Northern Arizona University
Institutional Animal Care and Use Committee
Inter-institutional Agreement
This Inter-institutional Agreement provides assurance that the collaborative animal use has received
Institutional Animal Care and Use Committee (IACUC) review and specifies who is responsible for
animal husbandry and care.
Name of Collaborating Institution Providing IACUC Review (Collaborating Institution):
Collaborating Institution USDA Registration #:
Collaborating Institution Animal Welfare Assurance (AWA) #:
AAALAC Accreditation Status:
The Officials signing below agree that Northern Arizona University may rely on the designated IACUC
of
(Collaborating Institution name) for the review and continuing oversight of its research
involving animals described below: (check all that apply)
This agreement covers the following specific protocol(s):
Name of Research Project (grant/contract title):
Name of Principal Investigator:
Sponsor or Funding Agency, if any:
Sponsor’s Award Number, if any:
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IACUC Protocol Title:
IACUC Protocol Approval #:
IACUC Protocol Approval Date:
☐ Ownership of the animals is the responsibility of:
☐ Purchasing/Acquisition of animals is the responsibility of:
☐ Payment for animal care and procedures is the responsibility of:
☐ The animals will be housed at:
☐ Provision of animal housing, daily husbandry and veterinary care is the responsibility of:
☐ If NAU representatives are directly participating in the work involving live vertebrate animals,
NAU will provide occupational health training (up to ABSL2/BSL3) and the Collaborating Institution
will provide any additional training that is unique to mitigating risk in their facility/research program.
☐ Any additional information (describe):
The following documents are attached:
☐ Official documentation of approval by the IACUC
The NAU IACUC requests that the collaborating institution provide, as applicable:

Documentation of IACUC approval for modifications to the approved protocol as well as
triennial reviews of the protocols.
 Notification of review and reporting of any incidents of non-compliance with PHS Policy, the
Guide for the Care and Use of Laboratory Animals, or any suspension of this activity by the
IACUC
 Additionally, NAU requests that the collaborating institution provide notification of change in
PHS Assurance status or AAALAC International Accreditation status.
Northern Arizona University remains responsible for ensuring compliance with the IACUC’s
determinations and with the Terms of its OLAW-approved Animal Welfare Assurance. This document
must be kept on file by both parties and provided to OLAW upon request. Completion of this
document provides assurance that the review performed by the Collaborating Institution’s IACUC
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meets animal welfare requirements prescribed in the institution’s OLAW-approved Animal Welfare
Assurance.
Name and Signature of Signatory Official for Collaborating Institution:
Date:
(Type or Print Name)
Signature
(Title)
Name and Signature of Signatory Official for Northern Arizona University:
________________________________________
Date:
Nanda Gudderra M.Sc., M.S., Ph.D.
Associate Vice President for Research and Institutional Official
Northern Arizona University
This information should be submitted to:
Northern Arizona University
Institutional Animal Care and Use Committee
Attn: Tom M. Greene, IACUC Coordinator
Biology Building 21 Box 5640
Flagstaff, AZ 86011
tom.greene@nau.edu
Northern Arizona University Animal Welfare Assurance #: A3908-01
Northern Arizona University USDA Registration #: 86-R-0005
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