US Department of Energy -- Carlsbad Area Office (CAO) -- Carlsbad, NM
TECHNOLOGY TRANSFER APPLICATION
NOTE: --This form is to be used only for informal technology transfer of information technology:
- the U.S. Department of Energy Carlsbad
Area Office (DOE/CAO) and the Waste Isolation Division
(WID) of the Westinghouse Electric Company waive the
right to seek licensing fees,royalties and/or any other
form of financial compensation;
- the recipient is granted non-exclusive
rights; and 3) the transfer involves information
("soft") technology, such as training modules,
assessment tools, and other documents.
I. PURPOSE -- the purpose of this instrument is to provide a mechanism for the efficient, informal transfer of Waste Isolation Pilot Plant (WIPP)-developed information technology (manuals, procedures, training modules) to organizations outside of the Department of Energy (DOE) complex. WIPP is managed by the Waste Isolation Division (WID) of the Westinghouse Electric Corporation under contract to the DOE Carlsbad Area Office (CAO). The DOE Technology Transfer Program is designed to ensure that taxpayers receive maximum benefit from DOE-funded research and development, and to promote U.S. educational development, economic development, and global competitiveness.
II. CONDITIONS -- The conditions for
information technology transfer from WIPP to an outside
organization are
- The recipient is granted non-exclusive
rights to use the technology listed in this document. The
US Government reserves the right to share technologies
with other organizations. This ensures fairness of
opportunity;
- The US Government retains the right to use
the original technology worldwide;
- As allowed by law, the recipient agrees to
indemnify the US Government and its contractor for all
damages, costs, and expenses, including attorney fees,
arising from the utilization of such technologies,
including, but not limited to the making, using, selling
or exporting of products, processes, or services derived
from the technology transfer;
- Neither the US Government nor the
contractor will seek licensing fees, royalties, and/or
any other form of financial compensation from the
recipient;
- If printed materials are generated from
the transferred technology, the recipient will
acknowledge that
a) the products were produced from technology originally developed by Westinghouse under contract to the DOE/CAO;
b) the technology was shared through the DOE/CAO technology transfer program; and
c) the recipient indemnifies the U.S. Government and the contractor, pursuant to the terms set forth above.
- If the technology is to be commercialized,
the recipient will remove from printed materials all
other references to the WID, Westinghouse, the DOE/CAO,
and their employees unless otherwise stipulated.
- As requested, the recipient agrees to
provide DOE/CAO and WID a courtesy review/inspection of
modified technologies before they are used/sold.
- The recipient agrees to allow the DOE/CAO
and WID to publicize the technology transfer.
- As requested, the recipient agrees to report to the DOE/CAO and/or the contractor on usage status.
III. REQUIRED INFORMATION - completed starred (*) headings, as applicable
A. Requesting Organization Information
* 1. Name of Individual Making Request:
* 2. Title of Individual Making Request:
* 3. Name of Organization:
* 4. Street:
* 5. City: State: Zipcode:
* 6. Telephone Number of Individual Making Request: ( )
* 7. Fax Number of Individual Making Request: ( )
* 8. E-Mail Address of Individual Making Request:
* 9. Primary products or services of requesting organization:
10. Businesses only - other organizations skip to section "C"
* a. A small business? __y __n
* b. Woman-owned? __y __n
B. Requested Information Technology
1. MTDNA in MS-Word for Windows 95 via e-mail attachment
* C. Usage -- briefly describe how your organization anticipates using the tool:
D. Request
I am a representative of the organization listed in this section. I have read the conditions described in section II. My organization agrees to meet those conditions if the information technology described above is transferred to us. I recognize that submitting this request does not guarantee that a technology transfer will be approved.
*Type your name and the date here:
Now, skip to Section VII
WID/DOE USE ONLY
IV. WID Review
A. Assigned Tracking Number:
B. Organization eligible for transfer?: Y N If no, explain:
C. [ ]
William A. Keeley
Manager of Economic and Technological Development
V. DOE/CAO Review
A. Soft Technology eligible for transfer?: Y N If no, explain
B. [ ]
Patti Crockett
Administrative Specialist
VI. Feedback to Requesting Organization
A. [ ] Your request has been approved. This document now constitutes
the transfer agreement between your organization and WID/DOE.
B [ ] Your request has not been approved; see explanation.
VII. Final Review
Have you completed all of the applicable starred (*) items in section III?
You're finished! Please e-mail the ENTIRE technology transfer
application to:
[ click on one of the
following to download a copy of this application
]
![[ click here -- to download a rich-text-format word processor version of this file ]](../images/rtf.gif){kind=small}
< mtdna.rtf ·········· ![[ click here -- to download a text version of this file ]](../images/text.gif){kind=small}
< mtdna.txt (if
you use Notepad turn word wrap on)
[
note: application available for ![[ click here for the MSOD PUBlic FTP site directory ]](../images/ftp.gif){kind=small}
download as an rtf or as a pure text file ]
