Signature Title Clause Samples

Signature Title. Deputy Director of the Department for Preventive Care, according to credentials Date……………………….. List of attachments: Appendix 1 – Protocol Appendix 2 – Financial assistance Appendix 3 – Bank details Appendix 4 – copy of Local Ethics Committee Approval, copy of SÚKL notification Šablona dvoustranné smlouvy mezi zdrav. zařízením a CRO SMLOUVA O NEINTERVENČNÍM KLINICKÉM HODNOCENÍ Tato smlouva (▇▇▇▇ ▇▇▇ „smlouva“) nabývá platnosti a účinnosti dnem uveřejnění v registru smluv („datum účinnosti”). A je uzavírána mezi těmito stranami: MAPI Life Science UK Limited, společnost zřízená a působící podle zákonů Spojeného království, se sídlem Concept House, ▇ ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇, ▇▇▇▇ ▇▇▇ Velká Británie, DIČ GB 193 9420 80, kterou zastupuje ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇, Global Head, Operations Support Management, zplnomocněná k jednání pro účely této smlouvy, (▇▇▇▇ „CRO”), která jedná jménem společnosti ▇▇▇▇▇ PHARMA S.A.S., (▇▇▇▇ ▇▇▇ „▇▇▇▇▇“ nebo „zadavatel studie”), a Nemocnice Na Bulovce, se sídlem na adrese ▇▇▇▇▇▇▇▇ ▇▇/▇, ▇▇▇ ▇▇, ▇▇▇▇▇-▇▇▇▇▇, kterou zastupuje MUDr. ▇▇▇▇▇ ▇▇▇▇▇▇▇▇, MBA, náměstkyně pro vědu, výzkum, grantové činnosti a rozvoj, dle pověření, (▇▇▇▇ „zdravotnické zařízení“ nebo „pracoviště studie”), uvedené strany budou ▇▇▇▇ ▇ ▇▇▇▇ smlouvě označovány jednotlivě jako „(smluvní) strana“ a společně jako „(smluvní) strany”.

Signature Title. Title: ------------------------------------------------------------------------------- Exhibit B ACCREDITED INVESTOR QUESTIONNAIRE The undersigned is an "Accredited Investor," based upon the following (check all that apply):

Signature Title. Guarantor address (1)

Signature Title. Payment Information Please fill out this application & return the original by April 1, 2019 to AAGA Member Pricing: TRADE SHOW BOOTH PRICES Standard & Double (non-sponsor) booths include admission for 2 (two). Save Time: Register & Pay Online at ▇▇▇.▇▇▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇▇-▇▇▇▇.▇▇▇▇ Sponsor Booths include admission for 3 (three), premium location (near entrance, bar, photo booth, or other high-traffic area), recognition on printed & promotional Trade Show material (including signage, programs, photo booth strips, cups, etc.) and online recognition on AAGA’s website & social media. Additional representatives may attend at the rate of 1. PART OF CONTRACT: These rules and regulations are a part of the contract for exhibit space. The Apartment Association of Greater Augusta (AAGA) reserves the right to render all interpretations and decisions should questions arise, and to establish further regulations as may be deemed necessary to ensure the success and well being of the trade show. The decisions of the AAGA are final in all cases. 2. DATE, LOCATION, AND TIME: Date: Thursday, April 25, 2019. Location: Columbia County Exhibition Center - Exhibit Hall B, ▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇. Time: 5:30 p.m. to 8:30 p.m.

Signature Title. Note: A stated child care policy may include services and/or benefits for employees and their families, including infants through school-age child care centers or family day care homes, before and after school programs, day camps, services for ill children, children with special needs, family leave and more. Please refer to the attached instructions for definitions. Please check ALL items on the form that apply to your business concern. PART ONE YES NO If YES, please attach a copy PART TWO If YES, Please check which form/s ofassistance Level I Assistance Paid parental leave • M □ Purchase of spaces for employees in community child care Level II Assistance Salary set-aside/flexible spending account funded with Level III Assistance Flex-place/work-at-home 0 D Work-at-home following maternity leave 0 D Other (Describe) I have read and completed the “Child Care Declaration Statement” and verify that the information provided is true and cprrect. Name and Title ' " ’ —• Date City Departments: Please return a copy of this form to: ▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, #▇▇▇▇, ▇▇▇ ▇▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇ EXHIBIT E Introduction

Signature Title. Annexes: A copy of an extract from a commercial register which certifies that the undersigned is a duly authorized legal representative of the Company and/or has the power to represent the Company through a personal identification document such as a copy of valid ID.

Signature Title. E.P.E. ‘Fundació Mies van der ▇▇▇▇’‌ ▇▇▇. ▇▇▇▇ ▇▇▇▇▇ Director

Signature Title. President & CEO

Signature Title s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇ Chief Executive Officer, Chairman and Director - -------------------------- (Principal Executive Officer) ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇ /s/ R. ▇▇▇▇▇ ▇▇▇▇▇▇ Vice Chairman, Vice President and Director - --------------------------