For General Use and All International Clients

THIS DISCLAIMER MUST BE COMPLETED WITH EACH ORDER BEFORE THE NMDP / ASHI CELL REPOSITORY WILL SHIP CELL LINE CULTURES OR PELLETS

"I hereby agree that the cell lines provided are for clinical quality assurance, test validation or research purposes only and their products shall not be sold or used for commercial purposes. Nor will cells be distributed further to third parties for the purposes of sale, or producing for sale, cells and their products. 

I understand that, although human cells distributed by the NMDP / ASHI Cell Repository have been subjected to stringent tests and observations which indicate the absence of extraneous agents and deleterious properties, I agree to indemnify and hold harmless the United States Government and the NMDP / ASHI Cell Repository from any claims, costs, damages, or expenses resulting from any injury (including death), damage or loss that may arise from the use of the cell lines either directly or in the preparation of a product. 

I assume all risks and responsibilities in connection with the receipt, handling, storage and use of the material and warrant that I have authority to execute this agreement on behalf of the recipient institution."

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   _________________________________                           __________________________________

   Type / Print Name authorized to execute                                                    Institution

   _________________________________                           __________________________________

   Signature                                 Date                                                         Department

   _________________________________                           __________________________________

   Telephone                                                                                             Street Address

   _________________________________                           __________________________________

   Fax                                                                                             City / State / Zip / Country

Note: This form may not be altered in any way. Upon receipt of this signed form, the NMDP / ASHI Cell Repository will process your requests for cell line cultures and pellets.