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ECG Analysis Report with Mean Comparator Change

Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947854

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 2 / DAY 21 / PRE DOSE
23-DEC-2015
13:26:05

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

13-MAR-1958
5009002

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: V5
Heart Rate (bpm) :

Mean
81

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

744

N/A

N/A

PR Interval (ms) :

163

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

93

N/A

N/A

387

N/A

N/A

424

N/A

N/A

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

A Nagamani
10-JUL-2016 22:00 ET

Date: ____________________________

Generated on: 10-JUL-2016 22:05:53


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 10-JUL-2016 22:05:53

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947854
COLLECTED: 23-DEC-2015

13:26:05

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947866

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 3 / DAY 15 / 1.5 POST DOSE
08-OCT-2015
12:24:42

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

24-JAN-1948
5009001

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
68

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

880

N/A

N/A

PR Interval (ms) :

138

N/A

N/A

83

N/A

N/A

375

N/A

N/A

393

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:47 ET

Findings
Conduction:

Left Anterior Hemiblock

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:52:56


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:52:56

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947866
COLLECTED: 08-OCT-2015

12:24:42

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947867

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 3 / DAY 15 / PRE DOSE
08-OCT-2015
10:36:48

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

24-JAN-1948
5009001

Interval Duration Measurements


Warren, Dominic
Lead Reversal

Collected By:
Tracing Quality:
Lead Analyzed: V4
PR Interval (ms) :

Mean
129

Comparator
Mean
N/A

Change
N/A

Lead Analyzed: V6
Heart Rate (bpm) :

Mean
66

Comparator
Mean
N/A

Change
N/A

909

N/A

N/A

95

N/A

N/A

QT Interval (ms) :

395

N/A

N/A

QTc Fridericia's (ms) :

405

N/A

N/A

RR Interval (ms) :
QRS Interval (ms) :

Evaluation
Interpretation:

Abnormal

Evaluation Comments:

Limb Lead Reversal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:47 ET

Findings
Conduction:

Left Anterior Hemiblock

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:52:38


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:52:38

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947867
COLLECTED: 08-OCT-2015

10:36:48

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947863

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 2 / DAY 8 / PRE DOSE
03-SEP-2015
09:17:16

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

24-JAN-1948
5009001

Interval Duration Measurements


Warren, Dominic
Missing Leads

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
60

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

995

N/A

N/A

PR Interval (ms) :

142

N/A

N/A

77

N/A

N/A

390

N/A

N/A

391

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:47 ET

Findings
Conduction:

Left Anterior Hemiblock

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:52:26


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:52:26

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947863
COLLECTED: 03-SEP-2015

09:17:16

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947860

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 1 / DAY 15 / 1.5 POST DOSE
20-AUG-2015
11:48:15

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

24-JAN-1948
5009001

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
60

Comparator
(3 of 3)
Mean
61

Change
-1

RR Interval (ms) :

1002

985

17

PR Interval (ms) :

137

131

79

84

-5

QT Interval (ms) :

396

406

-10

QTc Fridericia's (ms) :

396

408

-12

QRS Interval (ms) :

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:47 ET

Findings
Conduction:

Left Anterior Hemiblock

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:52:14


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:52:14

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947860
COLLECTED: 20-AUG-2015

11:48:15

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947833

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
UNSCHEDULED PREDOSE
23-MAR-2016
14:51:56

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

05-OCT-1939
5009003

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
94

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

641

N/A

N/A

PR Interval (ms) :

197

N/A

N/A

83

N/A

N/A

361

N/A

N/A

418

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:43 ET

Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: / /

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:49:47


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:47

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947833
COLLECTED: 23-MAR-2016

14:51:56

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947845

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 2 / DAY 1 / LEE011 4 POST
DOSE
02-FEB-2016
14:17:48

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:

Comparator
Mean
N/A

Change
N/A

813

N/A

N/A

159

N/A

N/A

83

N/A

N/A

QT Interval (ms) :

443

N/A

N/A

QTc Fridericia's (ms) :

475

N/A

N/A

Lead Analyzed: II
Heart Rate (bpm) :

Mean
74

RR Interval (ms) :
PR Interval (ms) :
QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

A Nagamani
07-JUL-2016 23:44 ET

Date: ____________________________

Generated on: 07-JUL-2016 23:49:45


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:45

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947845
COLLECTED: 02-FEB-2016

14:17:48

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947836

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
UNSCHEDULED 1.5 POSTDOSE
04-JAN-2016
16:45:56

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

05-OCT-1939
5009003

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
69

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

875

N/A

N/A

PR Interval (ms) :

205

N/A

N/A

86

N/A

N/A

432

N/A

N/A

452

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:43 ET

Findings
Conduction:

First Degree AV Block

Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: RUNIN CYCLE 3 / DAY 15 / 1.5 POST DOSE

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:49:22


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:22

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947836
COLLECTED: 04-JAN-2016

16:45:56

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947848

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 21 / LEE011 4 POST
DOSE
27-JAN-2016
14:32:50

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
73

RR Interval (ms) :
PR Interval (ms) :

Comparator
(3 of 3)
Mean
66

Change
7

817

913

-96

164

177

-13

75

82

-7

QT Interval (ms) :

422

432

-10

QTc Fridericia's (ms) :

451

445

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

A Nagamani
07-JUL-2016 23:44 ET

Date: ____________________________

Generated on: 07-JUL-2016 23:49:25


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:25

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947848
COLLECTED: 27-JAN-2016

14:32:50

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947841

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 2 / DAY 15 / 1.5 POST DOSE
16-FEB-2016
12:18:28

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
76

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

789

N/A

N/A

PR Interval (ms) :

162

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

74

N/A

N/A

435

N/A

N/A

471

N/A

N/A

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

A Nagamani
07-JUL-2016 23:44 ET

Date: ____________________________

Generated on: 07-JUL-2016 23:49:13


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:13

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947841
COLLECTED: 16-FEB-2016

12:18:28

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947838

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 1 / DAY 15 / 1.5 POST DOSE
23-NOV-2015
13:01:20

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

05-OCT-1939
5009003

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
78

Comparator
(3 of 3)
Mean
81

Change
-3

RR Interval (ms) :

768

735

33

PR Interval (ms) :

205

182

23

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

79

91

-12

379

368

11

413

407

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

A Nagamani
07-JUL-2016 23:43 ET

Findings
Conduction:

First Degree AV Block

Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: RUNIN CYCLE 1 / DAY 15 / PRE DOSE

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 23:49:00


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 23:49:00

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947838
COLLECTED: 23-NOV-2015

13:01:20

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947843

Subject Information
Date of Birth:
7 Digit Subject Number:

5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
UNSCHEDULED PREDOSE
02-FEB-2016
08:51:14

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

13-MAR-1958
5009002

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
65

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

929

N/A

N/A

PR Interval (ms) :

174

N/A

N/A

74

N/A

N/A

414

N/A

N/A

424

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

Muhammad Iqbal
07-JUL-2016 17:19 ET

Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: PART 2 CYCLE 2 / DAY 1 / PRE DOSE

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 17:28:45


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:28:45

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947843
COLLECTED: 02-FEB-2016

08:51:14

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947849

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 8 / PRE DOSE
13-JAN-2016
12:16:52

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
68

Comparator
(3 of 3)
Mean
66

Change
2

RR Interval (ms) :

881

913

-32

PR Interval (ms) :

171

177

-6

75

82

-7

QT Interval (ms) :

413

432

-19

QTc Fridericia's (ms) :

431

445

-14

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:19 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:28:16


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:28:16

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947849
COLLECTED: 13-JAN-2016

12:16:52

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947853

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 1 / 1.5 POST DOSE
08-JAN-2016
12:22:11

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
65

Comparator
(3 of 3)
Mean
66

Change
-1

RR Interval (ms) :

921

913

PR Interval (ms) :

180

177

81

82

-1

QT Interval (ms) :

419

432

-13

QTc Fridericia's (ms) :

431

445

-14

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:19 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:54


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:54

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947853
COLLECTED: 08-JAN-2016

12:22:11

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947830

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 8 / 1.5 POST DOSE
13-APR-2016
11:50:10

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

05-OCT-1939
5009003

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
92

Comparator
(3 of 3)
Mean
81

Change
11

RR Interval (ms) :

653

738

-85

PR Interval (ms) :

193

183

10

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

76

97

-21

364

369

-5

419

409

10

Evaluation
Interpretation:

Abnormal

Evaluation By:
Evaluation Date/Time:

Muhammad Iqbal
07-JUL-2016 17:20 ET

Findings
Ectopy:
T Waves:

Atrial Premature Complexes


Flat

For Site Use Only.


Investigator Signature: __________________________________________________

Date: ____________________________

Generated on: 07-JUL-2016 17:27:53


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:53

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947830
COLLECTED: 13-APR-2016

11:50:10

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947856

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
RUNIN CYCLE 2 / DAY 8 / 1.5 POST DOSE
11-DEC-2015
12:41:44

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
56

Comparator
Mean
N/A

Change
N/A

RR Interval (ms) :

1067

N/A

N/A

PR Interval (ms) :

183

N/A

N/A

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

81

N/A

N/A

438

N/A

N/A

429

N/A

N/A

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:19 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:40


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:40

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947856
COLLECTED: 11-DEC-2015

12:41:44

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947831

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 8 / PRE DOSE
13-APR-2016
10:12:03

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

05-OCT-1939
5009003

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
80

Comparator
(3 of 3)
Mean
81

Change
-1

RR Interval (ms) :

746

738

PR Interval (ms) :

195

183

12

QRS Interval (ms) :


QT Interval (ms) :
QTc Fridericia's (ms) :

79

97

-18

364

369

-5

401

409

-8

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:20 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:27


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:27

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947831
COLLECTED: 13-APR-2016

10:12:03

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947846

Subject Information
Date of Birth:
5009
7 Digit Subject Number:
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 21 / LEE011_1.5 POST
DOSE
27-JAN-2016
11:48:52

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

13-MAR-1958
5009002

Interval Duration Measurements


Thompson, Zadora
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
70

RR Interval (ms) :
PR Interval (ms) :

Comparator
(3 of 3)
Mean
66

Change
4

862

913

-51

163

177

-14

81

82

-1

QT Interval (ms) :

419

432

-13

QTc Fridericia's (ms) :

440

445

-5

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:19 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:23


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:23

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947846
COLLECTED: 27-JAN-2016

11:48:52

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947852

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 1 / LEE011 4 POST
DOSE
08-JAN-2016
15:43:13

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

13-MAR-1958
5009002

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
68

RR Interval (ms) :
PR Interval (ms) :

Comparator
(3 of 3)
Mean
66

Change
2

882

913

-31

168

177

-9

74

82

-8

QT Interval (ms) :

417

432

-15

QTc Fridericia's (ms) :

434

445

-11

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:19 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:02


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:02

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947852
COLLECTED: 08-JAN-2016

15:43:13

Page 2 of 2

ECG Analysis Report with Mean Comparator Change


Sponsor:
Protocol:
Account:
Transmittal Number:

Array BioPharma Inc.


CLGX818X2109
746874
12947832

Subject Information
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 2 CYCLE 1 / DAY 1 / LEE011 4 POST
DOSE
06-APR-2016
17:15:36

Site ID:
Investigator Name:
Address:

Visit:
Collection Date:
Collection Time:

Date of Birth:
7 Digit Subject Number:

05-OCT-1939
5009003

Interval Duration Measurements


Warren, Dominic
Good Tracing

Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :

Mean
82

RR Interval (ms) :
PR Interval (ms) :

Comparator
(3 of 3)
Mean
81

Change
1

728

738

-10

185

183

93

97

-4

QT Interval (ms) :

389

369

20

QTc Fridericia's (ms) :

433

409

24

QRS Interval (ms) :

Evaluation
Interpretation:

Normal

Evaluation By:
Evaluation Date/Time:

For Site Use Only.


Investigator Signature: __________________________________________________

Muhammad Iqbal
07-JUL-2016 17:20 ET

Date: ____________________________

Generated on: 07-JUL-2016 17:27:01


1818 Market Street
Philadelphia, PA 19103
United States of America

Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ

PROTOCOL:

Array BioPharma Inc. - CLGX818X2109

SITE:

5009

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:27:01

ERT

ACCOUNT: 746874

TRANSMITTAL: 12947832
COLLECTED: 06-APR-2016

17:15:36

Page 2 of 2

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