MTA (Incoming) Is there measurable personnel effort for the project that is related to the unfunded agreement? Please indicate what type(s) of materials are being transferred and provide additional details as requested: Human derived materials (isolated tissue, samples, cells, etc.) if yes, describe – Cells (other than those derived from human subjects or patients) if yes, – describe Plasmid/Vector/DNA/RNA (other than those derived from human subs) if yes, – describe Mouse/Rat strain name, # of males, # of females – Other model organism (yeast, zebrafish, drosophila) if yes, describe – Antibody if yes, describe – Protein if yes, describe – Chemical Compound if yes, describe and Is the structure of this compound – confidential? Software/code if yes, describe – Device if yes, describe – Other material if yes, describe – Are any of the materials radioactive? If yes, please provide radiation policy committee approval number. Are materials dangerous to handle, store or use? If yes, describe Is this a hazardous chemical that has a capacity constraint? If yes, describe Will the use of the materials in the proposed activity involve any of the following? Human research? Recombinant or synthetic nucleic acid molecules (rDNA or SNA)? Containment level? Has the work been submitted to the IBC for review/approval? Biological toxins or agents that are infectious or hazardous to humans, animals or plants? If yes, describe. Is the material on the Federal Select Agent/Toxin list? Unbound engineered nanoscale particles or nanofabrication technology? If yes, describe Use or derivation of human induced pluripotent stem cells or human embryonic stem cells? (Must provide approval number.) Human-derived materials (cells, tissue, fluids)? If yes, describe Are the materials that you will be receiving export controlled? Does the research you will be conducting with the materials involve possible export controls, classified research or security clearances? Is the material being provided by a repository? (Which one?)
MTA (Incoming) Is there measurable personnel effort for the project that is related to the unfunded agreement? Please indicate what type(s) of materials are being transferred and provide additional details as requested: Human derived materials (isolated tissue, samples, cells, etc.) – if yes, describe Cells (other than those derived from human subjects or patients) – if yes, describe Plasmid/Vector/DNA/RNA (other than those derived from human subs) – if yes, describe Mouse/Rat – strain name, # of males, # of females Other model organism (yeast, zebrafish, drosophila) – if yes, describe Antibody – if yes, describe Protein – if yes, describe Chemical Compound – if yes, describe and Is the structure of this compound confidential? Software/code – if yes, describe Device – if yes, describe Other material – if yes, describe Are any of the materials radioactive? If yes, please provide radiation policy committee approval number. Are materials dangerous to handle, store or use? If yes, describe Is this a hazardous chemical that has a capacity constraint? If yes, describe Will the use of the materials in the proposed activity involve any of the following? Human research? Recombinant or synthetic nucleic acid molecules (rDNA or SNA)? Containment level? Has the work been submitted to the IBC for review/approval? Biological toxins or agents that are infectious or hazardous to humans, animals or plants? If yes, describe. Is the material on the Federal Select Agent/Toxin list? Unbound engineered nanoscale particles or nanofabrication technology? If yes, describe Use or derivation of human induced pluripotent stem cells or human embryonic stem cells? (Must provide approval number.) Human-derived materials (cells, tissue, fluids)? If yes, describe Are the materials that you will be receiving export controlled? Does the research you will be conducting with the materials involve possible export controls, classified research or security clearances? Is the material being provided by a repository? (Which one?)