Standard Indemnification Agreement

Researchers at private universities, foundations, and companies, or at state institutions that can accept the wording of the Standard Indemnification Agreement must complete this form in order to obtain specimens from the NHLBI Biologic Specimen Repository. An alternate State Institution Compliance Agreement for researchers at US public institutions that cannot sign this Standard Indemnification Agreement is provided. Researchers at institutions that are unable to accept the terms of the Indemnification or Compliance Agreement must complete the Waiver of Indemnification Agreement; such individuals will not be able to receive specimens that are known to contain an infectious agent. US Government employees are not required to submit an indemnification agreement.

________________________________________________________________________ agrees to indemnify and hold harmless the United States, the Contractor, their suppliers and contributors, from any claims, costs, damages, or expenses resulting from any injury (including death), damage or loss that may arise from the possession and use of the specimens or any derivative thereof by the Receiving Party. The individual executing this agreement on behalf of the Recipient Institution warrants that the individual has full authority to do so, and to thereby bind the Recipient Institution.

*This officer cosigning above must be capable of legally binding the institution

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