WEMA Products License Application Form
WEMA Products License Application Form
A. Company overviewRegistered name
Telephone / FAX
E-mail / Website
Mailing address
City/Town / Province/State / Country
Principal place of business
CEO name and signature
TYPE OF BUSINESS: Please check as appropriate
Sole proprietorship / Limited liability company
Parastatal / cooperative
A company registered in the country of:
AFSTA membership / Yes / No / If Yes, Since
Membership to National Seed Association
Years in operation / Yes ____ No ____ If yes, since ______
Number of employees
n Management Staff
n Technical Staff
n Sales Staff
Annual maize volume sales
n Total (No. of 20kg bags)
n Hybrids (No. of 20kg bags) / ______
Licensing experience
n Years In-licensing
n Years Out-licensing
B. Market coverage
Markets served (countries or parts of countries . . . which parts?)
Distribution channels (%age) / Agents / Agro- dealers / Direct to farmers
Training capacity (describe ability to educate agro-dealers/farmers)
C. Commercial product range
No. of maize hybrids your company has registered
% annual maize sales in hybrids vs. OPV
D. Breeding and development capacity
Company testing networks (locations and institutions)
Breeding stock (%age of hybrids from own pipeline vs. licensing from others)
E. Foundation seed production capacity
Annual Production Capacity
n Foundation seed (tons)
Seed storage capacity
n Total storage (MT)
n Cold storage (MT)
Irrigation capacity
n No. of Hectares
n %age of Production Capacity
F. Certified seed production capacity
Annual Production Capacity
n Certified seed (tons)
Seed storage capacity
n Total storage (MT)
n Cold storage (MT)
Irrigation capacity
n No. of Hectares
n %age of Production Capacity
G. Seed Quality
Accreditation to ISTA, etc (include company ID.)
Routine Germplasm maintenance /purity testing capability (describe equipment, processes, overall quality management program)
H. WEMA Products requested for commercialization
n Name of hybrid (s) of interest ______
n Designation of Parental lines ______
n Interest/capability in producing Foundation seed for own use: Yes___ No___ If yes, how much (tons)? ______
n Interest/capability in producing Foundation seed for others: Yes___ No___ If yes, how much (tons)? ______
n Interest/capability in producing certified seed for own use: Yes___ No___ If yes, how much (tons) ______
n Interest/capability in producing certified seed for others: Yes___ No___ If yes, how much (tons)? ______
n Interest/capability in selling certified seed to smallholder farmers: Yes___ No___ If yes, how much (tons)? _____
Additional information to support the Application (provide any additional information that the applicant would like to submit in the support of the application)
Date ______By______
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Submit completed application forms to:
The Chair
WEMA Application Review Committee
C/O AATF Deployment Unit
African Agricultural Technology Foundation
P.O. Box 30709-00100, Nairobi, Kenya
Tel: +254 20 422 3746/3742: Fax: + 254 20 422 3701
Email:
Confidentiality Statement
This document contains proprietary and confidential information. All data submitted to the WEMA Application Review Committee (ARC) is provided in reliance upon its consent not to use or disclose any information contained herein except in the context of its business dealings with your company. In the event the confidential information must be disclosed pursuant to judicial order or requirement of law, the Party to whom such order is directed shall immediately notify the other Party of such order or requirement and shall take all reasonable steps to limit such disclosure, and vice versa.
The WEMA ARC shall not disclose or communicate confidential information except to their employees who have a need to know the confidential information and any third party mutually authorised by the Parties, in writing, to receive the confidential information.
The WEMA ARC also agrees not to duplicate or distribute or permit others to duplicate or distribute any material contained herein without your company’s express written consent.
Your company retains all title, ownership and intellectual property rights to the materials and trademarks pertaining to it, contained herein, including all supporting documentation.
Each Party’s obligations of confidentiality described in this Agreement shall be binding throughout the duration of this engagement and for a period of five years following the expiration or termination of this Agreement.
NOTE:
Please note that once a seed company has been selected by the WEMA ARC to receive either WEMA hybrids or inbred lines, it need not complete the entire application form for subsequent products of interest. From the date qualification is granted, the provided data remains valid for three years and will be used in subsequent applications reviews as long as the company re-submits section H of the application form to request consideration for product available. The seed company also needs to confirm that the previous information is still valid.
WEMA Products License Application Form – CONFIDENTIAL 4