Dominican Republic

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

Clinical Trial Application	Brazil 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, your CRO will need to obtain coverage on your behalf.
Standard Limits	Between 1.000.000 and 5.000.000 USD for the whole duration of the protocol
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Portuguese • Brazilian Tax ID (CNPJ number) • Legal Representative in Brazil or Local CRO details (Contact Person Name, Address, Telephone Number and E-Mail Address) No refund for policy cancellation PLEASE READ: In addition to Sponsor binding approval, the Local Broker will issue the local quotation to the Brazilian CRO/Entity for confirmation of binding. Sponsor to follow-up with CRO to confirm binding and relay back to ABD. THE PROCESS TO ISSUE DOCUMENTS IS SLOW. PLEASE ALLOW ENOUGH TIME AS WE ARE NOT ABLE TO EXPEDITE DOCUMENTS. It is very SLOW due to all of the intermediaries involved. Please allow a minimum 2 months before receipt of documentation. Brazil can take 7-10 days to receive quote and about 4-6 weeks to receive the documentation. Please allocate this additional time into your submission process. Submission should be made to ABD at least one month before documents are required.