Common Contracts

Contract

Contract Amendment • October 21st, 2016

• Contract Type
  Contract Amendment
• Filed
  October 21st, 2016

CONTRACT AMENDMENT #2 D ODATEK Č. 2 KE SMLOUVĚ THIS CONTRACT AMENDMENT #2(“Contract Amendment #2”), dated as of the last signature hereof (the “Effective Date”), is by and between Fakultní nemocnice u sv. Anny v Brně located at Pekařská 53, 656 91, Brno, Czech Republic, ID No.: 00159816, Tax registration No.: CZ00159816, represented by,director (the “Institution”) and Pharmaceutical Research Associates CZ, s.r.o. located at Jankovcova 1569/2c, Post code 170 00, Prague 7, Czech Republic, Company ID number (IČ): 27636852, Tax registration No.: CZ27636852 represented by MUDr. Andrea Klč, proxy (“PRA”), acting as an independent contractor for TEVA PHARMACEUTICALINDUSTRIES LTD located at 5 Basel Street, Petach Tiqva, 49131, Israel (the “Sponsor”) and, born on ,with permanent residency address at,acting within the scope of his/her employment, who shall serve as the principal investigator, (the “Investigator”) responsible for the Study as defined below. PRA has agreed to accept certain obli