India

Clinical Trial Application	India Specific Clinical Trial Quote Request
Mandated Coverage	Yes
Standard Limits	From 1 to 5 Million USD in aggregate
Tail Coverage	6 months (up to 1 year available for an additional premium)
Data Required to Quote	• Country-specific Application and Application must be printed and signed PRIOR to binding coverage • Protocol and Informed Consent Form in English • A local entity must be named as the Policyholder (Investigator or CRO) - No refund for policy cancellation - India requires payment to the carrier PRIOR to release of certificate To bind coverage: • provide Permanent Account Number (PAN) of the Local CRO. PAN number is a ten-digit alphanumeric number, issued in the form of a laminated card by the Income Tax Department • provide Good and Services Tax (GST) number of the Local CRO Please allow additional time for processing. Please allow at least one month before issuance of policy documents

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"