BBS – Technology Offer Form

Company Profile - Description of the company

(All fields are mandatory - The fields in grey are confidential and for internal use only)

Company: / City: / Country:
Street: / Postal Code:
www-Address: / Contact person:
Position in the company: / Telephone: / Fax
General e-mail address: / E-mail contact person:

Year established:

Turnover in million Euro: / Number of employees in the enterprise:
Up to 2 million / 1 – 9
2 to 10 / 10 – 49
10 to 50 / 50 – 249
More than 50 Million / More than 250

Technology Offer:

Title:
Abstract of the offer(max. 500characters):
Description of the offer (min. 100characters):
Innovations and advantages of the offer(min. 50 characters):
Technology Keywords:
Further Information (Technical Details Concerning the Profile):

Current Stage of Development:

Development phase – laboratory tested
Available for demonstration
Available for demonstration – field tested
Already on the market

Intellectual Property Rights:

Patent(s) applied for but not yet granted / Patents granted
Copyright(s) registered / Exclusive rights
Secret know-how / Others (registered design, plant variety right, etc)

IPR - Comments:

Domain of Application

Current and Potential Domain of Application:

Detailed Market Application Codes (VEIC):

Collaboration Details:

Where there are 2 levels, only select the relevant Level 2 collaboration details.

Level 1 / Level 2
Licensing Agreement
Technical Cooperation / Joint further development
Testing of new applications
Adaptation to specific needs
Joint Venture
Manufacturing Agreement (Subcontracting & Co-contracting) / Transfer of knowledge in new raw materials
New way to use an existing production line
Change in the partner sought's currently used technology (installations, process, facilities)
Absolutely novel process
Commercial Agreement with Technical Assistance / Assembly
Engineering
Technical Consultancy
Quality control
Maintenance
Financial resources

Collaboration Details / Comments:

Mandatory

- Type of partner sought:
- Specific area of activity of the partner:
- Task to be performed:

Exploitation of RTD Results:

None
EU RTD results – FP4 to FP7
JRC
EURKEKA
ESA
National Programmes
Private Research
Others

RDT Results – comments:

Preferred Countries (for information):

Privacy notice (ART. 13 of Leg. Dec. 30 June 2003, n. 196

“Personal Data Protection Code” (hereinafter “The Privacy Code”)

According to Leg. Dec. 30 June 2003, n. 196., the collection, treatment, processing and publication of personal data by Unioncamere Emilia-Romagna are intended exclusively to enable Unioncamere Emilia-Romagna to fulfill its institutional purposes.

Personal data treatment is subject to Italian legislation in the area of data protection, respecting the principle of transparency, correctness, lawfulness;

Unioncamere Emilia-Romagna, as partner of the regional consortium “SIMPLER” (member of Enterprise Europe Network) will treat separately all confidential information. Only SIMPLER partners (Cestec Spa, CCIAA Milano, CCIAA Ravenna, Alintec, FAST, Aster) as well as European Commission and European Commission Agency will have access to some confidential information included in Unioncamere Emilia-Romagna activity reports. The said data will be in any case subject to confidential information constraints.

Data relating to taking part into Unioncamere Emilia-Romagna’s events must be considered as public data according to Leg. Dec. 30 June 2003, n. 196 and therefore can be sent to other Enterprise Europe Network members and/or third parties.

Data principal is Unioncamere Emilia-Romagna, Viale A. Moro 62, 40127 Bologna.

Data Subject can exercise his specific rights by addressing himself to Unioncamere Emilia-Romagna, according to art. 7 Leg. Dec. 30 June 2003, n. 196.

For more information please go to

Data subject Consent

The undersigned ______, having read this privacy notice

gives its consent □ doesn’t give its consent □

to the data personal treatment referred to this privacy notice.

signature: ______

Data treatment shall be performed by the Data Principal, through its Data Processors, appointed among the Chambers of commerce of Emilia-Romagna, in order to promote the participation at their institutional events.

Data subject Consent

The undersigned ______, having read this privacy notice

gives its consent □ doesn’t give its consent □

to the data personal treatment referred to this privacy notice.

signature: ______

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BBS Database – Technology Offer