Ukraine

Clinical Trial Application	Ukraine Clinical Trial Quote Request Clinical Trials Quote Request
Mandated Coverage	Yes
Standard Limits	Limit per protocol = 10.000 USD x number of patients
Tail Coverage	3 years
Data Required to Quote	The process is SLOW. Please allow additional time for processing. Typically up to 3 weeks • Clinical Trial Quote Request • Protocol and Informed Consent Form in English • Protocol Title in Ukrainian • Certificate of Incorporation of Sponsor (for new Sponsors in Ukraine only) • Name and Title of Authorized Signatory who will countersign policy • Name of document which gives the Signatory the authorization to countersign the policy. (i.e. Charter, Power of Attorney, Resolution by the Board of Directors) - Ukraine requires payment and payment confirmation documentation PRIOR to release of certificate - No refund for policy cancellation - Original documents are not required to be delivered to the local CRO. Only require copy of the Certificate which is issued by the carrier once the premium has been received

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