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Application Instructions

voice:
(937) 253-1777

fax:
(937) 253-2634

http://www.ncicfund.com

NCIC Release And Indemnification Agreement For Individuals Submitting A Proposal To The National Center For Industrial Competitiveness

The undersigned, to induce the National Center for Industrial Competitiveness (the "Corporation") to consider its request for the funding of the project submitted by the undersigned to the Corporation, hereby releases and discharges the Corporation, its directors, officers, employees and agents, and any third parties with whom the Corporation may consult, from any and all liability for any use, misappropriation or disclosure to third parties of any information, including confidential information and trade secrets, furnished to the Corporation, its directors, officers, employees or agents, or such third parties by or on behalf of the undersigned and from any and all liability for any claims, damages, or expenses arising or alleged to have arisen in connection with review of the proposal or advice given by such persons, including liability for personal injury, property damage, or other loss.

The undersigned further agrees to indemnify and hold harmless the Corporation, its directors, officers, employees and agents, and any third persons with whom the Corporation might consult, against any claims, damages, costs and expenses arising out of or alleged to have arisen out of (1) review of the proposal or advice given by such persons, including any claims, damages, costs and expenses such as personal injury or property damage; or (2) disclosure of information furnished to the Corporation, its directors, officers, employees or agents or such third parties by or on behalf of the undersigned including but not limited to any purported misuse, misappropriation or improper disclosure of confidential information or trade secrets; provided, however, that the undersigned shall have no duty to indemnify an employee or consultant of the Corporation with respect to any claims by the Corporation against such employee or consultant.

DATED this _________day of _____________________, 20__.

By: _________________________________

Title: ______________________________

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