Common use of Protocol Title Clause in Contracts

Protocol Title. ­­­­­­­­­­­­­­­­­(Insert Details) Sponsor: ­­­­­­­­­­­­­­­­­(Insert Details) Entered into by and between: (Hereinafter, “the Provider”) Registered Physical address of Provider: Wits Health Consortium (Pty) Ltd, a wholly owned company of the University of the Witwatersrand, Johannesburg 31 Princess of Wales Terrace, Parktown Johannesburg, 2193 Registered physical and postal address of Principal Investigator: Email: xxx@xxxxxxxxxx.xx.xx Tel: Fax: Cell: Email: (Hereinafter, “the Recipient”) Registered physical and postal address of Recipient: Tel: Fax: Cell: Email: (Hereinafter, “the Human Research Ethics Committee”) Registered physical and postal address of Human Research Ethics Committee: University of the Witwatersrand Human Research Ethics Committee (Medical) Research Office, Senate House University of the Witwatersrand, 0 Xxx Xxxxx Avenue, Braamfontein, Johannesburg, 2000 Tel: 000 000 0000 Fax: 000 000 0000 Email: xxx@xxxxxxxxxx.xx.xx

Protocol Title. ­­­­­­­­­­­­­­­­­(Insert Details) Sponsor: ­­­­­­­­­­­­­­­­­(Insert Details) Entered into by and between: (Hereinafter, “the Provider”) Registered Physical address of Provider: Wits Health Consortium (Pty) Ltd, a wholly owned company of the University of the Witwatersrand, Johannesburg 31 Princess of Wales Terrace, Parktown Johannesburg, 2193 Registered physical and postal address of Principal Investigator: (Insert Details) Email: xxx@xxxxxxxxxx.xx.xx Tel: Fax: Cell: Email: (Hereinafter, “the Recipient”) Registered physical and postal address of Recipient: Covance (Insert Details) Tel: Fax: Cell: Email: (Hereinafter, “the Human Research Ethics Committee”) Registered physical and postal address of Human Research Ethics Committee: University of the Witwatersrand Human Research Ethics Committee (Medical) Research Office, Senate House University of the Witwatersrand, 0 Xxx Xxxxx Avenue, Braamfontein, Johannesburg, 2000 Tel: 000 000 0000 Fax: 000 000 0000 Email: xxx@xxxxxxxxxx.xx.xxXxxxxxx.Xxxxx@xxxx.xx.xx

Protocol Title. ­­­­­­­­­­­­­­­­­(Insert Details) Sponsor: ­­­­­­­­­­­­­­­­­(Insert Details) Entered into by and between: (Hereinafter, “the Provider”) Registered Physical address of Provider: Wits Health Consortium (Pty) Ltd, a wholly owned company of the University of the Witwatersrand, Johannesburg 31 Princess of Wales Terrace, Parktown Johannesburg, 2193 Registered physical and postal address of Principal Investigator: Email: xxx@xxxxxxxxxx.xx.xx Tel: Fax: Cell: Email: (Hereinafter, “the Recipient”) Registered physical and postal address of Recipient: Tel: Fax: Cell: Email: (Hereinafter, “the Human Research Ethics Committee”) Registered physical and postal address of Human Research Ethics Committee: University of the Witwatersrand Human Research Ethics Committee (Medical) Research Office, Senate House University of the Witwatersrand, 0 Xxx Xxxxx Avenue, Braamfontein, Johannesburg, 2000 Tel: 000 000 0000 Fax: 000 000 0000 Email: xxx@xxxxxxxxxx.xx.xxXxxxxxx.Xxxxx@xxxx.xx.xx

Protocol Title. ­­­­­­­­­­­­­­­­­(Insert Details) Sponsor: ­­­­­­­­­­­­­­­­­(Insert Details) Entered into by and between: (Hereinafter, “the Provider”) Registered Physical address of Provider: Wits Health Consortium (Pty) Ltd, a wholly owned company of the University of the Witwatersrand, Johannesburg 31 Princess of Wales Terrace00 Xxxxxxxx xx Xxxxx Xxxxxxx, Parktown JohannesburgXxxxxxxx Xxxxxxxxxxxx, 2193 0000 Registered physical and postal address of Principal Investigator: Email: xxx@xxxxxxxxxx.xx.xx Tel: Fax: Cell: Email: (Hereinafter, “the Recipient”) Registered physical and postal address of Recipient: Tel: Fax: Cell: Email: (Hereinafter, “the Human Research Ethics Committee”) Registered physical and postal address of Human Research Ethics Committee: University of the Witwatersrand Human Research Ethics Committee (Medical) Research Office, Senate House University of the Witwatersrand, 0 Xxx Xxxxx Avenue, Braamfontein, Johannesburg, 2000 Tel: 000 000 0000 Fax: 000 000 0000 Email: xxx@xxxxxxxxxx.xx.xx