1、附件1BILATERAL COOPERATION FORM OF ZHEJIANG-ALBERTA INDUSTRIAL R&D PROJECT浙江加拿大产业联合研发项目表（Please fill in both English and Chinese请用中英文双语填写）1. General Information项目基本信息1.1 Project Title 项目名称 1.2 Short Summary项目摘要(Do not exceed 300 characters) （不超过300字）1.3 Technology Sector & subsector of project项目所属技术领域
2、及子领域1.4 Participants contributions参与单位贡献No Company Name公司名称 Role of participant项目中作用 Country国别 Contribution %贡献率% Budget 预算（元）Duration (month)投入时间(月)Total 合计2. Project Outline项目概要 2.1 Project Description 项目内容描述 （大约一页A4纸，立项意义、国内外技术水平、合作基础、实施条件、合作目标等）1.5 Start Date项目开始时间End Date项目结束时间2.2 Technological
3、 Development Envisaged（Level of Innovation）技术先进性及创新性 （大约一页A4纸，工艺路线、技术参数等，可附图）2.3 Market Potential and Commercialization Plan市场前景和商业化计划（生产规模、目标产品、市场渠道等）2.4 Cooperation between Participants 双方合作开展的工作(Synergies, advantages, complementarities, etc.)（如：双方合作互补的优势等）2.5 Expected Outcome of Project项目预期成果（工艺、
4、产品、专利、市场销售等）2.6 IP Ownership Agreement (Please attach a separate signed “Letter of Intent”)知识产权归属安排（请另附双方已签署的意向协议）3. Project Participants Partner 1 (Zhejiang)项目参加单位第1合作方 浙江企业 3.1 Zhejiang Participant Profile 浙江企业资料3.1.1 General Profile 企业基本信息Full Name of company全称Parent Organization总公司Type of Compan
5、y公司类型SME中小企业 Large Enterprises 大企业 Others其他 Web-Site网站Company Address企业地址Post Code邮编3.1.2 Contact Person联系人信息Last Name姓First Name名Position职务E-mail电子邮件Tel./ Mobile Phone Number直线电话或手机Fax传真Resume of main applicant中方项目主要申请人简历3.1.3 Organization Background 公司背景Year Established成立时间Stage 企业发展所处阶段(R&D, Init
6、ial Revenues, Preparing to go public, Listing)（研发、已有产品销售、准备上市、上市）Number of Employees职工总数Number of .R&D Personnel研发人员总数General Business Description & Area of Expertise业务概述与专业领域Technology Description (Main Products/ Services)技术描述（主要产品/服务）IP 知识产权Targeted Customers目标客户Current year i本年i-1去年i-2前年Sales for
7、 last 3 years最近三年销售业绩3.2 Work-Description and Contributions to the Project 浙江企业在项目中承担的工作及对项目的贡献3.3 Work Plan and Timeline项目工作计划和时间表3.4 Budget and Resources项目预算和经费来源（企业自筹、投融资、申请资助等）3.5 Other Sources of Financial Support Related to Proposed Research项目其他经费支持来源该项目是否有其他经费支持，如有，请提供经费来源、数目和到位时间。Is this, or
8、 related R&D, presently being supported by other sources? If yes, indicate other sources, amounts, and dates of performing the R&D under this support企业以前是否得到政府资助？如有，请列出项目经费名称和取得时间。Has your company previously received other sources of governmental support? If yes, list up sources and dates.4. Project
9、 Participants Partner 2 (Alberta)项目参加单位第2合作方 加拿大4.1Alberta Participant Profile 加拿大机构资料4.1.1 General Profile 机构基本信息全名Full Name总公司Parent Organization机构地址Organization AddressPost Code邮编网站Website4.1.2 Contact Person联系人信息Last Name姓First Name名Position职务E-mail电子邮件Tel./ Mobile Phone Number直线电话或手机Fax传真Resume
10、 of main applicant加方项目主要申请人简历4.1.3 Organization Background 公司背景Year Established成立时间Stage 企业发展所处阶段(R&D, Initial Revenues, Preparing to go public, Listing)（研发、已有产品销售、准备上市、上市）Number of Employees职工总数Number of .R&D Personnel研发人员总数General Business Description & Area of Expertise业务概述与专业领域Technology Descrip
11、tion (Main Products/ Services)技术描述（主要产品/服务）IP 知识产权Targeted Customers目标客户Current year i本年i-1去年i-2前年Sales for last 3 years最近三年销售业绩4.2 Work-Description and Contributions to the Project加拿大企业在项目中承担的工作及对项目的贡献4.3 Work Plan and Timeline项目工作计划和时间表4.4 Budget and Resources项目预算和经费来源（企业自筹、投融资、申请资助等）4.5 Other Sou
12、rces of Financial Support Related to Proposed Research项目其他经费支持来源该项目是否有其他经费支持，如有，请提供经费来源、数目和到位时间。Is this, or related R&D, presently being supported by other sources? If yes, indicate other sources, amounts, and dates of performing the R&D under this support企业以前是否得到政府资助？如有，请列出项目经费名称和取得时间。Has your comp
13、any previously received other sources of governmental support? If yes, list up sources and dates.5. Statement of Cooperation 合作声明The participants signing this form intend to co-operate within the project as described in this form with the aim realizing the technical developments as set forth under p
14、oint 2. In addition the participants have or intend to put in place, a formal collaboration agreement. 签署本表格的参与单位打算在本表格所述项目内进行合作，目的是为了实现第2点所述的技术开发。另外，参与单位应签订或打算签订一份正式的合作协议。5.1 Signature of Partner 1 合作方1 的签字Company Name 公司名称First Name名 Last Name姓Title职称Position职务Signature 签字5.2 Signature of Partner 2 合作方2的签字Company Name 公司名称First Name 名Last Name姓Title职称Position职务Signature 签字
