Letter of Intent

Production information

Complete the form below if you are interested in pursuing any commercial activities related to photography, film, videotaping or any other electronic media. The Film Office will provide the most up-to-date requirements necessary for the municipality for which you are interested.

IMPORTANT NOTE: Please be as specific, accurate and complete as possible as this information will be used to assess your request and to populate your permit, if and when issued.

First Name:

Last Name:

Applicant/Contact's Job Title:

Production Co. Full Legal Name:

Include "LLC," "Inc.," etc. This will be the entity named on your film permit.

Project Name/Working Title:

Company Address:

City:

State:

Zip:

Country:

Email:

Phone:

Fax:

Budget:

Potential Economic Impact:

General Information/Purpose:

Type of Shoot:

If other, please specify:

Do you know where you want to shoot

If so, where? If not, describe your requirements so we may provide suggestions:

Notes/Requirements on Location:

Please list specific areas of the location(s) and provide as many details as possible

Upload Map/Diagram (optional):

Dates/Times:

Total Cast & Crew Size:

Equipment:

Vehicles:

Any traffic control or disruption to local activity?:

Yes No

If so, briefly describe:

Any weapons, incendiary effects or police/military wardrobe?:

Yes No

Will you require any hotels, catering services or other accommodations?:

Any questions for us?:

What brought you to Westchester for locations?:

Summary of insurance requirements

For projects on the property or otherwise under the jurisdiction of Westchester County, your production must provide:
1. A valid certificate of insurance, with a minimum limit of $2 million for general liability, naming:
"County of Westchester, 148 Martine Ave., White Plains, NY 10601" as additional insured.
If you fail to use that exact wording and address, your permit may be delayed or denied.
2. Proof of workers compensation insurance on NYS Form C-105.2. New York State statutory limits apply.
Additional insurance may be required depending the nature of the project.
Complete requirements are specified in Schedule B of your location agreement and permit.

Read & understood.

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