Confidential Disclosure Agreement Page 5

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IN WITNESS WHEREOF, the parties hereto have executed this Confidential Disclosure Agreement as of
the Effective Date by their duly authorized representatives.
[insert University name]
GLAXOSMITHKLINE LLC
By:
By:
Name:
Name: Jon L. Collins Ph.D.
Title:
Title:
US Head of Chemistry; DPAc
Date:
Date:
ACKNOWLEDGED AND AGREED
By:
University Investigator
5

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