defend, indemnify, and hold harmless Provider, its officers, employees and agents from and against any and all claims, liabilities, losses, damages, costs and expenses (including reasonable attorneys' fees) arising out of Recipient's possession, use, handling, storage, or disposal of the materials, except to the extent caused by Provider's gross negligence or willful misconduct.

Recipient personnel listed on this form have completed required biosafety training
Necessary Institutional/Regulatory approvals (IBC, IACUC, permits) are in place prior to transfer
Materials will not be redistributed, shared, or used for commercial purposes without written consent

PAYMENT TERMS

Fee for materials and handling (if any): $

Late fee:    Collection costs: Recipient will reimburse Provider for reasonable costs of collection and enforcement.

TERM AND TERMINATION

Term Commencement Date:    Termination Date (if applicable):

Either party may terminate this Agreement for convenience upon written notice to the other party delivered at least days prior to the effective date of termination. Termination does not relieve Recipient of obligations relating to materials already transferred, including proper disposition and indemnification obligations.

CONFIDENTIALITY

Unless otherwise agreed in writing, Recipient shall treat any non-public proprietary information disclosed by Provider in connection with the materials as confidential and shall not disclose such information to third parties. This confidentiality obligation shall survive termination of this Agreement for a period of three (3) years.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of laws principles. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings and agreements, whether written or oral.

MISCELLANEOUS

Any amendment to this Agreement must be in writing and signed by authorized representatives of both parties. Notices required under this Agreement shall be in writing and delivered to the addresses provided by the parties below.

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