United Arab Emirates

United Arab Emirates

United Arab Emirates

United Arab Emirates

Clinical Trial Application

n/a

Mandated Coverage

Yes

Standard Limits

USD 2,000,000

Tail Coverage

12 months

Data Required to Quote

• Clinical Trial Quote Request
• Protocol and Informed Consent Form
• Local CRO/Legal Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address)

o Legal Representative details of the Sponsor in UAE to include authenticated documents proving ownership e.g. complete T/L, Share Certificate, Share Register, MOA, AOA, Annual Report, Ownership Chart etc. The document must clearly show the ownership % or holding shares and if there is any entity in the ownership pattern who holds >25% shareholding, futher ownership docs are required until the natural person with owning or controlling interests of >25% are identified.

o Completed KYC AML form

Ecuador

Ecuador

Clinical Trial Application

Ecuador Clinical Trial Quote Request

Ecuador Know Your Customer Form

Mandated Coverage

Yes

Standard Limits

n/a

Tail Coverage

n/a

Data Required to Quote

• Clinical Trial Quote Request
• Protocol and Informed Consent Form in English
• Protocol Title in Spanish
• Local Legal Representative/CRO details (Contact Person Name, Telephone Number and E-mail Address) and RUC number (Ecuadorian Tax ID)
• No refund for policy cancellation

- CRO or Local Legal Representative must provide the completed "Know Your Customer Form"