RSC Renewal 2015
BIOLOGICAL SAFETY CERTIFICATE RENEWAL
AND AMMENDMENT APPLICATION
This renewal and amendment application can be used when an approved Biological Safety Certificate has expired or
requires revision. Provided the project does not have any significant changes, a new application is not required.
Upon review, the Biological Safety Officer will contact the Principal Investigator if a new application is required,
otherwise a new certificate will be issued and mailed to the Principal Investigator. Please indicate below whether
this is a renewal or amendment. For Renewal applications that do not require changes please complete Section 1,
check the appropriate box in Section 2, sign the declaration and return to the Chemical Control Centre. For
amendments and renewal applications requiring changes, please complete Section 1, check the appropriate box in
Section 2 and relevant section(s) below. Attach all documentation, sign the declaration and return to the Chemical
Control Centre.
☐ Renewal
☐ Amendment
Biological Certificate Number: Click here to enter text.
Section 1: Applicant Information:
Principle Investigator:
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Department:
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Mailing Address:
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Email Address:
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Project Title:
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Page 1
Building:
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Telephone Ext.:
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RSC Renewal 2015
Section 2: Changes to Application:
☐ There are no changes to previous Biological Safety Application
☐ There are changes to previous Biological Safety Application
Please indicate what section(s) require changes and ONLY attach the NEW information for review. Link to print
out Sections
☐ Section B: Funding &/or Agency Information
☐ Section C: Facilities/ Project Location
☐ Section D: Biological Safety Cabinet(s)
☐ Section E: Animal Utilization
☐ Section F: Radiation Utilization
☐ Section G: Biological Agent Utilization
☐ Section H: Regulatory Oversight
☐ Section I: Personnel
☐ Section J: Immunization
Declaration
I declare that I am familiar with the contents of the Canadian Biosafety Standards and Guidelines, 1st Edition (2012),
Public Health Agency of Canada, and that the above describes my research program, insofar as this includes the use
of hazardous biological agents and materials, in its entirety.
As the legally responsible individual, I will ensure that all research conducted under my direction in the above
laboratories and by the above personnel conforms to the requirements of the University of Windsor’s Biological Safety
Program. In addition, I understand that if either myself and/or designated personal are found to be in breach of
either institutional and/or Public Health Agency of Canada guidelines all funding maybe frozen until corrective action
is taken.
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Signature of Principle Investigator
Date
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Signature of Biosafety Officer
Date
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RSC Renewal 2015
Declaration:
By signing this declaration, the Principal Investigator acknowledges full responsibility for the activities under her /his
supervision, and agrees to maintain and operate her / his laboratory facilities in compliance with the University of
Windsor’s Biological Safety Program.
Review and Approval: The completed, signed application form must be submitted to the University of Windsor’s
Responsible Officer (RO) / Biosafety Officer for review and approval. If the proposed activity requires a permit or the
approval of any other agency (e.g., Health Canada, Agriculture and Agri-Food Canada, Canadian Food Inspection
Agency), evidence of such approval must be provided.
Biological Safety Certificate Validity, Expiration, and Amendments: University Biological Safety Certificates
for activities requiring Containment Level 1 are valid for 2 calendar years from the date of approval by the University
Biological Safety Committee Chair or, in the case of renewals, from the expiration date of the previous Certificate.
Similarly, University Biological Safety Certificates for activities requiring Containment Level 2 or Containment Level 3
are valid for 1 year only. Only those activities and agents identified on the application form and attachments are
covered. Significant changes (e.g., use of additional hazardous biological agents and materials, new personnel, animal
use) must be reported to the University of Windsor’s Responsible Officer (RO) – Biological Safety so that an
appropriate amendment may be made to the Biological Safety Certificate. The submission of another application form
may not be necessary. In most cases, amendments will be recorded as an attachment to the current Certificate on
file.
Requests for an amendment must include the following information: (A) Principal Investigator’s name; (B) Principal
Investigator’s signature; (C) Current University of Windsor Biological Safety Certificate number; and (D) Description
of the requested amendment. This information must be provided to:
Biological Safety Officer
Chemical Control Centre
University of Windsor
401 Sunset Ave, Essex Hall – B37
Windsor, Ontario N9B 3P4
(519) 253-3000 ext. 3524
Fax (519) 973-7013 ccc@uwindsor.ca
Assistance, Information, and the World Wide Web:
The University of Windsor’s Biological Safety Program is available at: http://www.uwindsor.ca/biosafety
This site contains the text of the University of Windsor’s Biological Safety Program, reference guides, contact
information, MSDS information, and other biological safety related information. Should you require further assistance
questions can be directed to:
Biological Safety Officer
Chemical Control Centre
University of Windsor
401 Sunset Ave, Essex Hall – B37
Windsor, Ontario N9B 3P4
(519) 253-3000 ext. 3524
Fax (519) 973-7013 ccc@uwindsor.ca
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