Medtronic Trading NL B.V. Postbus 2542 …, . . 6401 DA Heerlen - Tel.: 045—5668800 Fax: iMS-5668276 Medtromc Heelien‚ 22nd April 2014 De weledelgeleerde heer Afdeling Cardiothoracale Chirurgie Leids Universitair Medisch Centrum Postbus 9600 2300 RC Leiden Deor- At our request. you haye kindly agreed to participate at the CRS Symposium which will be held in Figi Zeist on 25”} April and to give a presentation on the topic of “End Stage Hearitaiiure: Cordioc Support devices, Heart Transplantation & Corrdiothorocic surgical Treatment options". As compensation for the above, we will pay you on honorarium of € 880‚— which will be transferred to your bank account following the meeting and upon receipt of 0 copy of your presentation. in accordance with Medironic‘s expense reimbursement policies, we shall cover the following costs for your participation in the above event: ' - Travel costs: Ground transportation (0.29 euro/km) lf not directly paid by Medtronic, such expenses wili be reimbursed upon your submission of the original receipts. Please note that any additional hoie! costs, such os minibar, telephone, expenses for accompanying persons (double occupancy) or for an extension of your story cannot be organized or reimbursed by Medtronic. You shall own all copyrights to materials created by you and which are distributed or otherwise presented during the meeiing. However, you agree that you will gfant to Medtronic an unlimited, perpetual, worldwide and royalty tree license to use, copy ond distribute such copyrighted materials in any medium. Medtronic a rees to include the following legend in any reprints: Reprinted with the permission 0“ in addition, you agree that Medtronic Wishes to receive the information presented by you on a non-confidential basis so we can use your advice ond suggestions in our process of developing and improving our pro ucts. We asl< that you do not disclose to Medtronic any ideas that you consider confidential o_r proprietary. Accordingly, _we are free to use your comments and suggestion's .in“ our products. Should you wish to disclose an idea to Medtronic in confidence, lt must be the subject oi d separate agreement. ‚if you agree torthe above mentioned arrangement may we ask you to piease sign this letter ‘ in the space provided below, to submit it to your medical institution administration er employer for signature, and return a signed origian to our office. .We would‘like to state that this Agreement does not create ony obligation or expectation ior . you or your medical institution to use, promote or purchase Medtronic products. - . ‘- oule PC‘ 9 ] Of 3 ' ‚9 . _ ISOÈDBÍ ‚ _ ;;. @ Medtronic Allwìnlí;g Brin -Rulufing H!IIÜII -Evlamiing [ìjì We greaily appreciate your willingness io share wiih us your insights and ihe benefli of your experience. Only by parinen'ng wiih and learning from experis like you can Medtronic design and develop medical devices, which coniinually improve our poiienis‘ quality of life. Yours sincerely, MEDTRONl ‚Tra/din N DGÌ€:Â.Z ’ Ö “Í ’ 2—ÓÏ (‘( Dole: D?? W M/î/ ! MEDICAL Iiv'STlïU'il0N/EMPLOYER LUMC has reviewed, and hereby approves and aulhorizes, each and all of ihe ierms anal provisions of ihis Agreemeni. The individual signing below represenis anal agrees iha’r he/she is auihorized io sign ihls Agreemeni as a represeniaiive of, and on behalf of LUMC. mr.drs. Paul Bllars . managing director' ' Department ol lnlernal medmme By: ' al Geniei Tiiie: Daie: ["' rv’ Í'U" By‚accepiing the above arrangement, Medical insiiiuiion and Physician agree ihoi Medtronic may store in a global electronic database for its ongoing and future processing and use, coniraci and adminisiraiive inicrmaiion, including persónal data {Le_.‚ name, address, em.) in relation io Medical lnsiiiuiion and Physician. Medical lnsiiiuiion "and Physician furiher agree ihai such informaiion may be provided io olher Medironic eniiiles including Medironic, inc. in the United Staies and to any appropriaie regulatory authority, consisieni with Medlronic's obiígoiìons io same. Page 2 of 3 E‘OIIIC Afl=vfmfnxfafn-R«rvrfnszmfrh-Evrmdiw« REQUEST FOR RElMBURSEMENT or EXPENSES CRS Symposium 2014 Flgl Zelst 25'h April 2014 De weledelgeleerde heer Afdeling Cardiolhoroccrle Chirurgie -. Leids Universitair Medisch Centrum :- ' Poslbus 9600 2300 RC Leidem __ -lf expenses are to be reîmbursed under lhls Agreement, please complete the Information below and forward lhls requesl lo our office together wllh your original receîpls: \ (âáëbl L\M‚\ & O_‚ícvej Exgenses: J Ground lrcrnsporlcrllon: ...... Ë.;. ….f?>. ....... € Total: Bank details: Accoun’r holder: Accounl number: — _ Bonk: _ IBAN: Page 3 of 3