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"

Clinical Trial Application	Albania Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Unknown. Please confirm with your CRO
Standard Limits	50.000 €/patient 1.000.000 €/protocol 1.000.000 €/period of insurance
Tail Coverage	18 Months
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 Advise if an original copy of the Policy is required for Sponsor's files. Payment to be made directly by Sponsor within 14 days of receiving the Policy. Only a Policy is provided. No certificate. No refund for policy cancellation