Moldova

Clinical Trial Application	Moldova Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 5.000 and 10.000 €/patient Limit per protocol = limit per patient x number of patients
Tail Coverage	n/a
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • No refund for policy cancellation

Clinical Trial Application	Mexico Clinical Trial Quote Request
Mandated Coverage	Yes
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	THE PROCESS IN MEXICO IS SLOW. PLEASE ALLOW UP TO TWO MONTHS FOR DOCUMENTS TO BE PROCESSED. Please provide all documentation outlined below otherwise the process is further delayed. PLEASE PROVIDE THE FOLLOWING INFORMATION • Clinical Trial Quote Request • Protocol and Informed Consent Form in English and Spanish • Protocol Title in Spanish • The following documents to be provided by the Sponsor: (i) Copy ID of the legal representative of the Sponsor (this should be the same as the person completing the form) (ii) Proof of address of the sponsor (not older than 3 months) (iii) Document confirming the legal establishment of the sponsor ---> Legal representative details of the Sponsor in Mexico Note the Legal Representative will be responsible for providing the following documents: (i) Copy of the Memorandum of Association registered upon the Property & Commerce Public registry (ii) Copy of the Fiscal Identification Schedule (RFC) (iii) Copy of an Official Identification and Notary’s Testimony of the local CRO (iv) Copy of a Domicile Voucher