expense arising from the use of the material or any derivative, but only to the extent provided under the Federal Tort Claims Act (28 U.S.C. Chap. 171). When tissue is to be used by all institutions: The institution agrees to assume all risks and responsibility in connection with the receipt, handling, storage and use of tissues from the Autopsy Services. It further agrees to indemnify and hold harmless the Autopsy Services and the United States Government from any claims costs, damages or expenses resulting from the use of the tissues provided by the Autopsy Services. The undersigned warrant that they have authority to execute this agreement on behalf of the recipient institution. BY MY SIGNATURE I AGREE TO THE TERMS SET IN THE ABOVE AGREEMENT _____________________________ ______________________________________________ Typed Name of Recipient Typed Name of Official Authorized to Sign for the Agency ______________________________ ______________________________________________ Signature of Recipient Date Authorized Signature Date ______________________________ ______________________________________________ Name of Agency Division Receiving Specimens UPON RECEIPT OF THESE SIGNED UNDERSTANDINGS AND THE INFORMATION REQUESTEDABOVE, OSUWMC AUTOPSY SERVICES WILL CONSIDER THIS REQUEST AND ALL FUTURE REQUESTS FOR TISSUE. Specific questions your application should be directed to Jennifer Sachire at 614-247-7499 or
expense arising from the use of the material or any derivative, but only to the extent provided under the Federal Tort Claims Act (28 U.S.C. Chap. 171). When tissue is to be used by all institutions: The institution agrees to assume all risks and responsibility in connection with the receipt, handling, storage and use of tissues from the Autopsy Services. It further agrees to indemnify and hold harmless the Autopsy Services and the United States Government from any claims costs, damages or expenses resulting from the use of the tissues provided by the Autopsy Services. The undersigned warrant that they have authority to execute this agreement on behalf of the recipient institution. BY MY SIGNATURE I AGREE TO THE TERMS SET IN THE ABOVE AGREEMENT _____________________________ ______________________________________________ Typed Name of Recipient Typed Name of Official Authorized to Sign for the Agency ______________________________ ______________________________________________ Signature of Recipient Date Authorized Signature Date ______________________________ ______________________________________________ Name of Agency Division Receiving Specimens UPON RECEIPT OF THESE SIGNED UNDERSTANDINGS AND THE INFORMATION REQUESTEDABOVE, OSUWMC AUTOPSY SERVICES WILL CONSIDER THIS REQUEST AND ALL FUTURE REQUESTS FOR TISSUE. Specific questions your application should be directed to Jennifer Sachire at 614-247-7499 or
UserAgreementforInvestigators.docx