Firenze 23 Luglio 2008
Prot. N. 9151.7
Oggetto: Promozione dell'industria toscana del Medical Device.
Toscana Promozione e ICE, in collaborazione con PONTECH, hanno inserito nelle Attività Comuni
d’Intervento 2008 l’organizzazione di un Workshop e un Seminario nel comparto dei Dispositivi
medici , con operatori e Venture Capitalist statunitensi.
L’iniziativa si pone l’obiettivo di creare forme di collaborazione, partnership tecnologiche, di know-how,
finanziarie ecc. e nuovi investimenti nel settore indicato.
In questa ottica, per favorire la programmazione di incontri bilaterali che riescano a creare
concrete premesse di collaborazione tra imprese, enti di ricerca, poli tecnologici e venture
capitalist, Toscana Promozione e ICE si rivolgono a tutti i soggetti interessati, pregandoli di
compilare dettagliatamente la presente scheda di manifestazione di interesse. La scheda compilata
sarà difatti lo strumento attraverso il quale l’ufficio ICE di Los Angeles potrà attivare il lavoro
di matching con le imprese locali.
ICE FIRENZE
Il Direttore
Dr.ssa Andreina Guerrieri
TOSCANA PROMOZIONE
Il Dirigente Servizio Referenti Imprese
Stefano Romagnoli
Firma in sede
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STATEMENT OF INTEREST IN PARTICIPATING TO THE INITIATIVE
BUSINESS TO BUSINESS USA
INITIATIVE: BUSINESS TO BUSINESS USA
Pontedera, November 30th – December 4th , 2008
Please return:
by e-mail to: [email protected] or by fax to no. 055/4628025 by and no later than
September 22th , 2008;
COMPANY DATA
Company Name____________________
Address_______________ _____________Town ____________Province ____
Legal representative or Contact ____________________________________________
E-mail
__________________
Telephone ______________________________
Internet site _________________________________
Employees ___
Established______
Turnover____________(€)
Export (% on sales) ______________Exports to USA (% on Export total)____________
Sector :
Medical Devices
Biotech
Pharmaceutical
Type of activity within own sector (please indicate one or more fields and detail the activity carried out)
□ Research & Development in the field:
□ Production of
□ Laboratory for testing/ measurement/analysis for
□ Marketing o
□ Services for
□ Other, (please specify) design of plants and machinery____________________________
ARE YOU AVAILABLE FOR LET THE USA ENTERPRISE VISIT YOUR COMPANY ?
YES
NO
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- WHAT COULD YOUR COMPANY OFFER TO A POTENTIAL PARTNER FROM THE UNITED
STATES
R&D Activities – please specify the main research projects underway or already completed (in this case,
give a brief description of the results achieved), that have been developed within the company or in
cooperation with external organizations or other companies (in this case, please specify who they are):
List company’s patents and specify for what products and year of expiration:
______________________________________________________________________________________
- WHO ARE THE POTENTIAL PARTNERS YOU WOULD LIKE TO MEET?
Companies/organizations you would like to get in touch with. If known, please indicate who they are; if
they are not known, please indicate – below the table - the type of activity/service they should carry out:
Company
Name /
Location (City
and/or State)
Relationship
Project objectives
Name of
Organization
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Contacts / relationships already underway with companies / organizations / research centres, if
affirmative please indicate which ones and the type of common project:
Company
Name /
Name of
Organization
LOCATION Relationship Project objectives
(City and
Country)
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- WHAT WOULD YOU LIKE TO ACCOMPLISH AND WHAT CAN YOUR COMPANY
OFFER TO A US PARTNER?
Which type of project/cooperation would you like to realize with a US partner, please indicate the type
and detail the interest:
Transfer of know-how and technologies
Sale/purchase of patent
Licence Agreements
Sale of machinery/
equipment/devices…
Other (please specify)
_______________________________________________________________________________________
_______________________________________________________________________________________
Venture Capital
Venture Capital
JV/technological partnership
JV/financial partnership
JV/market partnership
JV/production partnership, new
products
Other (please specify)
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
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Co-operations, agreements, other kinds of partnerships
Scientific and technical co-operation
Agreement for commercial
distribution / logistics agreements
Production agreements
Agreements for local technical
assistance
Other (please specify)
_______________________________________________________________________________________
_______________________________________________________________________________________
___________________________________________________________________________________
What can your company offer to a potential US partner? briefly indicate strong points.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Date:
Signature of Company’s Legal Representative or Delegate
N.B. You authorize us to process and communicate, in accordance with Legislative Decree 196/2003 “Codice in
materia di protezione dei dati personali” (Personal data protection code), the data you have given us, which will only be
used in connection with the promotional activities of Toscana Promozione. In this specific case, the information
included in the form will be used for researching and contacting companies in USA, during the course of this initiative.
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