Common use of Signatures of the Parties Clause in Contracts

Signatures of the Parties. Signed for and on behalf of Children’s Hospital Foundation Queensland ABN 11 607 902 687 by its authorised representative: Signed for and on behalf of Institution Name & ABN by its authorised representative in the presence of: Signature of authorised representative Signature of authorised representative Name of authorised representative (BLOCK LETTERS) Name of authorised representative (BLOCK LETTERS) Date: Signature of witness Name of witness (BLOCK LETTERS) Address of witness Date: Awardee acknowledgement: ______________________________________ (signature) Date: Part A – Award Plan Application and Award Reference Number Award Type Award Activity As defined in Application #XXXXXXXXX Administering Institution representative and contact details Authorised representative and contact details for notices and consents: Authorised representative and contact details for day to day activities: Children’s Hospital Foundation representative and contact details Authorised representative and contact details for notices, consents and day to day activities: Delivery address: Level 00, 000 Xxxx Xxxxxx Xxxxx Xxxxxxxx XXX 0000 Postal address: PO Box 8009 Woolloongabba QLD 4102 Email: xxxxxx@xxxxxxxxx.xxx.xx Telephone: 00 0000 0000 Scientific Title Specified Personnel Awardee Supervisor (if applicable) Clinical Collaborator (if applicable) Enter others here Enter others here Award Period Commencement Date Conclusion Date Approved Budget Financial Year Amount Total Award Co-Contribution Funding Financial Year Amount Total Co-Contribution Funding Co-funding body (if applicable) Insert terms of co-funder if any or if not enough space, insert ‘as set out in the Special Conditions’ Clearances Required Prior to Funding Commencement Clearance Type Date Due Reporting Requirements Report Type Pro-Forma Personnel responsible Date Due Part B – General Conditions Definitions and interpretation

Signatures of the Parties. Signed for and on behalf of Children’s Hospital Foundation Queensland ABN 11 607 902 687 by its authorised representative: Signed for and on behalf of Institution Name & ABN by its authorised representative in the presence of: Signature of authorised representative Signature of authorised representative Name of authorised representative (BLOCK LETTERS) Name of authorised representative (BLOCK LETTERS) Date: Signature of witness Name of witness (BLOCK LETTERS) Address of witness Date: Awardee acknowledgement: ______________________________________ (signature) Date: Part A – Award Plan Application and Award Reference Number Award Type Award Activity As defined in Application #XXXXXXXXX Administering Institution representative and contact details Authorised representative and contact details for notices and consents: Authorised representative and contact details for day to day activities: Children’s Hospital Foundation representative and contact details Authorised representative and contact details for notices, consents and day to day activities: Delivery address: Level 00, 000 Xxxx Xxxxxx Xxxxx Xxxxxxxx XXX 0000 Postal address: PO Box 8009 Woolloongabba QLD 4102 Email: xxxxxx@xxxxxxxxx.xxx.xx Telephone: 00 0000 0000 Scientific Grant Title Specified Personnel Awardee Supervisor (if applicable) Clinical Collaborator (if applicable) Enter others here Enter others here Award Period Commencement Date Conclusion Date Approved Budget Financial Year Amount Total Award Co-Contribution Funding (if applicable) Financial Year Amount Total Co-Contribution Funding Co-funding body (if applicable) Insert terms of co-funder if any or if not enough space, insert ‘as set out in the Special Conditions’ Clearances Required Prior to Funding Commencement Clearance Type Date Due Reporting Requirements Report Type Pro-Forma Personnel responsible Date Due Part B – General Conditions Definitions and interpretation