EQUIPMENT LOAN AGREEMENT
Number: LA-XXXXX
Date: MM/DD/YY
Customer:
NAME OF PI/LAB HEAD
Provider:
Neurotar Oy Ltd
Address:
STREET ADDRESS
CITY, ZIP, COUNTRY
Address:
Viikinkaari 4, 00790 Helsinki,
Finland
VAT:
VAT:
FI22912406
Contact person:
LAB REPRESENTATIVE’S NAME
Contact person:
NAME, LAST NAME
Email address:
XXXXX@XXXX
Email address:
first.lastname@neurotar.com
Phone number:
+XX XXXXXXXXXXX
Phone number:
+358 XX XXX XXXX
The following equipment is supplied by Neurotar for evaluation purposes: MOBILE HOMECAGE MODEL,
ACCESSORIES. Commercial value: USD/EUR XX.
Trial dates: MM/DD/YY (equipment must be ready for pick up on the last day of trial)
Round trip shipment (and cargo insurance) costs are paid by Neurotar. The customer shall prepare the
equipment for return shipment in its original packaging.
The customer acknowledges his/her responsibility to use the equipment listed above following the instructions
provided by Neurotar. The customer agrees to return the device(s) in the same condition as originally supplied and
properly packaged. The customer accepts responsibility for any loss or damage caused by inadequate packaging or
mishandling/misuse of the equipment and agrees to compensate Neurotar for such.
The customer shall not use the equipment with virally infected mice (except AAV) nor place the equipment in a
virus-handling facility. AAV viral injections are allowed.
The customer acknowledges that the equipment remains Neurotar’s property throughout the trial period.
I hereby accept the responsibility for the equipment listed above from the date of delivery to the date of the
return shipment.
Customer: INSTITUTION Provider: Neurotar Oy Ltd
Signature: Signature:
Print name: PI NAME Print name:
