Colombia

Clinical Trial Application	Colombia Clinical Trial Quote Request
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 details (Contact Person Name, Telephone Number and E-mail Address) • Site List required in Spanish if a generic statement that all sites are covered by the policy is insufficient for the EC - Note that Colombian tax is 16%. There is currently no mechanism set up in Colombia for payment of taxes on non-admitted business - The carrier would evidence the tax on the policy, however they would not collect this so the Sponsor needs to be aware that this may become payable in the future

Clinical Trial Application	Indonesia Clinical Trial Quote Request
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 • Site List in English, inclusive of Full Name(s) of Principal Investigator(s), the Hospital(s)/Site Location(s) Address(es) with Area Code • Local Representative/CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address) - Premium payment and payment confirmation required PRIOR to release of certificate - No refund for policy cancellation Please allow additional time for processing