ContractClinical Investigator Agreement • August 2nd, 2017
CLINICAL INVESTIGATOR AGREEMENT - BIPARTITE SMLOUVA O ZABEZPEČENÍKLINICKÉHO HODNOCENÍ – DVOUSTRANNÁ This Clinical Study Agreement (this “Agreement”) when signed by all parties, will set forth certain agreements by and between Tato Smlouva o provedení a zabezpečení Klinického hodnocení (dále jen„Smlouva“) pokud je podepsaná všemi smluvními stranami nastavuje dohodu mezi PPD Investigator Services LLC,with its registered address at 929 North Front St, Wilmington, NC 28401, USA,Company ID: 46-2919241 ("CRO") PPD Investigator Services LLC,se sídlem 929 North Front St, Wilmington, NC 28401, USAIČO: 46-2919241(dále jen „CRO “), and a Fakultni nemocnice v Motole,state funding organisation, with its registered address at V Uvalu 84, 150 06 Prague 5, Czech Republic, represented by MUDr. Pavel Budinsky, Ph.D., MBA based on authorisation dated 29thNovember 2016 Fakultní nemocnice v Motole,státní příspěvková organizace se sídlem V Úvalu 84, 150 06 Praha 5, Česká republika, zastoupen
ContractClinical Investigator Agreement • September 4th, 2018
CLINICAL INVESTIGATOR AGREEMENT Reg. No.08/OVZ/17/065-P SMLOUVA O KLINICKÉM HODNOCENÍ Ev. č. 08/OVZ/17/065-P This Clinical Study Agreement (this “Agreement”) when signed by all parties, will set forth certain agreements by and between IQVIA RDS Czech Republic s.r.o., having a place of business at Pernerova 691/42, 186 00 Praha 8 - Karlín, Czech Republic, Identification number: 247 68 651, Taxidentification number: CZ247 68 651, represented by(“IQVIA” or “CRO”), and Fakultní nemocnice Ostrava, having a place of business at 17. listopadu 1790/5, Ostrava – Poruba, postcode 708 52, Czech Republic, Identification number: 008 43 989, Tax identification number: CZ00843989, Founding Deed of the Ministry of Health of the Czech Republic dated of November 25th, 1990, ref. No. OP- 054-25.11.90, represented by MUDr. Josef Srovnal, Vice-director for Medical Treatment (the “Institution”) and ,with a place of work at Fakultní nemocnice Ostrava, Hemato- Oncology Clinic, 17. listopadu 1790,708 52 Os
CLINICAL INVESTIGATOR AGREEMENT - TRIPARTITEClinical Investigator Agreement • January 14th, 2015
The Institution and the Investigator are hereinafter called “Institution/Investigator” when it is intended that they be referred to jointly.
ContractClinical Investigator Agreement • January 23rd, 2017
CLINICAL INVESTIGATOR AGREEMENT - TRIPARTITE SMLOUVA O ZABEZPEČENÍ A PROVEDENÍ KLINICKÉHO HODNOCENÍ– TROJSTRANNÁ This Agreement (“Agreement”) is becomes effective on the day of signature by all contractual parties (hereinafter the ‘Effective Date”) and is entered into, by and between ICON Clinical Research Limited(hereinafter called “ICON”) with a vat number IE 8201978R,Company no.: 201978and a place of business at South County Business Park, Leopardstown, Dublin 18, Ireland, and Oblastní nemocnice Kolín, a.s., nemocnice Středočeského kraje with a place of business at Kolín, Žižkova 146, PSČ 28000Company no.: 27256391 Represented by: MUDr. Peter Chudomel MBA (hereinafter called the “Institution”) andXXXDate of birth: XXX Address: XXX Tato smlouva (dále jen „smlouva“) vstupuje v platnost dnem jejího podpisu všemi smluvními stranami (dále jen „datum účinnosti“) a uzavírají ji mezi sebou společnost ICON Clinical Research Limited(dále jen „společnost ICON“)DIČ: IE 8201978R, IČO:
ContractClinical Investigator Agreement • March 29th, 2017
AMENDMENT No. 2 DODATEK č. 2 TO CLINICAL INVESTIGATOR AGREEMENT KE SMLOUVĚ O ZABEZPEČENÍ KLINICKÉHO HODNECENÍ This Agreement Amendment No. 2(“Amendment”) is made and entered into effective as of the date …………………. (hereinafter called “Effective date”) Tento dodatek č. 2 ke smlouvě (dále jen “dodatek”) byl uzavřen a vstupil v platnost dne ………………….. (dále jen “datum platnosti”) by and between mezi ICON Clinical Research Limitedwith a VAT number IE 8201978Rand a place of business at South County Business Park, Leopardstown, Dublin 18, Ireland,represented by XXXXXXXXXClinical Operations Manager (hereinafter called “ICON”) ICON Clinical Research LimitedDIČIE 8201978R,se sídlem vSouth County Business Park, Leopardstown, Dublin 18, Irsko,zastoupená XXXXXXXXXClinical Operations Manager (dále jen „ICON“), and a Falultni nemocnice Plzenwith a VAT number CZ 00669806with a place of business at Edvarda Benese 1128/13, 305 99 Plzen,Czech Republic, represented byMUDr. Vaclav Simanek, Ph.D. managing
ContractClinical Investigator Agreement • September 4th, 2017
CLINICAL INVESTIGATOR AGREEMENT - TRIPARTITE SMLOUVA O ZABEZPEČENÍ KLINICKÉHO HODNOCENÍ –TROJSTRANNÁ This Clinical Study Agreement (this “Agreement”) when signed by all parties by and between Tato Smlouva o zabezpečení Klinického hodnocení (dále jen „Smlouva“) mezi PPD Investigator Services LLC,with its registered address at 929 North Front St, Wilmington, NC 28401, USA,Company ID: 46-2919241 ("CRO") PPD Investigator Services LLC,se sídlem 929 North Front St, Wilmington, NC 28401, USAIČO: 46-2919241(dále jen „CRO “), and a Fakultni nemocnice Hradec Kralove, located at Sokolska 581, 500 05 Hradec Kralove, Novy Hradec Kralove, Czech Republic, represented by prof. MUDr. Vladimir Palicka, CSc., dr.h.c., director (the “Institution”) Fakultní nemocnicí Hradec Králové,se sídlem na adrese Sokolská 581, 500 05 Hradec Králové - Nový Hradec Králové, Česká republika, zastoupená prof. MUDr. Vladimírem Paličkou, CSc., dr. h. c., ředitelem (dále jen „Poskytovatel“) and a 4th Departmen
ContractClinical Investigator Agreement • December 20th, 2016
CLINICAL INVESTIGATOR AGREEMENT - TRIPARTITE SMLOUVA O ZABEZPEČENÍ A PROVEDENÍ KLINICKÉHO HODNOCENÍ - TROJSTRANNÁ This Agreement (“AGREEMENT”) is entered TATO SMLOUVA (dále jen „SMLOUVA“) se into this ……………….. uzavírá dne …………………. BY AND BETWEEN MEZI ICON Clinical Research Limitedwith a VAT number IE 8201978Rand a place of business atSouth County Business Park, Leopardstown, Dublin 18, Ireland,represented by XXXXXXXXXXXXSr. Director Project Management (hereinafter called “ICON”) ICON Clinical Research LimitedDIČIE 8201978R,se sídlemSouth County Business Park, Leopardstown, Dublin 18, Irsko,zastoupený XXXXXXXXXXXXSr. Director Project Management (dále jen „ICON“), AND A Fakultni nemocnice Brnowith a VAT number CZ 65269705with a place of business at Jihlavska 20, 625 00 Brno, Czech Republic, represented byMUDr. Roman Kraus, MBA managing director(hereinafter called the “Institution”) Fakultní nemocnice BrnoDIČ CZ65269705se sídlem Jihlavská 20, 625 00 Brno,Česká republika, jednajícíMUDr
ContractClinical Investigator Agreement • December 7th, 2016
AMENDMENT No. 1 DODATEK č. 1 TO CLINICAL INVESTIGATOR AGREEMENT KE SMLOUVĚ O ZABEZPEČENÍ KLINICKÉHO HODNECENÍ This Agreement Amendment no. 1(“Amendment”) is made and entered into effective as of the date …………………. (hereinafter called “Effective date”) Tento dodatek č. 1 ke smlouvě (dále jen “dodatek”) byl uzavřen a vstoupil v platnost dne ………………….. (dále jen “datum platnosti”) by and between mezi ICON Clinical Research Limitedwith a VAT number IE 8201978Rand a place of business at South County Business Park, Leopardstown, Dublin 18, Ireland,represented by XXXXXXXXXXXXSr.Director Project Management (hereinafter called “ICON”) ICON Clinical Research LimitedDIČ IE 8201978R,se sídlem vSouth County Business Park, Leopardstown, Dublin 18, Irsko,zastoupený XXXXXXXXXXSr. Director Project Management (dále jen „ICON“), and a Falultni nemocnice Plzenwith a VAT number CZ 00669806with a place of business at Edvarda Benese 1128/13, 305 99 Plzen,Czech Republic, represented byMUDr. Vaclav Simanek, Ph.D
ContractClinical Investigator Agreement • December 7th, 2016
CLINICAL INVESTIGATOR AGREEMENT - TRIPARTITE SMLOUVA A ZABEZPEČENÍ A PROVEDENÍ KLINICKÉHO HODNOCENÍ - TROJSTRANNÁ This Agreement (“AGREEMENT”) is entered Tato smlouva (dále jen „SMLOUVA“) se into this …………………. uzavírá dne ......................... BY AND BETWEEN MEZI ICON Clinical Research Limitedwith a VAT number IE 8201978Rand a place of business atSouth County Business Park, Leopardstown, Dublin 18, Ireland,represented by XXXXXXXXXXXXXXSr. Director Project Management (hereinafter called “ICON”) ICON Clinical Research LimitedDIČIE 8201978R,se sídlemSouth County Business Park, Leopardstown, Dublin 18, Irsko,zastoupený XXXXXXXXXXXXSr. Director Project Management (dále jen „ICON“), AND A Falultni nemocnice Plzenwith a VAT number CZ 00669806with a place of business at Edvarda Benese 1128/13, 305 99 Plzen,Czech Republic, represented byMUDr. Vaclav Simanek, Ph.D. managing director(hereinafter called the “Health Service Provider”) Fakultní nemocnice PlzeňDIČCZ 00669806se sídlem Edvarda
ContractClinical Investigator Agreement • March 15th, 2018
Dodatek 1 keSmlouvě o zabezpečení klinického hodnocení TROJSTRANNÁ č. 08/OVZ/17/015-P Amendment 1 toCLINICAL INVESTIGATOR AGREEMENT - TRIPARTITE no. 08/OVZ/17/015-P Tento dodatek 1 ke smlouvě o zabezpečení klinického hodnocení („dodatek 1“) mezi: This Amendment 1 to CLINICAL INVESTIGATOR Agreement (“Amendment 1”) between: PPD Investigator Services LLC.,se sídlem 929 North Front St, Wilmington, NC 28401, USA(“CRO”) PPD Investigator Services LLC.,with its registered address at 929 North Front St,Wilmington, NC 28401, USA (“CRO”) a and Fakultní nemocnice Ostrava, se sídlem 17. listopadu 1790/5, 708 52 Ostrava - Poruba, Česká republika, ve věcech této smlouvy oprávněn jednat a podepisovat: MUDr. Josef Srovnal, náměstek ředitele pro léčebnou péči. Zřizovací listina MZ ČR ze dne 25. listopadu 1990 č.j. OP-054-25.11.90IČ: 00843989 DIČ: CZ00843989(„Zdravotnické zařízení“) Fakultni nemocnice Ostrava, registered address at 17. listopadu 1790/5, 708 52 Ostrava, Czech Republic, entitled to act a
ContractClinical Investigator Agreement • March 6th, 2019
CLINICAL INVESTIGATOR AGREEMENT- TRIPARTITE SMLOUVA SE O PROVEDENÍ KLINICKÉHO HODNOCENÍ – TROJSTRANNÁ This Agreement (“Agreement ”) is entered TATO SMLOUVA (dále jen „Smlouva“) se uzavírá by and between Mezi ICON Clinical Research Limitedwith a VAT number IE 8201978R and a place of business at South County Business Park, Leopardstown, Dublin 18, Ireland, represented byXXXXXXXXXX,Sr. Clinical Operations Manager (hereinafter called “ICON”) ICON Clinical Research LimitedDIČ IE 8201978R,se sídlem South County Business Park,Leopardstown, Dublin 18, Irsko zastoupenáXXXXXXXXXX,Sr. Clinical Operations Manager (dále jen „ICON“) And A Fakultní nemocnicí Královské Vinohrady,Company ID: 0006417/3, VAT Number: CZ00064173,With a place of business at Šrobárova 1150/50, 100 34 Praha 10, Czech Republic, represented by Doc. MUDr. Robert Grill, Ph.D., MHA,, Director, ref. No.: KH 39/2018, cost center: 43038(hereinafter called the “Institution”) Fakultní nemocnicí Královské Vinohrady,IČ: 0006417/3
ContractClinical Investigator Agreement • December 27th, 2016
CLINICAL INVESTIGATOR AGREEMENT- TRIPARTITE SMLOUVA O ZABEZPEČENÍ A PROVEDENÍ KLINICKÉHO HODNOCENÍ – TROJSTRANNÁ This Agreement (“AGREEMENT”) is entered into this August 30 2012, by and between ICON Clinical Research Limited (hereinafter called “ICON”) with a VAT number xxx and a place of business at South County Business Park, Leopardstown, Dublin 18, Ireland Tato Smlouva (dále jen „Smlouva“) se uzavírá dne 30.8.2012 mezi společností ICON Clinical Research Limited (dále jen „ICON“), xxx, se sídlem v South County Business Park, Leopardstown, Dublin 18, Irsko and a Hospital Na Bulovce with a place of business at Budinova 2, 180 81 Prague 8, Czech Republic xxx (hereinafter called the “Institution”) Nemocnicí Na Bulovce, Budínova 2, 180 81 Praha 8, zastoupenou xxx (dále jen„ZDRAVOTNICKÉ ZAŘÍZENÍ“) and a xxx with a place of business at FN Na Bulovce, Institute of Pneumology and chest surgery, Budinova 2, 180 81 Prague 8, Czech Republic (hereinafter called the “Investigator”). xxx, s vý
