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Translation Agreement This Translation Agreement and all attachments and addenda thereto (collectively, the “Agreement”) is made effective as of this 29th day of April 2022 (the “Effective Date”) by and between International Health Terminology Standards Development Organisation (“IHTSDO”) operating as SNOMED International, registered address One Kingdom Street, Paddington, London W2.6BD, England, and Health and Welfare Information Systems Centre, Estonia, known here as “the Member”. WHEREAS, The IHTSDO desires that the Member agree to the requirements as specified in accordance with the terms of this Agreement. WHEREAS, the Member is willing to abide by the terms of this Agreement 1. Definition This agreement details the process to enable the IHTSDO to support members in their translation activities. The agreement supports the implementation of “IHTSDO Policy on Support for Member Country Translation” 2. Scope The agreement applies to all Members of the IHTSDO and all translations other than the IHTSDO managed Spanish translation. This agreement supports the policy, which is intended to supplement those related provisions in the Articles of Association and not replace them. Of particular relevance are the regulations around the ownership of intellectual property of derivations of SNOMED CT. The policy includes information on the practical considerations and on a financial provision designed to stimulate translation development. The policy does not concern itself with the technical considerations and methodology of translation development. 3. Agreement requirements IHTSDO will reimburse up to 100% of the agreed upon translation scope and costs per the policy after initiation of the translation development, provided the below conditions are met. The maximum amount of the agreement between IHTSDO and the Member under this agreement is 38,400 USD. Reimbursement will be 20% at project initiation (i.e. after the signing of this agreement), 60% when finalizing initial translation, and 20% after IHTSDO has performed quality assurance (QA) of translation process and approved that process. To obtain reimbursement, the Member must: Page 1 of 3   Supply invoices to IHTSDO. If the translation and/or quality assurance work has been outsourced, the invoices between the Member and those contractors must be submitted with the Member’s invoice to IHTSDO.  Provide quarterly progress reports to IHTSDO through the regional Customer Relations Lead or other designated IHTSDO representative. Within 6 months of project initiation, the Member must submit to IHTSDO for approval a set of quality metrics for use in evaluating the quality of the translation. If such a document is not approved by IHTSDO, additional reimbursements will be suspended until such time as they are approved. Final IHTSDO approval of the translation project, which is required for reimbursement of the final 20% of the total amount listed above, is conditional upon IHTSDO’s review and approval of an audit trail submitted by the Member. The audit trail must show how the following documents have been implemented or followed:  “Guidelines for Translation of SNOMED CT”  “Guidelines for Management of Translation of SNOMED CT”  “A methodology and toolkit for evaluating SNOMED CT Translation Quality.” (Background material is available at “Developing a methodology and toolkit for evaluating SNOMED CT Translation Quality – Background.”)  “IHTSDO Quality Assurance Framework” In addition, the final 20% reimbursement is contingent upon the Member providing the SNOMED CT translation to IHTSDO for publication via a central web-based library. The Member agrees to maintain the translation with an update cycle that is at least yearly. In the event of the Member not submitting a translation to IHTSDO or otherwise breaking the terms of the Agreement, fees already paid by IHTSDO to the Member shall be reimbursed from the Member to IHTSDO. 4. Responsibilities SNOMED CT is a dynamic product and translation is not a one-off exercise. Once the initial development phase is complete the member will establish an on-going service to ensure the translation is kept up to date The Member will make the translation available to the IHTSDO and other Members on an on- going basis this should be mean a minimum of an annual update. The IHTSDO will make the translation available to all members via appropriate means. If for any reason the member discontinues translation development, then the partial efforts will be made available to the IHTSDO. This allows any other Member at the time or in the future to continue the translation. Page 2 of 3 5. Intellectual property The intellectual property of the translation remains with the member, whilst the member remains as part of the IHTSDO. In the event of the member leaving the IHTSDO, the IHTSDO has the continued right to distribute the translation as it sees fit, with no obligation to the member. 6. Deliverables  Translation of content in specified format (RF2)  Updates to content translation (minimum annual update)  Translation of documents in agreed format IN WITNESS WHEROF, the parties hereto have caused this Agreement to be signed by duly authorized officers or representatives as of the Effective Date: HEALTH AND WELFARE INFORMATION INTERNATIONAL HEALTH SYSTEMS CENTRE, ESTONIA TERMINOLOGY STANDARDS DEVELOPMENT ORGANISATION Signature Signature MARGUS ARM DON SWEETE Print Name Print Name DIRECTOR CHIEF EXECUTIVE OFFICER Title Title Page 3 of 3