LETTER OF AGREEMENT

For ACCME and State Medical Society Accredited CME Sponsor Regarding Terms,

Conditions and Purposes of an Educational Grant

Between Johns Hopkins University School of Medicine (Sponsor) and Supporter(Commercial Supporter)

Title of CME Activity: Third Theranostics World Congress on GA-68 and PRRT

Location: Johns Hopkins Medical Institution, Baltimore, Maryland Date(s): March 12 -14, 2015

Commercial Supporter (Company Name/Branch): Supporter

Address: Supporter Address, City, State

Telephone: Supporter Phone Fax: Supporter Fax Contact Person: Supporter Contact Name

The above company wishes to provide support for the named continuing medical education activity by

means of an educational grant for support of the CME activity in the amount of $Grant Amount.

Activity Budget #:80034404 Coordinator: Laura Friend Email:

RETURN TO:

JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE, OCME, TURNER 20, 720 RUTLAND AVENUE, BALTIMORE, MARYLAND 21205-2195 or
FAX: 443-224-9544

1. Statement of Purpose: Program is for scientific and educational purposes only and will not promote the Commercial Supporter's products, directly or indirectly.

2. Control of Content & Selection of Presenters & Moderators: Sponsor is responsible for control of content and selection of presenters and moderators. Because the Sponsor must maintain independence, the Commercial Supporter agrees not to direct the content of the program or provide suggestions for topics or speakers.

3. Disclosure of Financial Relationships: Sponsor will ensure meaningful disclosure to the audience, at the time of the program, of (a) Commercial Supporter funding and (b) any significant relationship between the Sponsor and the Commercial Supporter (e.g., grant recipient) or between individual speakers or moderators and the Commercial Supporter.

4. Involvement in Content: There will be no "scripting," emphasis, or direction of content by the Commercial Supporter or its agents.

5. Ancillary Promotional Activities: No promotional activities will be permitted in the same room or obligate path as the educational activity. No product advertisements will be permitted in the program room.

6. Objectivity & Balance: Sponsor will make every effort to ensure that data regarding the Commercial Supporter's products (or competing products) are objectively selected and presented, with favorable and unfavorable information and balanced discussion of prevailing information on the product(s) and/or alternative treatments.

7. Limitations on Data: Sponsor will ensure, to the extent possible, meaningful disclosure of limitations on data, e.g., ongoing research, interim analyses, preliminary data, or unsupported opinion.

8. Discussion of Unapproved Uses: Sponsor will require that presenters disclose when a product is not approved in the United States for the use under discussion.

9. Opportunities for Debate: Sponsor will ensure meaningful opportunities for questioning or scientific debate.


10. Independence of Sponsor in the use of Contributed Funds:

a.  funds should be in the form of an educational grant made payable to

Johns Hopkins / 80034404 .

WIRE TRANSFER TO JOHNS HOPKINS:
Bank Name: / Bank of America
Account Name: / Johns Hopkins University Central Lockbox
Account Number: / 003936830516
ABA Number: / 052001633
Reference: / Continuing Medical Education
Contributor’s Name: / Supporter
CHECKS:
Bank Name: / Bank of America
Address: / 12529 Collections Center Drive
Chicago, IL 60693

b. all other support associated with this CME activity (e.g., distributing brochures, preparing slides, etc.) must be given with the full knowledge and approval of The Johns Hopkins University School of Medicine.

c. no other funds from the Commercial Supporter will be paid to the program director, faculty, or others involved with the CME activity (additional honoraria, extra social events, etc.).

The Commercial Supporter agrees to abide by all requirements of the ACCME Standards for Commercial Support of Continuing Medical Education.

The Accredited Sponsor agrees to: 1) abide by the ACCME Standards for Commercial Support of Continuing Medical Education; 2) acknowledge educational support from the Commercial Supporter in program brochures, syllabi, and other program materials, and 3) upon request, furnish the Commercial Supporter a report concerning the expenditure of the funds provided.

This contract is to be interpreted in accordance with Maryland law, with the exception of choice of law provisions, and any dispute between the parties shall be brought in the state or federal courts of Maryland.

Any press releases, newspaper articles, web listings, audio- and/or video- recordings in conjunction with this CME activity must be approved prior to release by The Johns Hopkins University Office of Continuing Medical Education, as well as the activity director.

AGREED

2

revised 7/12/11 GES

LETTER OF AGREEMENT

For ACCME and State Medical Society Accredited CME Sponsor Regarding Terms,

Conditions and Purposes of an Educational Grant

Commercial Supporter Representative:
Signature: / Date:
CME Department Director or Designee: / Todd Dorman, MD, FCCM, Associate Dean / Director, CME
Signature: / Date:
CME Activity Coordinator / LMF (initials)

2

revised 7/12/11 GES

LETTER OF AGREEMENT

For ACCME and State Medical Society Accredited CME Sponsor Regarding Terms,

Conditions and Purposes of an Educational Grant

2

revised 7/12/11 GES