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	Pakistan 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 • Local CRO/Legal Representative details (Contact Person Name, Address, Telephone • Number and E-Mail Address), Tax Number and Sales Tax Number The Legal Representative is responsible for providing the following: • Tax number and sales tax number • Board resolution for insurance purposes • List of members/directors • Identity document of the person authorized to deal with the insurance carrier - Pakistan requires payment and wire payment confirmation PRIOR to release of documentation - Sponsor pays the carrier directly once invoice is provided - No refund for policy cancellation Quote process is VERY slow in Pakistan due to fronting and reinsurance carriers. Submission should be made to Newfront at least 45 days before documents are required.