Application form for the supply of laboratory mice( Population/Frozen embryo )To:
Center for Animal Resources and Development (CARD)
Kumamoto University
The conditions stated below are for the supply of laboratory mice in which I am
applying for.
(Please print)
Date of application:

Receipt date:

Receipt number:

Name of the applicant including title of address (Mr.Ms.Mrs.Dr.)

Institution

Address

Zip codeCountry

Name of Division

Name of Responsible Person

Phone

Fax

E-mailName of mouse Strain

ID number:

Purpose of Reserach:Preferred condition of mice (mark a cross)□Population□Frozen Embryo□Frozen
Population
Frozenembryo Sperm

Did you attach the written acceptance from the Provider? (mark a cross)

YesNoX
Signature of Applicant / Date20070110

Agreement for the supply of laboratory mice
To:Director
Center for Animal Resource and Development
Kumamoto University
2-2-1 Honjo, Kumamoto 860-0811, JapanThe undersigned hereby agree to the following terms and conditions in relation to the request forthe supply of laboratory mice deposited in Center for Animal Resource and Development (hereinafter
called “CARD”), Kumamoto University .
1.

The material that is covered in this Agreement includes the laboratory mouse, its
deposited in CARD asadditional progeny or derivatives and any related information which is received by the Recipient
under this Agreement (collectively hereinafter called “Material”) for use in the research of
Recipient Scientist relating to(hereinafter called “Research”).
2. The Recipient shall pay the Price for mouse resources by the date of payment of invoice issued by
The National University Corporation, Kumamoto University and agrees to pay the fee remittance,
the shipping expense for sending the Material and the return expense of the shipping container.
Payment shall be made in Japanese Yen by the transfer of funds to a bank account designated by
the invoice. Accounts not paid by the date of payment shall be deemed delinquent and are
subjected to interest charges of five percent (5 %) per annum on the unpaid balance.
3. In the case requested by the Depositor, the Recipient should obtain an approval from the Depositor
using the Approval Form prior to the request for the supply of mouse resource.
4. The Material will be used only the non-commercial scientific research of the Recipient. The
Recipient shall not use the Material for diagnosis or treatment of humans or other direct
applications to human bodies or as food source for humans.
5. The Material shall not be distributed to any others without a prior written consent ofCARD.

6. If the Research using the Material results in a discovery, invention or new use (collectively,hereinafter called “Invention”), the Recipient agrees to disclose promptly such Invention to CARD
in confidence. Both parties shall discuss the legal title to the Invention and the patentapplication.
7. The Recipient agrees to expressly describe the acknowledgement to CARD as the source of theMaterial in any publications of Research results and shall send a copy of such publication toCARD. CARD may disclose publicly, the copy or otherwise use such publication to promote thecontribution by CARD.
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8. Nothing in this Agreement shall be interpreted expressly or impliedly that CARD grants theRecipient any rights under any patents or other intellectual property, or licenses thereunder withrespect to the Material.
9. The Recipient assumes all liability for claims against the Recipient and CARD by third parties
relating to alleged infringement of any patent or other intellectual property rights, which may arise
from the use, storage or disposal by the Recipient of the Materials, except for the case that theclaims is caused by the gross negligence or willful misconduct of CARD.
10. The Recipient acknowledges that the Material delivered pursuant to this Agreement may havedefective, hazardous or faulty properties and may not necessarily fit for a particular purpose andthat the Recipient assumes all liability for any consequences resulting from the use by theRecipient of the Material.
11. Even if the Recipient dose not get good results after thawing of frozen mouse embryos, CARD
does not take the consequences for it.
12. The Recipient agrees that any handling or other activities undertaken in their laboratory with theMaterial shall be conducted in compliance with all applicable laws, regulations and guidelines.
The Recipient shall, if necessary, take any steps or procedures to comply with legal requirements
for handling of the Materials.
13. Both parties shall discuss to enable amicable resolution of any accidents during shipment of theMaterials.
14. Where the Recipient is in breach of this Agreement, CARD may request the Recipient to cease its
subsequent use of the Material and other mouse resources of CARD.
15. Both parties shall discuss in good faith to enable the amicable resolution of matters, arising inconnection with the interpretation or performance hereof as well as the matters which are notexpressly set forth in this Agreement.
16. This Agreement shall be governed by and construed in accordance with the laws of Japan and eachparty submits to the exclusive jurisdiction of Kumamoto District Court, Japan.
RECIPIENT
Name of Authorized Representative:
Position:
Institution:
Address:
Signature:

Date:

RESIPIENT SCIENTISTName of Scientist:
Position:
Institution:
Address:
Signature:

Date:
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Approval Form(“Provider”) and(“Provider scientist”)(“Recipient”) with materials as describedagree to provide(“Recipient scientist”) for use in a research project, subject
below as requested byto the terms and conditions set forth in this form.
1. This agreement applies to the material specified as, its additional
progeny or derivatives and any related information which is received by recipient under this form
for use in the research of recipient scientist relating to(“Research”).
2. The material described above is being provided under the condition described below (Check one offollowing).
(“Provider scientist”)
Recipient scientist will acknowledge
as the source of the material in any publications of Research results.
Recipient scientist agrees to use the material on the collaborative basis. Both parties
shall discuss in good faith to enable the amicable resolution of matters, arising incollaborative work.
(“Provider scientist”)
Recipient scientist agrees to add
as authors in the first publications. Thereafter, the Recipient scientist agrees toacknowledge(“Provider scientist”) as
the source of the Material in any publications of Research results.
Recipient and Recipient scientist agree to use the material in the following condition.

3. Provider retains ownership of the Material, including any Material contained or incorporated inmodifications. If the Research using the Material results in a discovery, invention, new use or aproduct (collectively, the “Invention”), Recipient agrees to disclose promptly such Invention toProvider in confidence. Legal title to the Invention shall be determined by mutual agreement
between the parties taking into account the role and contribution of individuals involved thedevelopment of Invention.
Provider and Recipient do hereby sign two original forms of this Agreement and each party holds
one signed form.

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Name:
Position:
Institution:
Address:
Signature:

Date:

PROVIDER
Name (authorized representative):
Position:
Institution:
Address:
Signature:

Date:

RECIPIENT
Name (authorized representative):
Position:
Institution:
Address:
Signature:

Date:

RECIPIENT SCIENTIST
Name:
Position:
Institution:
Address:
Signature:

Date:

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