DATE OF THIS AGREEMENT: THE PARTIES: (A) University Hospitals Bristol NHS Foundation Trust whose administrative office is at Trust Headquarters, Marlborough Street, Bristol, BS1 3NU (the "Trust"); and (B) XXXXXXX● whose [registered][administrative] office is at ● (the "Recipient"). THE BACKGROUND: (A) The Trust is the custodian of the Material. (B) The Recipient wishes to use a sample of the Material for a specified use (a "Scheduled Purpose") pursuant to the Human Tissue Act 2004 (the "Act") (C) This Agreement does NOT apply where the Scheduled Purpose is transplantation or a “human application” pursuant to the Human Tissue (Quality and Safety for Human Application) Regulations 2007. AND The Material is held with approval by a recognised research ethics committee, being either a research ethics committee established under and operating to the standards set out in the governance arrangements issued by the UK Health Departments (www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuid ance/DH_4005727); or a research ethics committee recognised by United Kingdom Ethics Committee Authority or a person or committee recognised for that purpose by the Secretary of State, the National Assembly of Wales or the Department of Health, Social Services and Public Safety in Northern Ireland or any such equivalent under Applicable Law (www.opsi.gov.uk/si/si2004/20041031.htm). Therefore the Trust is able and willing to provide a sample of the Material on the terms and conditions of this Agreement and the Recipient agrees to comply with such terms and conditions. THE "MATERIAL" is both anonymised patient data and anonymised saliva, blood and tissue samples which have been collected for the purposes of the research trial sponsored by the Trust entitled: Head and Neck 5000 as further described in the Annex being "relevant material" for the purposes of the Act and includes any and all materials, documents and information that the Trust may provide to the Recipient under or in connection with this Agreement: THE "SCHEDULED PURPOSE(S)" OR Where the Scheduled Purpose is “research in connection with disorders or the functioning of the human body” the NHS Research Ethics Committee (the "NHS REC") or other applicable research ethics authority favourable opinion or pending favourable opinion approval reference number and the anticipated expiry date are: [●]. The Investigator is the following named officer or employee of the Recipient [●]. THE "TERM" of this Agreement: [●]. THE "INVESTIGATOR" the following named officer or employee of the Recipient: [●]. THE "PREMISES" where the Scheduled Purpose will be conducted: [●]. TO THE BEST OF THE TRUST’S KNOWLEDGE CONSENT (IF IT IS REQUIRED) has been given for the Scheduled Purpose(s). This Agreement comprises the main body of this Agreement, the Annex and the Standard Terms and Conditions attached. SPECIAL CONDITIONS: [●] All full papers and press releases must be sent to the Head and Neck 5000 Executive for approval (headandneck5000@uhbristol.nhs.uk) along with a completed papers checklist prior to submission. We request that we are provided with an electronic copy of any reports, theses and other publications that use the Head and Neck 5000 resource as soon as possible The Director and/ or one or more nominated member(s) of the Head and Neck 5000 Executive should also be included as an author on papers using data from Head and Neck 5000 resource. This person must see and sign off the final version of the paper to ensure it is accurate and does not bring the study into disrepute The following standard acknowledgements section must be included in all papers: We would like to thank the people with head and neck cancer who took part in this study. We would also like to thank the research and clinical staff who supported this study. This publication presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0707-10034). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. AGREED by the parties through their authorised signatories on the date appearing above. Signed by for and on behalf of the Trust as an authorised representative of the University Hospitals Bristol NHS Foundation Trust. Signed by for and on behalf of the recipient as an authorised representative of UH Bristol Version No.1 22.05.15 ANNEX: Further description of the Material & the Scheduled Purpose Section 1: To be completed by the Recipient Project Title Named Collaborators and their host organisations Scheduled Purpose (please delete as appropriate) Anatomical examination Determining the cause of death Establishing after a person’s death the efficacy of any drug or other treatment administered to him Obtaining scientific or medical information about a living or deceased person which may be relevant to any other person (including a future person) Public display Research in connection with disorders, or the functioning, of the human body Transplantation Clinical audit Education or training relating to human health Performance assessment Public health monitoring Quality assurance Lay summary of proposal (max 200 words) Study proposal / protocol Peer review Funding Material requested Description Quantity Frequency of delivery Disposal policy UH Bristol Version No.1 22.05.15 Section 2: To be completed by the Trust Storage conditions Data to be stored within provision of Data Protection Act Living/deceased donor Information released with Material e.g. Relevant donor info/medical history, circumstances of donation Proposed processing of the Material UH Bristol Version No.1 22.05.15 Standard Terms & Conditions 1. Definitions "Publications" means any proposed or draft publications, including (but not limited to) papers, letters, reports, presentations and funding applications, which describe the work carried out under the Scheduled Purpose and which are intended for public disclosure. Under these terms and conditions, unless the context otherwise requires, the following definitions shall apply: "Applicable Law" means all laws, rules, regulations, codes of practice, research governance or ethical guidelines, or other requirements of any Regulatory Authority, that may apply to the use of the Material by the Recipient from time to time, including (but not limited) to the Human Tissue Act 2004 or the Human Tissue (Scotland) Act 2006, the Human Tissue (Quality and Safety for Human Application) Regulations 2007, the Human Fertilisation and Embryology Act 1990 (as amended), the EU Tissues and Cells Directive (2004/23/EC) and Commission Directives 2006/17/EC and 2006/86/EC, the Human Tissue Authority Directions and Codes of Practice, and the Medicines for Human Use (Clinical Trials) Regulations 2004, as updated and amended from time to time and, where relevant, the national implementations of the same. A "Regulatory Authority" is the Human Tissue Authority, the Human Fertilisation and Embryology Authority, the Medicines Healthcare and products Regulatory Agency, or any other competent authority in relation to the use of the Material under Applicable Law. A "research ethics authority" is: "Confidential Information" includes (but is not limited to) information relating to the Material, any information relating to a donor of the Material, any Invention, the Scheduled Purpose results, any Publication or any technical information disclosed by the Trust or any other information disclosed by the Trust under this Agreement and identified as confidential. a Research Ethics Committee (a "REC") established under and operating to the standards set out in the governance arrangements issued by the UK Health Departments www.dh.gov.uk/en/Publicationsan dstatistics/Publications/Publication sPolicyAndGuidance/DH_4005727 ; or a REC recognised by United Kingdom Ethics Committee Authority (the "UKECA")(www.opsi.gov.uk/si/si20 04/20041031.htm) or a person or committee recognised for that purpose by the Secretary of State, the National Assembly of Wales or the Department of Health, Social Services and Public Safety in Northern Ireland or any such equivalent under Applicable Law. “Intellectual Property” means any Invention and any intellectual property rights, including all patents, patent applications, copyright, and other similar proprietary rights, data, and all intangible rights and privileges of a nature similar to any of the foregoing, and whether or not registered and including all granted registrations and all applications for registration in respect of any of the same 2. Supply & use of the Material 2.1 The Recipient agrees to be bound by the terms and conditions in consideration of the Trust making the Materials available to the Recipient for the Scheduled Purpose. An "Invention" means any new discovery, improvement, invention or product relating to the Material. 2.2 The Trust hereby grants the Recipient a non-exclusive licence to use the Material solely for the Scheduled To "use" means (as applicable) to procure, test, process, use for a Scheduled Purpose, import, store, return and dispose of the Material. UH Bristol Version No.1 22.05.15 Purpose at the Premises. Any use of the Material outside the scope of the Scheduled Purpose or outside the Premises requires the prior written consent of the Trust. Subject to the Recipient complying with clause 2.4(b), if the Recipient is NHS REC approved the Recipient may remove Material from the Premises without the Trust’s prior written consent for use within the scope of the REC protocol. 2.3 2.4 (e) 2.5 The Material is supplied without cost, but the Recipient shall reimburse the Trust for all costs that the Trust may incur when preparing and sending the Material to the Recipient. Supply of the Material is subject to availability. The Recipient shall: (a) (b) as applicable, provide written evidence to the Trust and its DI: (i) that the Scheduled Purpose has been granted a favourable opinion by a research ethics authority or that such a favourable opinion is pending OR (ii) of an appropriate licence granted by a Regulatory Authority OR (iii) if the Scheduled Purpose is being conducted outside England, Wales and NI, such equivalent evidence as required under Applicable Law OR (iv) that the Scheduled Purpose has been approved by a licensed tissue bank; procure that the Investigator and any other employees, students, officers or other representatives of the Recipient or third party collaborators involved in the Scheduled Purpose and with access to the Material abide by these terms and conditions; (c) use the Material only for the Scheduled Purpose; (d) keep the Material secure at the Investigator's laboratory or applicable offices (for data only) at the Premises and ensure that no-one other than the Investigator and those individuals under the Investigator’s supervision have access to the Material; and not remove the Material from the Premises. The Material shall be immediately returned (or if the Trust so requires, disposed of in accordance with Applicable Law): (a) on termination of this Agreement for any reason; or (b) in the event that the Recipient is in breach of any of these terms and conditions or (c) at any other time on request of the Trust or the DI; or (d) on completion of Scheduled Purpose; or (e) in respect of any donor if the donor withdraws consent to the use of Material pertaining to them as advised by the Trust. the 3. Intellectual Property 3.1 Except as provided by clause 2.2, no licence under any Trust Intellectual Property or material is granted or implied by this Agreement. 3.2 In the event that the Recipient makes or observes an Invention then the Recipient will promptly bring this to the attention of the Trust. 3.3 The Trust will, at all times, retain the right to use an Invention and any results arising under the Scheduled Purpose for non-commercial research or teaching purposes. 3.4 Save as provided in this clause 3 the Recipient shall own all Intellectual Property in the results of the Scheduled Purpose. 4. Publications & Acknowledgements 4.1 If identified as a Special Condition, the Recipient shall send to the relevant person at the Trust (such person to be identified in the Special Condition) a copy of any Publications for review by the Trust not less than 30 days prior to publication. The Trust shall be entitled to delay publication for a period not exceeding 60 days in order to protect intellectual property or remove the Trust's confidential information disclosed in the Publication. Until their publication the parties shall treat UH Bristol Version No.1 22.05.15 Publications information. 4.2 confidential (c) In any Publications arising from the Recipient’s use of the Materials the Recipient shall: (a) acknowledge the Trust as the source of the Material; and (b) provide (where customary and appropriate) authorship to those Trust officers or employees involved in the Scheduled Purpose; and (c) 5. as 6.2 acknowledge the participation of any funder advised to you by the Trust. Confidentiality Save to the extent that the Confidential Information has come into the public domain through no fault of the Recipient or as required by Applicable Law, the Recipient shall not disclose Confidential Information disclosed by the Trust to the Recipient to any third party and shall only disclose such Confidential Information to those of its officers or employees as need to know. The Recipient shall treat the Trust's Confidential Information with the same degree of care as it treats its own confidential information. 6. Warranties & Liability 6.1 The Material is experimental in nature and provided "as is" to the Recipient. The Trust makes no representation and gives no warranty or undertaking in relation to the Material. As examples, but without limiting the foregoing, the Trust gives no warranty that: (a) (b) it is the custodian of all necessary property and other rights in the Material and that their use will not infringe any intellectual property rights of any third party; or the Material is free from disease or infection, fit for any particular purpose, has been developed with reasonable care and skill or tested for the presence of pathogens or otherwise, or is viable, safe or non-toxic; or that all necessary consents or authorisation have been obtained from the donors (whether deceased or living) or licenses have been obtained from the Regulatory Authority. The Trust shall have no liability to the Recipient, whether in contract, tort or otherwise, in relation to: (a) the supply of the Material to the Recipient; or (b) the use of the Material by Recipient or by any other person; or (c) the consequences of its use; to the maximum extent permitted under Applicable Law. 6.3 The Recipient warrants that: (a) it shall comply with all Applicable Law in the storage, use and disposal of the Material or as otherwise applicable to the Scheduled Purpose; (b) it may lawfully use the Material for the Scheduled Purpose and that it has the full power and capacity to enter into this Agreement; (c) where the Scheduled Purpose is research, the Scheduled Purpose has received a favourable opinion by a research ethics authority or that a favourable opinion is pending, or that an appropriate licence has been granted by the Regulatory Authority to use the Material, or that there is approval from a licensed tissue bank; (d) for Scheduled Purposes other than research, the Recipient holds an appropriate HTA Licence (or equivalent issued by the relevant Regulatory Authority) for the storage and use of the Material; and (e) if the Material is supplied by the Trust in an anonymised form, the Material will be kept anonymised and the Recipient UH Bristol Version No.1 22.05.15 shall not attempt to identify any donor or, if information is given to the Recipient whether intentionally or not that could lead to identification of one or more donors of the Material, then the Recipient shall treat that information as confidential information in accordance with clause 5 of this Agreement. 6.4 In relation to the supply and use of the Material the Recipient undertakes to indemnify the Trust and keep it indemnified fully at all times against all claims, demands, actions, proceedings, damages, losses or costs (including not limited to any, expenses, fines, prosecutions or charges) which are made or brought against or incurred by the Trust in respect of the use of the Material by the Recipient, including (without limitation), claims and losses arising from: (a) injury to the Recipient's employees, officers, contractors, agents or any other person; (b) infringement of third party intellectual property rights; (c) failure by the Recipient to abide by Applicable Law; or (d) use of the Materials within or outside the scope of this Agreement. 7. Term & Termination 7.1 This Agreement shall commence on the date of signature and shall continue in force for the Term unless terminated earlier in accordance with this clause. 7.2 Any breach of the terms of this Agreement by the Recipient or any event of insolvency involving the Recipient shall result in immediate termination of this Agreement. 7.3 The following clauses and any other clauses which are either expressed to survive termination or, from their nature or context are intended to survive termination shall survive termination of this Agreement for any reason: clauses 3, 4, 5, 6 and 7 and any special conditions. 8. General 8.1 The Recipient shall not assign, transfer, or part with any of its interests, rights, duties or obligations under this Agreement without the prior written consent of the Trust. 8.2 This Agreement sets out the entire agreement and understanding between the parties and supersedes all prior agreements, understandings or arrangements (oral or written) in respect of the subject matter of this Agreement. 8.3 The Recipient acknowledges that it has entered into this Agreement in reliance only on the representations, warranties promises and terms contained in it and, save as expressly set out in this Agreement, the Trust shall have no liability in respect of any other representation, warranty or promise made prior to the date of this Agreement unless it was made fraudulently. 8.4 No purported variation of this Agreement shall be effective unless it is in writing and signed by or on behalf of each of the parties’ authorised representatives. 8.5 To the extent that any provision of this Agreement is found by any court or competent authority to be invalid, unlawful or unenforceable in any jurisdiction, that provision shall be deemed not to be a part of this Agreement, it shall not affect the enforceability of the remainder of this Agreement nor shall it affect the validity, lawfulness or enforceability of that provision in any other jurisdiction. 8.6 The Trust may, in whole or in part, release, compound, compromise, waive or postpone, in its absolute discretion, any liability owed to it or right granted to it in this Agreement by any the Recipient without in any way prejudicing or affecting its rights in respect of that or any other liability or right not so released, compounded, compromised, waived or postponed. 8.7 No single or partial exercise, or failure or delay in exercising any right, power or remedy by the Trust shall constitute a waiver by it of, or impair or preclude any further exercise of, that or any UH Bristol Version No.1 22.05.15 right, power or remedy arising under this Agreement or otherwise. 8.8 The Recipient shall not use the name or trade marks of the Trust in any way, including (but not limited to) in any advertising, press release, sales literature or fund raising event, without the prior written consent of the Trust. 8.9 Unless expressly provided in this Agreement, no term of this Agreement is enforceable pursuant to the Contracts (Rights of Third Parties) Act 1999 by any person who is not a party to it. 8.10 Any notice to a party under this Agreement shall be in writing signed by or on behalf of the party giving it and shall, unless delivered to a party personally, be left at, or sent by prepaid first class post in the case of the Trust to the address set out on page 1 of this Agreement and in the case of the Recipient to the Investigator at the Premises or as otherwise notified in writing from time to time. 9. Governing law English law shall apply to this Agreement, and the English courts shall have exclusive jurisdiction. UH Bristol Version No.1 22.05.15