Indonesia

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

Clinical Trial Application	Oman Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes, in most cases. Some ECs may accept the Master policy as evidence of coverage
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Legal Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address) • Signed and completed Hold Harmless Agreement (to be provided separately by ABD Life Science team) • Copy of the entity’s Commercial Register showing evidence that local company/entity is policy holder - Oman requires a local company/entity to be the policy holder. - Anti-Money Laundering regulations for Oman require that carriers provide evidence the policy holder is a registered company/entity in Oman – a copy of the entity’s Commercial Register - No refund for policy cancellation