Argentina

Clinical Trial Application	Argentina Clinical Trial Quote Request
Mandated Coverage	Yes. Please confirm with CRO if your study requires coverage for Pregnant partners and unborn child before making a submission in this portal. If this is required, please note that this process takes longer.
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 • Site List in Spanish, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code • Local Legal Representative details (Contact Person Name, Address, Telephone Number, E-Mail Address) and C.U.I.T number. This person will be very involved in the insurance process and will receive the insurance documents. • If pregnant partner coverage is required please supply pregnant partner ICF No refund for policy cancellation The process is SLOW in Argentina so please allow additional time.

Clinical Trial Application	Tanzania Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	THE PROCESS IN TANZANIA IS SLOW. PLEASE ALLOW UP TO TWO MONTHS FOR DOCUMENTS TO BE PROCESSED. Please provide all documentation outlined below otherwise the process is further delayed. • Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Certificate of Incorporation of Sponsor • Sponsor Business License • Tax Identification Number (TIN) number (FEIN will suffice) - Premium payment required in advance of receipt of policy documents - No refund for policy cancellation