This document, effective this ______________day of ______________ 200__, is entered into by and between ______________________, (hereafter referred to as “Sponsor”) and the Medical College of Georgia Research Institute, Inc. (hereinafter “MCGRI”) a nonprofit research and educational corporation, located at the Medical College of Georgia, Augusta, Georgia 309124810.
In anticipation for enrollment of subjects into a clinical trial, work shall be performed by the Medical College of Georgia including further development of a study protocol, regulatory submission to the Institutional Review Board (“Human Assurance Committee” or “Chesapeake Research Review, Inc.”), contract negotiation, budget development, technical assistance, and general study-set-up preparation.
The pre-contract work and costs described herein represent a separate obligation from those in any study contract that may follow. These costs are due and payable upon invoice, regardless of whether a study is subsequently approved by the IRB. A separate budget will be created for any subsequent related study. IRB fees will be billed directly to the Sponsor by the IRB, with payment of IRB fees to be made directly to the IRB as instructed via invoice.
As compensation for this work, the following costs shall be paid by the sponsor within 30 days of invoice:
Payee/Mailing address for payments:
MCG Research Institute
PO Box 945552
Atlanta, GA 30394-5552
Attention: ____________________
(Protocol #./Study me)
(See attached W-9.)
Agreed to by sponsor: Agreed to by MCGRI:
Name: Name: Betty Aldridge
Title: Title: Executive Director
Date: Date:
Agreed to by Principal Investigator:
Name: Date:
