China

Clinical Trial Application	China Clinical Trial Quote Request
Mandated Coverage	Yes
Standard Limits	Unknown
Tail Coverage	3 months
Data Required to Quote	THE PROCESS TO ISSUE DOCUMENTS IS SLOW. China is a cash for cover country, meaning payment must be made PRIOR to the release of documentation. Please allow 2-3 weeks for documentation to be issued • Clinical Trial Quote Request Form • Protocol and Informed Consent in English • Protocol Title in Chinese • Legal Representative or Local CRO contact information (Contact Person Name, Address, Telephone Number and E-Mail Address). The Legal Representative is named on the Policy. The Sponsor is the Additional Insured • Provide the Business License of Sponsor • Provide the Business License pf Chinese CRO • Provide the ID Copy of representative of Chinese CRO • Premium payments are paid directly by the Sponsor to the carrier. No refund for policy cancellation • Only Policies are typically issued in China. If the EC requests a Certificate to be issued, the Insurer will provide

Clinical Trial Application	Dominican Republic Clinical Trial Quote Request Dominican Republic Due Diligence Form - Spanish (Persona Juridica)
Mandated Coverage	Yes and No. Clinical Trial Insurance is not compulsory, however, it is made mandatory as part of the MoH submission.
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 • Legal Representative in Dominican Republic or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address) • No refund for policy cancellation Due to strict Anti-Money Laundering laws, the Legal Representative (typically your local CRO) will be responsible for providing the following documents: (i) Due Diligence Form, available in Spanish only (to be completed by US Sponsor and each named insured, including additional insureds) (ii) Fiscal ID certificate (iii) Mercantile Registry (iv) ID of the person acting on behalf of the Legal Representative (v) Certificate of final beneficiary Process in the Dominican Republic is SLOW, so please allow for additional time - minimum 1 month before receipt of documentation after binding coverage