EXHIBIT "A 
domestic municipal government) to practice and have practiced 
(made or have made, used or have used, sold or have sold) 
throughout the world by or on behalf of the Government of the 
United States. 
2. The Licensor covenants and warrants that he has the right 
to grant the foregoing license, and that any assignment or 
license which he may make of the invention or the said patent 
applications or patents thereon, shall expressly be made 
subject to this license. 
3 . The Licensor agrees that the Government shall not be 
estopped at any time to contest the enforceability, validity, 
scope of, or title to, any patent or patent application herein 
licensed. 
(Institution) 
(Signature) 
(Print or type name) 
Date 
(Official Title) 
CERTIFICATE 
I* , certify 
that I am the 
of the institution named as Licensor herein; that 
, who signed this 
License on behalf of the institution is 
of said Institution; and that said License was duly signed 
for and in behalf of said institution by authority of its 
governing body, and is within the scope of its corporate powers. 
11-14 
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