Tanzania

Clinical Trial Application	Tanzania Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	n/a
Tail Coverage	n/a
Data Required to Quote	THE PROCESS IN TANZANIA 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. • Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Certificate of Incorporation of Sponsor • Sponsor Business License • Tax Identification Number (TIN) number (FEIN will suffice) - Premium payment required in advance of receipt of policy documents - No refund for policy cancellation

Clinical Trial Application	Luxembourg Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Between 400 and 500.000 €/patient Between 3M and 5M €/protocol
Tail Coverage	3 years
Data Required to Quote	• Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in French • 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 EU Representative details (Contact Person Name, Address, Telephone Number and E-Mail Address)