Clinical Study Site AgreementClinical Study Site Agreement • October 18th, 2023
(Template agreement for investigator initiated clinical studies with human subjects, conducted in the Netherlands by academic (NFU) and non-academic (STZ) hospitals and NKI/AvL)
ContractClinical Study Site Agreement • April 26th, 2018
Smlouva s řešitelským centrem klinického hodnocení Clinical Study Site Agreement Tato smlouva s řešitelským centrem klinického hodnocení („smlouva“) uzavřená s platností od podpisu poslední smluvní strany („den posledního podpisu“) a účinností podle článku 27 níže, byla uzavřena mezi těmito smluvními stranami: This Clinical Study Site Agreement (“Agreement”), entered into as of the last date of signature (“Date of Final Signature”) and effective as set out in Section 27 below (“Effective Date”), is entered into by and among: Všeobecná fakultní nemocnice v Praze, U Nemocnice 499/2, 128 08 Praha 2, Česká republika, zastoupená Mgr. Danou Juráskovou, Ph.D., MBA– ředitelkou IČ: 00064165DIČ: CZ 00064165(„zdravotnické zařízení“) Vseobecná fakultni nemocnice v Praze, U Nemocnice 499/2, 128 08 Praha 2, Czech Republic, represented by Mgr. Dana Juraskova, Ph. D., MBA director Company ID no.: 00064165 Tax ID no.: CZ00064165(“Institution”), datum narození bytem na adrese(„zkoušející“) born on res
Clinical Study Site AgreementClinical Study Site Agreement • October 16th, 2020
Protocol Title Multi-centre randomised controlled trial to compare the clinical and cost-effectiveness of a ‘vein bypass first’ with a ‘best endovascular first’ revascularisation strategy for severe limb ischaemia due to infra-geniculate arterial disease
CLINICAL STUDY SITE AGREEMENT PROTOCOL NUMBER XXXXX SMLOUVA S ŘEŠITELSKÝM CENTREM ČÍSLO PROTOKOLU XXXXXClinical Study Site Agreement • September 8th, 2021
This AGREEMENT (“Agreement”) is effective as of the date of last signature of the parties below (“Effective Date”), is by and between: MedImmune, LLC, a wholly owned subsidiary of AstraZeneca, AB, with its principal place of business at One MedImmune Way, Gaithersburg, MD 20878, USA, represented by its authorized agent PPD Czech Republic, s.r.o., as described below Tax ID no: 52 1555759 (“MedImmune”); Tato SMOUVA („Smlouva“) je účinná od data posledního podpisu níže uvedených stran („Dne platnosti“) mezi: MedImmune, LLC, plně vlastněnou pobočkou společnosti AstraZeneca, AB, s hlavním místem podnikání na adrese One MedImmune Way, Gaithersburg, MD 20878, USA, zastoupenou společností PPD Czech Republic, s.r.o., níže jmenovaným oprávněným zástupcem DIČ: 52 1555759 (“MedImmune”);
ContractClinical Study Site Agreement • April 10th, 2019
Clinical Study Site Agreement Smlouva s centrem klinické studie This Clinical Study Site Agreement (“Agreement”), entered into as of the last date of signature (“Date of Final Signature”) and effective as set out in Section 25 below, is entered into by and among: Tato Smlouva s centrem klinické studie (dále jen „smlouva“), uzavřená ke dni data posledního podpisu (dále jen „datum posledního podpisu“) a vstupující v platnost tak, jak je stanoveno v bodu 25 níže, se uzavírá mezi těmito stranami: Fakultní nemocnice Brno, located at Jihlavská 20, Brno, 625 00, Czech Republic, registration No: 65269705, VAT No: CZ65269705,executive director: (“Institution”), Fakultní nemocnice Brno, se sídlem na adrese Jihlavská 20, Brno, 625 00, Česká republika, IČ: 65269705, DIČ: CZ65269705, jednající:- ředitel (dále jen„zdravotnické zařízení“), nar. nar. , bytem , bytem lékař Interní lékař Interní hematologické a onkologické kliniky Fakultní nemocnice Brno ("Investigator"), hemat
CLINICAL STUDY SITE AGREEMENT PROTOCOL NUMBERClinical Study Site Agreement • January 16th, 2018
This AGREEMENT (“Agreement”) is effective as of the date of last signature of the parties below (“Effective Date”), is by and between:
Clinical Study Site AgreementClinical Study Site Agreement • June 14th, 2017
This Clinical Study Site Agreement (the “Agreement”), effective as of the date of the last signature below, is entered into by and between:
CLINICAL STUDY SITE AGREEMENT PROTOCOL NUMBER CD-ID-MEDI4893- 1139 SMLOUVA S ŘEŠITELSKÝM CENTREM ČÍSLO PROTOKOLU CD-ID-MEDI4893- 1139Clinical Study Site Agreement • August 8th, 2024
This AGREEMENT (“Agreement”) is effective as of the date of last signature of the parties below (“Effective Date”), is by and between:
Amendment no. 1 to Clinical Study Site Agreement Dodatek č.1 ke smlouvě s centrem klinické studieClinical Study Site Agreement • January 21st, 2020
This Amendment is effective as of its publication in the Register of Agreements, but the parties agree to be bound by the rights and obligations arising from this Amendment from of 1 July 2019 (“Effective Date”), and is entered into by and among: Tento dodatek se uzavírá s účinností ode dne uveřejnění v registru smluv, avšak smluvní strany si přejí být úpravou práv a povinností obsaženou v tomto Dodatku vázány již od 1. července 2019 (dále jen „datum účinnosti“) a uzavírá se mezi těmito stranami
CLINICAL STUDY SITE AGREEMENT PROTOCOL NUMBER XXXClinical Study Site Agreement • December 9th, 2016
Conditional Procedures - Per Occurrence/Další procedury - za každé provedení Cost Per Subject per Procedure in CZK/Částka za Subjekt za proceduru v Kč Amount per subject per visit in CZK during the Study (90%)/ Platby za jeden subjekt hodnocení v Kč v průběhu klinického hodnocení (90%) Amount per subject per visit in CZK after the Study termination (10%)/Platby za jeden subjekt hodnocení v Kč po ukončení klinického hodnocení (10%) XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX XXX
CLINICAL STUDY SITE AGREEMENTClinical Study Site Agreement • December 11th, 2024
This template clinical study agreement is created in joint cooperation between the University Medical Center’s (UMC’s) in The Netherlands, supported by the Nationale Federatie van Universitair Medische Centra (NFU); the Vereniging STZ (Samenwerkende Topklinische opleidingsZiekenhuizen) on behalf of STZ-hospitals; and the Stichting Het Nederlands Kanker Instituut - Antoni van Leeuwenhoek Ziekenhuis (NKI/AvL).
CLINICAL STUDY SITE AGREEMENTClinical Study Site Agreement • November 14th, 2019
Universitair Ziekenhuis Brussel, located at Laarbeeklaan 101, 1090 Brussel, legally represented by prof. dr. Marc Noppen, CEO, VAT number 0449.012.406 (business unit number: 2.143.464.230) (hereinafter: “Sponsor”),
ContractClinical Study Site Agreement • January 24th, 2017
Clinical Study Site Agreement This Clinical Study Site Agreement (the “Agreement”), entered into as of the date of the last signature below (“Date of Final Signature”) and effective as set out in Section 23 below, is entered into by and between: : Nemocnice Strakonice, a.s., located at Radomyšlská 336, 386 29, Strakonice, Czech Republic, Identification number: 260 95 181, registered in Commercial Companies registry by Regional Court in České Budějovice, inlet B 1465, represented by MUDr. Bc. Tomáš Fiala, MBA, Chairman of Board of Directors and Ing. Luboš Kvapil, Vice-Chairman of Board of Directors (“Institution”), Quintiles Czech Republic, s.r.o. located at Praha 5, Jinonice, Radlická 714/113a, zip code 158 00, Identification number: 247 68 651, based upon a power attorney represented by ……………………………... (“CRO”), for the purpose of conducting the clinical study (the “Study”) described in the protocol entitled “A Randomized, Double-Blind, Proof-of-Concept, Phase 2 Study to Eva
ContractClinical Study Site Agreement • June 14th, 2017
AMENDMENT NO. 1TO CLINICAL STUDY SITE AGREEMENTPROTOCOL NUMBER MLN0002SC-3027 This Amendment No. 1 to Clinical Study Site Agreement (“Amendment”), effective as of the date of the last signature below, is entered into by and between: Nemocnice Tábor, a.s., located at kpt. Jaroše 2000, 390 03 Tábor, Czech Republic, Company ID no.: 26095203, Tax ID no.: CZ26095203,represented by Ing. Ivo Houška, MBA, Chairman of the Board of Directors, and MUDr. Jana Chocholová,Vice-Chairman of the Board of Directors (“Institution”), Quintiles Czech Republic, s.r.o. located at Praha 5, Jinonice, Radlická 714/113a, zip code 158 00,Identification number: 247 68 651, registered in the Commercial Register of Městský soud v Praze, section C, insert 172751, represented by Alasdair MacDonald (“CRO”) for the purpose of amending the Clinical Study Site Agreement among Institution and CRO dated 20 July 2016 (the “Agreement”) relating to the conduct of the clinical research (the “Study”) described in the protocol en
ContractClinical Study Site Agreement • April 7th, 2021
Amendment No 1to Clinical Study Site Agreement Dodatek č. 1ke Smlouvě s pracovištěm klinického hodnocení This Amendment (the “Amendment”), entered into as of the date on which the Amendment is published in the Czech Republic contract register, (“Effective Date”), is entered into by and among: Tento dodatek (dále jen „Dodatek“) se uzavírá ke dni jeho zveřejnění v registru smluv České republiky (dále jen „Datum účinnosti“) mezi: Fakultní nemocnice Ostrava, located at17. listopadu 1790/5, Ostrava – Poruba, 708 52, Czech Republic, IČ: 00843989, DIČ: CZ00843989, Establishment list of the Ministry of Health of 25 November 1990 File no. OP-054-25.11.90, in the affairs of this contract is entitled to act and sign:, Deputy Director of Science, Research and Education (“Institution”)and Fakultní nemocnice Ostrava, se sídlem na adrese 17. listopadu 1790/5, Ostrava –Poruba, 708 52, Česká republika, IČ: 00843989, DIČ: CZ00843989, Zřizovací listina MZ ČR ze dne 25. listopadu 1990 č.j. OP-054- 25.
ContractClinical Study Site Agreement • January 22nd, 2018
Smlouva s řešitelským centrem klinického hodnocení Clinical Study Site Agreement Tato smlouva s řešitelským centrem klinického hodnocení („smlouva“) uzavřená s platností od podpisu poslední smluvní strany („den posledního podpisu“) a efektivní podle článku 27 níže, byla uzavřena mezi těmito smluvními stranami: This Clinical Study Site Agreement (“Agreement”), entered into as of the last date of signature (“Date of Final Signature”) and effective as set out in Section 27 below (“Effective Date”), is entered into by and among: Fakultní nemocnice Plzeňse sídlem na adrese Edvarda Beneše 1128/13, 305 99 Plzeň – Bory, Česká republikaIČO:00669806DIČ: CZ00669806 („poskytovatel/poskytovatel zdravotních služeb“) Fakultni nemocnice Plzen,located at Edvarda Benese 1128/13, 305 99 Plzen – Bory, Czech RepublicCompany ID :00669806 Tax ID: CZ00669806(“Institution”), xxxxxxxxxxxxxxxxxxxxdatum narození xxxxxxxxxxxxxxx bytem na adrese v („zkoušející“) xxxxxxxxxxxxxxxxxxxxx born on xxxxxxxxxxxxxxx residin
ContractClinical Study Site Agreement • February 27th, 2017
Smlouva o řešitelském centru klinického hodnocení Clinical Study Site Agreement Tato smlouva o řešitelském centru klinickéhohodnocení („smlouva“), uzavřená s platností od podpisu poslední smluvní strany a s účinností podle článku 26 níže („datum účinnosti“), byla uzavřena mezi těmito smluvními stranami: This Clinical Study Site Agreement (“Agreement”),entered into as of the last date of signature, (“Date of Final Signature”) and effective as set out in Section 26 below (“Effective Date”), is entered into by and among: Nemocnice Tábor, a.s.,se sídlem na adrese Tř. Kpt. Jaroše 2000, 390 03 Tábor, Česká republika IČO: 26095203 DIČ: CZ26095203zaps. v OR u Krajského soudu v Českých Budějovicích, odd. B, vl. 1463(„zdravotnické zařízení“), A Nemocnice Tabor, a,s,,located at Tr. Kpt. Jarose 2000, 390 03 Tabor, Czech Republic Company ID: 26095203 Tax ID: CZ26095203registered in the Regional Court in Ceske Budejovice, Section C, Insert 1463(“Institution”), and PPD Investigator Services LLC, se s
ContractClinical Study Site Agreement • November 23rd, 2016
Clinical Study Site Agreement This Clinical Study Site Agreement (the “Agreement”), effective as of the date of the last signature below, is entered into by and between: Fakultní nemocnice Královské Vinohrady, located at Šrobárova 50, 100 34 Praha 10, Czech RepublicCompany ID: 000 64 173,Tax identification number: CZ00064173, represented by MUDr. Andrea Vrbovská, MBA, Director, reference symbol KH 30/2015, internal cost center no. 22046(“Institution”), Quintiles Czech Republic, s.r.o. located at Praha 5, Jinonice, Radlická 714/113a, zip code 158 00,Identification number: 247 68 651, Tax ID: CZ24768651, (“CRO”), for the purpose of conducting the clinical study (the “Study”) described in the protocol entitled “A single arm open label study to assess mucosal healing in patients with moderately to severely active Crohn’s Disease treated with Vedolizumab”, Protocol No. MLN0002- 3028 (the “Protocol”) of which Takeda Development Centre Europe Ltd (“Sponsor”) is sponsor. With respect to the ri
ContractClinical Study Site Agreement • April 28th, 2014
Clinical Study Site Agreement Zmluva s centrom klinického skúšania Túto Zmluvu s centrom klinického skúšania (ďalej This Clinical Study Site Agreement (the “Agreement”), “zmluva”), uzatvárajú s účinnosťou od dátumu effective as of the date of the last signature below, is posledného z nižšie uvedených podpisov nasledujúce entered into by and between: zmluvné strany: • Fakultna nemocnica s poliklinikou F. D. Roosevelta • Fakultná nemocnica s poliklinikou F. D. Roosevelta Banska Bystrica Banská Bystrica Located at: Namestie L. Svobodu 1, 975 17 Banska so sídlom: Námestie Ľ. Svobodu 1, 975 17 Banská Bystrica, Slovak Republic Bystrica, Slovenská Republika Organisation Identification No.: 165549 IČO: 165549 Tax Identification No.: 2021095670 DIČ: 2021095670 VAT ID: SK2021095670 IČ DPH: SK2021095670 (“Institution”). (ďalej „zdravotnícke zariadenie”). a and Quintiles Slovakia s.r.o., so sídlom Zámocká 34, 81101 Quintiles Slovakia, s. r. o. Bratislava, Slovenská republika, located at
ContractClinical Study Site Agreement • July 15th, 2019
Clinical Study Site Agreement Smlouva s Místem provádění klinického hodnocení This Clinical Study Site Agreement (“Agreement”), entered into as of the last date of signature (“Date of Final Signature”) and effective as set out in Section 26 below, is entered into by and among: Tato Smlouva s Místem provádění klinického hodnocení (dále jen „Smlouva“) uzavřená k datu posledního podpisu („Datum posledního podpisu“), s účinností stanovenou v článku 26 níže, kterou mezi sebou uzavřeli: Všeobecná fakultní nemocnice v Praze, located at U Nemocnice 499/2, 128 08 Praha 2, Czech Republic, Identification number: 00064165, Tax identification number: CZ00064165, represented byunder a power of attorney(“Institution”), Všeobecná fakultní nemocnice v Praze, se sídlem U Nemocnice 499/2, 128 08 Praha 2, Česká republika, Identifikační číslo: 00064165, Daňové identifikační číslo: CZ00064165, zastoupená , na základě plné moci (dále jen„Zdravotnické zařízení“), , born onresiding at (“Investigator”),
ContractClinical Study Site Agreement • September 27th, 2013
Clinical Study Site Agreement Zmluva pre centrum klinického skúšania This Clinical Study Site Agreement (the “Agreement”), Túto Zmluvu pre centrum klinického skúšania (ďalej effective as of the date of the last signature below, is “zmluva”), uzatvárajú s účinnosťou od dátumu posledného entered into by and between: z nižšie uvedených podpisov nasledujúce zmluvné strany: Fakultna nemocnica s poliklinikou F. D. Roosevelta Fakultná nemocnica s poliklinikou F. D. Banska Bystrica Roosevelta Banská Bystrica located at: Namestie L. Svobodu 1, 975 17 Banska so sídlom: Námestie Ľ. Svobodu 1, 975 17 Banská Bystrica, Slovak Republic Bystrica, Slovenská Republika Organisation Identification No.: 165549 IČO: 165549 Tax Identification No.: 2021095670 DIČ: 2021095670 VAT ID: SK2021095670 IČ DPH: SK2021095670 (the “Institution”) (ďalej “ zdravotnícke zariadenie”) and a Jarmila Okapcova, MD , MUDr. Jarmila Okapcová, Slovak Republic, employee of the Fakultna nemocnica Slovenská Republika, zamestnanec
TO CLINICAL STUDY SITE AGREEMENTClinical Study Site Agreement • April 12th, 2018
This Amendment #1 (the “Amendment”), valid as of the date of last signature below (the “Valid Date”), and effective at the date of its publication in Contract Register in accordance with Act no. 340/2015 Coll. (the “Effective Date”), modifies and amends the Clinical Study Site Agreement for Protocol Number
AMENDMENT NO.2 TO THE CLINICAL STUDY SITEAGREEMENT DODATEK Č. 2 KE SMLOUVĚ O KLINICKÉ STUDIIClinical Study Site Agreement • January 22nd, 2020
ReveraGen BioPharma, Inc.(hereinafter the “ReveraGen”)and registered seat at 155 Gibbs Street, Suite #433, Rockville, MD 20850, Maryland – United States of America Společnost ReveraGen BioPharma, Inc.(dále jen „ReveraGen“)se sídlem 155 Gibbs Street, Suite #433 Rockville, MD 20850, Maryland – Spojené Státy Americké and a Fakultní nemocnice Brno,Registered seat at Jihlavská 20, 625 00 Brno, Czech RepublicId.No. 65269705, Tax Id.No. CZ65269705represented by(hereinafter the “Institution”), Fakultní nemocnice Brnose sídlem na adrese Jihlavská 20, 625 00 Brno, Česká republikaIČ: 65269705, DIČ: CZ65269705Jednající(dále jen „zdravotnické zařízení“), and a practitioning at Klinika dětské neurologie Fakultní nemocnice Brno(hereinafter the “Principal Investigator”) lékařka Kliniky dětské neurologie Fakultní nem- ocnice Brno(dále jen “hlavní zkoušející”) (ReveraGen and the Institution and the Princi- pal Investigator together as the “Parties”).(the Principal Investigator and the Institution
Clinical Study Site Agreement Zmluva pre pracovisko klinickéhoClinical Study Site Agreement • June 10th, 2016
This Clinical Study Site Agreement (the “Agreement”), effective as of the date of the last signature below, is entered into by and between:
