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INTERNSHIP AGREEMENT Note: The jury of which the student reports will not allow him to complete his PAE (Student Academic Program) with the internship credits while this student has not passed all the credits attached to the bachelor program. This principle respects art. 100 paragraph. 2 of the Decree (7 November 2013), defining the landscape of higher education and the academic organization of studies. This article allows the jury to establish a program of less than 60 credits by not including professional integration activities for which the student would not have acquired the prerequisites (that can not be transformed into co-requisites). BETWEEN: 1. The Université libre de Bruxelles, a university acting as a legal person by virtue of the law of 12 August 1911, amended by the law of 28 May 1970 and the decree of 31 March 2004, having its registered office in Av. Franklin Roosevelt, 50, 1050 Brussels, Belgium, and represented by the Dean of the Faculty. Mr. Pablo LHOAS Registration number: 46589 Hereinafter referred as the ULB or the University 2...... (Name of the organization hosting the internship) represented by Mr./Ms. Name Surname Address : Av.... Nr PB.. Postal number Locality.. Country Tel:..... Fax:...... E-mail:....... Hereinafter referred as the Host Company or the Host Institution. 3. Mr./Ms... A student studying in Master of Architecture Program number: MA-ARCH... Registration number.. Tel:.. Fax:.. E-mail:....@ulb.ac.be Hereinafter referred to as the Student or the trainee. Each individually hereinafter referred to as a party and collectively as the parties. Article 1: Subject of the Agreement This agreement governs the relations between the parties and their respective rights and obligations within the framework of the organisation of the internship figuring in the programme. This internship (UE STAG-P-5001) is mandatory in order to obtain the diploma certifying the Master Degree in Architecture (MA-ARCH) organised by the Faculty of Architecture. GM - Updated on 30/01/2017 1

Article 2: The Student s status The main purpose of the internship is to allow the practical application of the theoretical knowledge acquired at the ULB and to complete the Student s professional training. The internship is organised by the management of the Host Company in close collaboration with the ULB. The Host Company shall under no circumstances require the Student to undertake tasks not within the scope of his/her training. The internship shall take place from (DD/MM/YYYY). to... full-time Working days and hours:........ a one day/half day 1 per week, the., will be free for the student s academic training (optional, tick it if necessary). Address where the internship will take place (if different to the one stated above in the Host Company): Av... Nr PB.. Postal number Locality Country... The Student must remain registered at the ULB. For the duration of the internship and within the limits of the current academic year, the Student s registration at the Université libre de Bruxelles will allow him/her to maintain/preserve his/her student status. Article 3: Internship content and supervision Objective of the internship: To recap, the Master course STAG-P-5001 is to allow students to concretely apprehend a prime aspect of professional life of architect and, to initiate or develop their professional skills. It can be done as part of a traditional architecture agency work as well as in experimental and professional prospective in the field of architecture. The student will foster the choice of an internship program based on his personal research in line with his studio work related with specific courses chosen and / or his Master s thesis. Students seek an internship with a tutor who will actually allow him to experiment his professional choice in the area of student interests. 1 Cross out the option not selected. GM - Updated on 30/01/2017 2

In this specific case:...... Description of the tasks or functions assigned to the Student (to be specified as precisely as possible):............ Specific modalities with regard to the execution of these tasks or functions:.......... The Student s integration into the Host Company: Coordinator (person assuming responsibility for the Student during the internship): Mr/.Ms. Name.... Surname.... Position:.. Tel.:... Fax:. E-mail: Person at the ULB to be contacted in the case of any difficulty (academic mentors): Permanent Teachers : Ms Geneviève Martin +32 (0) 2 639 24 29 genevieve.martin@ulb.ac.be Ms Christine Godfroid +32 (0) 2 639 24 31 christine.godfroid@ulb.ac.be Secretary : Ms Najat Verreycken +32 (0) 2 643 66 73 najat.verreycken@ulb.ac.be Ms Kahina Benyacoub +32 (0) 2 643 66 73 kahina.benyacoub@ulb.ac.be GM - Updated on 30/01/2017 3

Article 4: The Student s Obligations During the internship, the Student must adhere to the Host Company s internal rules and regulations and to the instructions given by those in charge of organising the internship. Any sick leave must be backed up by a doctor s certificate. The Student undertakes not to keep in his/her possession, take away or copy any document of any kind belonging to the Host Company without the prior agreement of the Host Company s representative. The University itself undertakes that its staff shall respect the confidentiality of all information it may become aware of through the Student s internship. Article 5: Risk assessment In application of the Royal Decree (AR) of 21 September 2004 on the protection of trainees on work placements (amended by the AR of 30/09/2005) and in accordance with said decree, the Host Institution declares that the trainee does not need health monitoring when considered as not being exposed to any risk, insofar as the trainee has had a school medical check-up within the last five years: YES - NO ([1]) Should any risk subsist requiring health monitoring under the terms of the law, the Host Institution would like to ([2]) a) perform itself the health monitoring associated with the trainee's activities; b) make use of the service offered by the ULB-Erasmus-Bordet Joint Prevention and Work Protection Department (Service Commun de Prévention et de Protection au Travail) to monitor the trainee's health. For this purpose, the Host Institution shall provide the Application form: trainee health monitoring (see Annex 1) AND a document compiled by the Host Institution describing the risks assessed at the trainee s workplace. This document must cover: a description of the workplace, the preventive measures to be applied the necessity for health monitoring [1] Cross out where not applicable [2] Cross out the option (a or b) not selected GM - Updated on 30/01/2017 4

mandatory examinations and/or vaccinations measures with regard to maternity protection the contact data of the prevention counsellor - company doctor at the place of work. The trainee, once he/she has these TWO documents, must ring up the ULB-Erasmus Occupational Medicine Department (Tel. 02 555 37 80) for an appointment. The actual check-up takes place either at Solbosch or Erasmus. Whatever the case, the conclusion of the health monitoring examination is specified on the health assessment form (see Annex 1) and handed back to the trainee (with a copy sent to the Faculty). Article 6: Early termination. Should either party fail to respect its obligations under this agreement, each other party may terminate this Agreement, after formal notice has been given to the party at fault and when this has not been acted upon within 8 days. This will also apply in the case of any misconduct on the part of the Student, whereby the ULB retains the right to apply disciplinary measures. Article 7: Compensation Unless otherwise agreed between the Student and the Host Company, the internship takes place without any remuneration 2, though the Student may be compensated for any expenses incurred. Any remuneration for the student needs to be discussed between the Student and the host company, as the University cannot take part in such matters. The insurance included in the internship agreement only take effect in case of a gratuity (e.g. contribution to the cost of transport, shelter costs ) but will NOT cover the student if the internship is remunerated with a salary. If a salary is paid, the company has to issue its own agreement and its own contract/insurance. In case of gratuity, please complete the table below. Description Amount 2 Under French legislation, compensation is mandatory GM - Updated on 30/01/2017 5

Article 8: Insurance / civil liability The student will not be covered by the assurances if he/she has not paid the ULB registration fees. 1. Insurance against accidents and waiver * For accidents occurring on the way from his/her home to the internship workplace or viceversa, the Student is covered by ETHIAS insurance policy 45.045.747. Similarly, for any accident at the internship workplace, he/she is covered by ETHIAS insurance policy 65.695.22. In the case of an accident the internship coordinators undertake to immediately inform the ULB (the academic mentor) and to have the accident recorded by a doctor. The Student must inform the ULB s insurance department without delay of the accident using the form available on the University s website: http://www.ulb.ac.be/df/docs/accstage.pdf If the accident occurs while travelling between home and the internship workplace or viceversa, the Student should use the following form: http://www.ulb.ac.be/df/docs/accidentsmap.pdf If, however, the Student and the Host Company have reached a specific paid internship agreement, the Student will not be covered by the above-mentioned policies (policy no. 45.045.747-65.695.22). In that case, the Host Company undertakes to insure the Student against personal accidents at the workplace and while travelling between home and workplace. 2. Third-party liability cover and waiver * The ULB has signed a contract with ETHIAS insurance policy no. 45.072.897 providing thirdparty liability cover for its students. This covers the Student during his/her internship but not while travelling between home and workplace. Damages to the Student s property are explicitly excluded from the cover. It is agreed that as part of the internships organised by the University, the guarantee of third-party liability cover also applies to the Student s designated internship coordinators. This coverage extension applies only in cases of lack of cover or after all other cover available to the internship coordinators (in particular all professional liability coverage) has been applied (ETHIAS insurance policy 45.072.897). *Items 1 and 2 The policy includes a clause stating that Ethias waives its right to take action against the management and employees of the Host Company, except in cases of gross negligence. GM - Updated on 30/01/2017 6

3. Insurance cover when travelling abroad (illness accident repatriation) When doing an internship abroad, the Student is covered by the terms and conditions of ETHIAS policy no. 45.084.129 24/7 tel. - ETHIAS Assurances: tel. 00/32.4.220.30.40 E-mail ethias-assistance@ethias.be Article 9: Internship report. At the end of the internship, the Student shall submit a typed report describing the work done and any personal output related to the work internship. This report is taken into account in the final evaluation of the internship. The ULB may also request the Host Company to assess the Student s work. Article 10: Internship certification Internship certification is within the responsibility of the examination board of the teaching department concerned. Article 11: Special provisions Any special provision shall be annexed to this agreement and countersigned by all parties. Should any such special provision and the terms of this Agreement differ, the provisions set forth in the latter shall prevail. Article 12: Disputes Any dispute relating to this Agreement comes under the jurisdiction of the Brussels courts. GM - Updated on 30/01/2017 7

Drawn up and signed in triplicate in Brussels on. Each party acknowledges having received his own original copy. The Student For the University, Dean of the Faculty (Signature) (Signature and stamp) For the Host Company Academic mentor (Signature and stamp) (Signature) GM - Updated on 30/01/2017 8