Contract number: [complete] Restricted FWC conditions of October 2018 
 
 
 
 
 
Annankatu 18, P.O. Box 400, FI -00121 Helsinki, Finland | Tel. +358 9 686180 | Fax +358 9 68618210 | echa.europa.eu  
 
 
Annex V - statements on pre-existing rights 
 
Annex – Declaration on the list of pre-existing rights (a) 
I, [insert name of the authorised representative of the contractor ] representing [insert 
name of the contractor ] (‘the contractor’) , party to the framework for Providing services 
on SEA ECHA/2019/191 [option 1: warrant that the results are free of rights or claims from 
creators or from any third parties for any use the contracting authority may envisage and 
declare that the results do not contain any pre-existing rights to the results or parts of the 
results or to pre -existing materials as defined in the above -mentioned contract.] [ option 
2: warrant that the results and the pre -existing material incorporated in the results are 
free of rights or claims from creators or from any third parties for any use the contracting 
authority may envisage and declare that the results contain the following pre -existing 
rights:] 
Please fill in the table – one line per pre-existing right 
Result concerned Pre-existing 
material 
concerned 
Rights to pre-
existing material 
Identification of 
rights’ holder 
    
    
 
Annex - Statement of contractor concerning rights to delivered results (b) 
I, [insert name of the authorised representative of the contractor ] representing [insert 
name of the contractor], party to the [framework] [specific] contract [insert title and 
number] (‘the contractor’) warrant that the contractor  holds all rights to the delivered 
results listed below [insert titles and description of relevant results].  
The above-mentioned results were prepared by [ insert names of creators ]. The creators 
transferred all their relevant rights to the results to [the contractor] [ insert name of the 
rights holder] through [an agreement] [an employment contract] [a relevant extract of] 
which is attached to this statement.  
The creators [received all their remuneration on [insert date]] [will receive all their 
remuneration as agreed within [complete] weeks from [delivery of this statement] 
[receipt of confirmation of acceptance of the work]. [The statement of the creators 
confirming payment is attached]. 
Date, place, signature 
Annex – Statement by the creator (or right holder) (c) 
Concerning [insert name of the relevant result] delivered as part of the 
[framework] [specific] contract [insert title and number]  
concluded between the contracting authority and [name of the contractor] 
I the undersigned [insert name of the creator or authorised representative of the right 
holder] [representing [insert name of the right holder]] declare that I am the right holder 
of: [identify the relevant parts of the result] [which I created] [for which I received rights 
from [insert name of other right holder]].