ࡱ> 1305@ ;bjbj22 (&XX<<<<<<<P 8, @ Ph h " $;R*< *<< ? < <  xf<< \ tI U07 "7PP<<<<7<,  **PP PP CONFLICT OF INTEREST/COMMITMENT MANAGEMENT PLAN FOR insert name of company or faculty member DATE: _______________ BACKGROUND Here, put information about the faculty member or company; who founded the company and when; the location and the nature of its business. Include a discussion about the intellectual property on which the company is based. If this is extensive, use an attachment. Inventions to be used by the faculty member and/or company are to be properly disclosed and may be licensed to the faculty member(s) or company by the University if it is determined that the University owns the intellectual property. Conflict of Interest/ Conflict of Commitment for Faculty Pursuant to University regulations, Professor ___________ will report annually his/her activities with insert name of company in a Conflict of Interest/Conflict of Commitment Disclosure һƵment (attached). In addition, the Dean and the Vice President for Research will annually review Professor activities. Include text on the Professors expected time commitment, and how conflicts of interest and commitment will be avoided. In general, faculty should not be conducting day-to-day management of company activities. If it is necessary for faculty to do this for a limited period of time, explain how the conflict of commitment will be handled faculty leave, rigid time management, etc. Involvement of Other University Personnel OPTION 1 - At this time, there are no plans to involve other University personnel (students, postdoctoral employees, faculty, or staff) in this project. However, in order to avoid any potential conflict concerning these situations, the following process will be used: OPTION 2 University students and/or staff will be employed. Professor will notify the Dean and Vice President for Research in writing. The Vice President for Research will inform the impacted student(s) or staff in writing, using a form Notice Letter, about the faculty members relationship to the Company and that the student or staff member should notify the Vice President for Research if he/she feels their involvement with the Company (or their lack of involvement with the Company) in any way adversely affects their academic progress or employment status. The Vice President for Research will include a Complaint Form to be filled out and returned for this purpose. Copies will be sent to the Professor, Dean and Principals of the Company. Other University Research Describe how Professor research program at the University relates to the activities of the Company. Are they totally separate? How closely are they related? University Resources and Intellectual Property The Company will not use University facilities or equipment. OR, if it will, specify that a leasing, technical testing or facilities use agreement will be executed. Specify that all costs will be reimbursed to the University. Further, if the Company wishes to use University owned intellectual property, the company will negotiate a license agreement with the University. Review Cycle The Vice President for Research, the Dean and the Professor will meet on an annual basis to review progress and ensure compliance with this Conflict of Interest/Commitment Management Plan. An annual status report will be drafted. Attachments List of inventions or other creations disclosed to the University Lease, Technical Testing, or Facilities Use Agreement Disclosure Form һƵment List of University students or employees working with the Company. Include their title, student or employment status, number of consulting days incurred in the prior year and estimated number of consulting days in the upcoming year. Acknowledgement of Agreement: _______________________________ ______________ Professor Signature Date _______________________________ ______________ Dean Signature Date _______________________________ ______________ Vice President for Research Date Draft Conflict Management Plan Last Revised June 2004 PAGE  PAGE 2 6^_uv   * /  & '   1 7 L x &cdFK})H½½̭ۡ hl(6 h1m 6>* hu6>*hl( h1m >* hu>* h2>* h1m 5 h26>*h ^hu h26 h25h256>*h1m h256>*h2h1m ?12_`vw  y z p q  & F$a$gd1m $a$gd1m $a$:de}~V & F$a$gd1m $a$gd1m $a$gd216PQU_iyIJkl !"()*,-345679:;huhu0JmHnHu h20Jjh20JUh25CJaJh1m h25CJaJh1m h2hl(*1IJK| !*+,789:;h]hgd1m &`#$gd2&1h:pl(/ =!"#$%@@@ NormalCJ_HaJmH sH tH @@@ Heading 1$$@&a$5\>@> Heading 2$@& 5>*\:@: Heading 3$@&5\B@B Heading 4$ & F@&5\DA@D Default Paragraph FontViV  Table Normal :V 44 la (k(No List 4@4 Header  !4 @4 Footer  !4B@4 Body Text5\8P@"8 Body Text 26].)@1. 1m Page Number;&12_`vwyzpq d e } ~         V 1IJK| !*,78<00p00p00`0`0w0w0w0w0w( 0w0z0z0z0z0z8 0z0q0q0q0q0q0q8 0z0 0 0 8 0z0e 0e 0e 0e 0e 0e 0e 8 0z0 0 0 8 0z0  0   0   0   0  0p00p0000p0 000p000 0p@0My0@0IMy0F@0@0; ;:!!9<9<0166^_*/ &'LL..??[[::   F K # # > > H H   0 1 6FPPQU_iy0011HIkl||!),69<9< jdenverjdenverjdenverlfarrugismetoskysrperkino'2_808^8`0o(.^`o(.pLp^p`L.@ @ ^@ `.^`.L^`L.^`.^`.PLP^P`L.o'21m ^2l(u <S0@;@@UnknownGz Times New Roman5Symbol3& z Arial"h FfPUL UL !243H(? ^1CONFLICT OF INTEREST/ COMMITMENT MANAGEMENT PLAN jdenversrperkin Oh+'0  4@ \ h t 2CONFLICT OF INTEREST/ COMMITMENT MANAGEMENT PLAN 0ONFjdenverdendenNormal srperkinOF 7peMicrosoft Word 10.0@- @R^H@ֈH@xttIUL ՜.+,0, hp  һƵ Dominion UniversityA 2CONFLICT OF INTEREST/ COMMITMENT MANAGEMENT PLAN Title !"#$%&')*+,-./2Root Entry FĕtI41TableGWordDocument(&SummaryInformation( DocumentSummaryInformation8(CompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q