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	Vietnam Clinical Trial Quote Request
Mandated Coverage	Unknown. Please confirm with CRO.
Standard Limits	Unknown
Tail Coverage	Unknown
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Local Legal Representative/CRO details (Full Entity name, Address, Telephone Number and E-mail Address) No refund for policy cancellation