2013 ipg agency handbook

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The Interpublic Group Of Companies Blanket Production Insurance Program Television / Print Agency Production Handbook

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2013 Ipg Agency Handbook

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Page 1: 2013 Ipg Agency Handbook

The Interpublic Group Of Companies Blanket Production Insurance Program Television / Print Agency Production Handbook

Page 2: 2013 Ipg Agency Handbook

 

 

Aon/Albert G. Ruben Insurance for the Business of Entertainment

 

Overview The Interpublic Group (IPG) maintains a Production Insurance Program that provides the types of insurance coverage the Production Company / Photographer will typically need to produce your project. A complete schedule of the coverages provided is included in this Handbook. PLEASE NOTE THAT ALL DECLARATIONS are to be submitted to: [email protected] The Insurance Program does not provide Workers’ Compensation & Employer’s Liability, or Owned Automobile coverage. These coverages must be maintained by the Production Company/Photographer under their own insurance policy. If you have a claim

Production Company must immediately notify Aon, in writing, of any claims, threats of claims, suits, damage to property or any other loss. To ensure timely settlement of the claim, Production must provide all necessary documentation in support of your claim(s) on a timely basis. Production must also cooperate with and permit Aon and its insurance carriers to conduct the investigation and defense of all claims, suits or losses.

Higher-hazards and Special Risk Coverage

Production Company must advise Aon and Agency Insurance Program, in writing, of any special risks associated with your project. This includes: stunts, pyrotechnics, precision driving, aircraft, watercraft, railroads, foreign activities, animals, or any unusual or hazardous exposures and/or conditions involving either cast or crew.

Page 3: 2013 Ipg Agency Handbook

VERSION 3.2012 2

TABLE OF CONTENTS:

Aon/Albert G Ruben Sevice Team.................................................................................. 3 Instructions for Declaring a Job & Issuing Certificates.................................................. 4 Special Coverage Notice ................................................................................................ 6 Special Coverage Questionnaires.................................................................................. 7 Claim Reporting Forms................................................................................................... 23 Overview of Insurance Coverage…….…………………………………………………………………………………..26 Appendix

Declaration Form Addendum

Page 4: 2013 Ipg Agency Handbook

AON / ALBERT G RUBEN SERVICE TEAM Kristi Jones Vice President - Entertainment Account Executive

Office Phone: Cell Phone: Direct Fax: Email:

(818) 742-0840 (213) 590 3373 (847) 953-0885 [email protected]

Anthony Catanzaro Vice President - Entertainment

Office Phone: Direct Fax: Email:

(212) 337-4352 (847) 953-7503 [email protected]

James Pedrick Assistant (Certificates)

Office Phone: Email:

(212) 337-4356 [email protected]

Emergency: Laura Comerford Sr. Vice President – Entertainment Account Executive

Direct Fax: Email:

(847) 953-0886 [email protected]

CLAIM CONTACT Maria Clark Claims Manager

Office Phone: Direct Fax: Email:

(212) 463-5583 (847) 953-0892 [email protected]

Page 5: 2013 Ipg Agency Handbook

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Instructions for Declaring a Production Job to the Insurance Program

1. Agency completes the Declaration Form (see Appendix) 2. Email Declaration Form AND AICP, AICE, Storyboards/Treatments

and any other pertinent documents to: [email protected] Agency may also contact a Aon Service Team member as needed.

3. Aon will review submitted documents and contact the Production

Company to complete “Special Coverage Checklist Exhibit B” (sample on page 8) and provide evidence of Workers Compensation Coverage.

4. When Aon receives completed Checklist/Exhibit B and evidence of

Production Company Work Comp coverage Aon will email a Award Letter, Production Manual and Certificate of Insurance to Production Company with copy to Agency.

5. Agency will be emailed an Invoice for the premium.

6. The premium is determined by A-K + Directors Fee + Editorial less

mark-up X Rate = Premium

7. If special coverages are needed Aon will work with Production Company and Agency to obtain the necessary additional information to secure the coverage when possible. Additional Premiums may apply and Agency will be invoiced for additional premiums.

8. Claims are sent to Maria Clark – [email protected] and

[email protected] The Production Manual provides complete instructions for Production Company and Agency to submit a claim if needed.

Page 6: 2013 Ipg Agency Handbook

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Instructions for Issuing Certificates of Insurance

PRE-PRINTED CERTIFICATES OF INSURANCE ARE ISSUED TO THE PRODUCTION COMPANY FOR YOUR CONVENIENCE AND TO ENABLE THE PRODUCTION TO EFFICIENTLY EVIDENCE INSURANCE COVERAGE AS NECESSARY IN CONNECTION WITH A DECLARED JOB. CERTIFICATES ARE ISSUED FOR A SPECIFIC JOB AND CAN ONLY BE USED IN CONNECTION WITH THAT JOB ONLY. TO ISSUE A CERTIFICATE:

1. TYPE DATE IN UPPER RIGHT HAND CORNER 2. TYPE THE NAME AND ADDRESS OF THE VENDOR IN CERTIFICATE HOLDER BOX 3. TYPE IN THE HOLDER BOX (UNDER NAME AND ADDRESS OF VENDOR) THE TYPE OF VENDOR/SUPPLIER FOR WHOM SUCH CERTIFDICATE HAS BEEN ISSUED.

YOU MAY NOT ALTER, REVISE, AMEND, ADD TO OR CHANGE THE

CERTIFICATE OR THE INFORMATION CONTAINED THEREON IN ANY MANNER WHATSOEVER OTHER THAN AS EXPRESSLY PROVIDED IN 1-3

ABOVE. PRODUCTION COMPANY MAY NOT ISSUE ANY CERTIFICATE OF INSURANCE WHICH INVOLVES THE USE OF: ANIMALS OR HORSES, STUNTS, RACING/RACE CARS, WATERCRAFT, AIRCRAFT, RAILROAD, PYROTECHNICS, JEWELRY OR FINE ARTS OR ANY HAZARDOUS AND/OR UNUSUAL FILMING ACTIVITIES OR TO ANY VENDOR, SUPPLIER OR LOCATION OUTSIDE THE U.S. AND CANADA. Contact your Aon/Albert G Ruben Account Service Contact for any additional Instructions that may be needed. Should any certificate upon presentation be unacceptable to any third party or vendor contact your Aon/Albert G. Ruben contact immediately. UPON ISSUANCE OF ANY CERTIFICATE OF INSURANCE IMMEDIATELY MAIL OR EMAIL ONE (1) COPY OF EACH CERTIFICATE ISSUED TO:

Aon/Albert G. Ruben at [email protected] Or mail to: Aon / Albert G Ruben NY 171 Madison Avenue, Suite 401, New York, New York 10016

WHEN CONTACTING AON / ALBERT G RUBEN PLEASE REFERENCE THE CLIENT, JOB AND ADVERSTING AGENCY SO WE MAY BETTER ASSIST YOU.

Page 7: 2013 Ipg Agency Handbook

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Special Coverage

1. SHOULD THE PRODUCTION INVOLVE ANY OF THE BELOW LISTED ACTIVITES OR AS NOTED ON THE “SPECIAL COVERAGE CHECKLIST” COMPLETE THE APPROPRIATE ATTACHED QUESTIONAIRE:

Aircraft

Watercraft

Railroads

ANY AND ALL Stunts

Filming in Foreign or Remote Locations

Jewelry, Furs and or Fine Art

Use of Pyrotechnics and or any other hazardous or unusual activity

Information about Weather Insurance

Information about Cast Insurance, Essential Cast Member, Director, Key Person

If the production involves an ACTOR, DIRECTOR or KEY PERSON THAT CAN NOT BE REPLACED (so important that the loss of such an individual would cause a shutdown or abandonment) You may want to consider Cast Insurance.

Abandonment and or Non-Appearance

ANY other Special Risks as per paragraph 5 of the “Insurance Addendum”

2. Any Vehicle PURCHASED by the Production Company for use in the production is NOT

COVERED by the insurance program. Specific insurance must be arranged and placed for the vehicle. Contact your Account representative for additional information.

3. HIGHER LIMITS OF COVERAGE ARE AVAILABLE AS NEEDED PENDING WRITTEN

NOTIFICATION AND SUPPORTING DOCUMENTATION.

Any questions please contact your Account Representaive for additional information.

Page 8: 2013 Ipg Agency Handbook

Page 7 of 31

Special Coverage Checklist

General Information Production Company:

Contact Name: Phone #

Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

ChecklistAircraft (Helicopter, Fixed Wing‐Scouting or Filming, private charters or any other aircraft use: 

Yes     No    

Major Stunts:  Yes     No    

Watercraft:    Yes     No    

Pyrotechnics:  Yes     No    

Cast Coverage (Irreplaceable Talent &/or Director):   Yes     No    

Railroad Locations:  Yes     No    

Animals:  Yes     No    

Weather Coverage:    Yes     No    

Foreign Location:  Yes     No    

Jewelry, Furs, Fine Arts, Antiques:  Yes     No    

Any other SPECIAL RISKS as per item 5. Special Risk Coverage in the “Insurance Addendum”?  If yes, explain in detail and provide written documentation and supporting contracts with any vendors, suppliers and locations. 

What contingency plans are in place in the event equipment malfunctions or is damaged – will additional equipment be available to avoid shoot delay?  Please explain. 

Signature:  Printed Name:  Date: 

1. Complete this form for each new production  2. Complete appropriate questionnaire if you answered yes to any questions above and 

return 10 days prior to filming activities. 3. Email or fax the following: 

a. Completed Special Coverage Checklist b. The completed pertinent questionnaires 

                  Aon/Albert G Ruben at [email protected]  

Aon/Albert G Ruben

Page 9: 2013 Ipg Agency Handbook

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Insurance Requirements ‐ AIRCRAFT  

THE INSURANCE PROGRAM DOES NOT PROVIDE AUTOMATICE COVERAGE FOR THE USE OF ANY TYPE OF AIRCRAFT. 

 

Any aircraft use including but not limited to: fixed wing or rotor; any military aircraft; aerial stunts; air to air, air to ground or ground to air filming and or; aerial stunts or; parachuting or skydiving activities must be reported to your Account Representative well in advance of the planned activity.  These activities are NOT automatically covered under the Aircraft Insurance Program and will require additional information and sufficient advance notice in order to confirm coverage (if coverage is available). Please note that in 

some cases Insurance coverage may NOT be possible to obtain. Ultra Lights, Hang Gliders, Hot Air Balloons and Home Built Aircraft are EXCLUDED FROM AIRCRAFT COVERAGE. 

IN ORDER TO OBTAIN COVERAGE – YOU MUST:

1. Complete the attached aircraft questionnaire 2. Obtain from the aircraft vendor a VALID CERTIFICATE OF INSURANCE. THE FOLLOWING ENTITIES MUST BE LISTED AS ADDITIONAL INSUREDS:

PRODUCTION COMPANY, AGENCY, ADVERTISER & INTERPUBLIC GROUP INC.

The certificate must provide and include a waiver of subrogation in favor of all the above

mentioned entities in item 2 above with respect to Liability and Physical Damage to the aircraft The aircraft company must have limits of liability of at least $10,000,000 including passenger

liability Charter Aircraft must have Limits of Liability of at least $20,000,000. The certificate must state that the aircraft company’s policy is primary and non-contributory to any

other insurance maintained by an of the entities as listed In item 2 above

3. The aircraft company must confirm that the pilot is covered under the aircraft company’s policy. 4. The production company must obtain from the aircraft provider a HOLD HARMLESS AGREEMENT.

Consult your production counsel for contract wording. 5. Provide to your Account Representative the rental agreement between Aircraft Company and

Production Company SEND ALL REQUIRED INFORMATION TO ALL OF THE FOLLOWING PERSONS (MANDATORY):

The Interpublic Group of Companies Inc - Risk Management Greg Rowan - [email protected] Phone: (212) 704 1341 - Fax: (212) 704-2231

Jill Watson –[email protected] Phone: (212) 704 1342 - Fax: (212) 403-7664

Frenkel & Co., Inc. Andrea Kim - [email protected]

Tel: 212-488-0456/ Cell: 201-208-7482 / Fax: 212-488-0220/

Copy: Aon / Albert G Ruben Company

Kristi Jones - [email protected] / [email protected] Phone: (818) 742-0840

Page 10: 2013 Ipg Agency Handbook

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Aircraft Questionnaire

General Information Production Company:

Contact Name:

Phone # Fax # Email Address Agency:

Advertiser:

Job Title: Job Number:

Whenever an aircraft is hired, we will need to arrange Non-Ownership Aircraft Liability coverage protecting against liability for bodily injury and property damage to third parties arising out of the use of aircraft. In order for us to arrange this coverage, the following information is required prior to filming:

1. Exact date of use & hours each day:

2. Location:

3. Owner’s Name:

4. Description of aircraft: “N” Registration Number:

5. Name of Aircraft Company

Phone No. Fax No.

6. Details concerning filming, scouting, chartering, etc. activities:

7. Number of persons in aircraft at any one time and relationship to the Production Company:

No. of Persons Relationship

8. The seating capacity and weight of aircraft: Seating Capacity Weight

9. Value of hull if hull insurance is required on the aircraft: $

10. Name of pilot and number of hours experience in craft:

11. Who is the pilot employed by:

(Please confirm Pilot is covered Under Aircraft Owner’s Policy)

12. The Aircraft Owner must provide the Production with a certificate of insurance evidencing Aircraft Liability and Hull physical damage and naming the PRODUCTION COMPANY AGENCY, ADVERTISER AND THE INTERPUBLIC GROUP. AS ADDITIONAL INSUREDS.

Provide a copy of the Hold Harmless agreement and Waiver of Subrogation from the owner of the aircraft, in favor of the PRODUCTION COMPANY, AGENCY, ADVERTISER and THE INTERPUBLIC GROUP along with a copy of the rental

agreement between Production Company and Aircraft Company. The Aircraft Company’s Certificate must state that their coverage is primary & non-contributory.

Note: Refer to attached “sample” wording as respects hold harmless agreements.

Page 11: 2013 Ipg Agency Handbook

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Aircraft Hold Harmless “Sample Wording Only”

_______________________ agrees to indemnify, hold harmless and defend (“Owner of Aircraft”) ___________________ , their affiliates, subsidiaries, officers, directors and (“Production Company”, “Advertiser” & “Agency” “Interpublic Group”) employees from and against any and all claims, li ability, losse s, da mages, costs, and expenses, including attorney fees, arising out of the use of the aircraft. _____________________________________ hereby waives any claims against and releases (“Owner of Aircraft”) _____________________________________absolutely and forever, of and from any and (“Production Company”, “Advertiser” & “Agency” “Interpublic Group”) all claims a nd/or liability whatsoever arising in any wa y out of the use of the Aircraft in any ma nner in connection with the Production, including (but not limit ed to) any claims and/or liability for the damage and/or loss of use of the Aircraft and/or for any and all liability to any third parties whatsoever.

This is only sample wording and should be reviewed by and approved by your legal counsel

Page 12: 2013 Ipg Agency Handbook

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Watercraft Questionnaire General Information

Production Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

Whenever the production plans on using watercraft this form must be completed and forwarded to Aon/Albert G Ruben prior to filming. If less than 3 days before the anticipated use of the watercraft the information should be phoned in to the Aon/Albert G Ruben Company representative. WE MUST HAVE A COPY OF THE RENTAL AND CHARTER AGREEMENT IN ORDER TO PROVIDE A QUOTE AND/OR BIND THIS COVERAGE. THIS IS MANDATORY.

Applicant (Insured): Name of Vessel:

Declared Production:

Hull Coverage: Yes No Operating

P&I Coverage: Yes No Dockside

Registry or Documentation No.:

Date(s) Vessel to be used:

No. of Days:

Vessels Legal Owner

Address Phone No.

Contact Phone No.

Year of Vessel Length of Vessel Value of Vessel

Vessel Make & Type: Beam Width

Where is Vessel Docked?

Is this a “Report to Location” deal for the use of the vessel? Yes No

How many on board, at any one time Film Crew Vessel Crew

Name of person who will pilot the vessel

Who will employee the master and crew?

Name of owner or suppliers insurance broker:

Contact Phone

Address

Will vessel be operated under its own power during filming? Yes No

Description of how the vessel will be used (please be specific)

Any water-skiing?

Yes No Any stunts? Yes No

Other vehicles to be towed?

Any vessel to be used out of the water?

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Make a thorough inspection of the items shown on the following page, noting any deficiencies or damage (in writing) on the Charter Agreement or other contract or agreement form, and have the owner initial the same to acknowledge the items noted. Photographs of the vessel to document the condition of the vessel, is recommended. In the event of an extended period of use of a private yacht, we highly recommend an “on charter survey” be done to establish the exact condition of the vessel prior to our use and a subsequent “off charter survey” promptly when filming is completed.

In what condition is this vessel? Hull/Outside paint, scrapes, etc… Good Fair Poor

Interior wear & tear, mars & burns Good Fair Poor

Decks scrapes, wear & tear Good Fair Poor

Engine/transmission, trial run Good Fair Poor

Equipment/weathered, damaged Good Fair Poor

Page 14: 2013 Ipg Agency Handbook

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Railroad Questionnaire

General Information Production Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number: Whenever filming is to take place on a train or in a railroad facility, please provide the following prior to filming:

1. A copy of the railroad contractual agreement.

2. Description of scenes involving railroad equipment:

3. Dates and times equipment is to be used:

4. Locations of equipment: (exact street address)

Where is equipment being stored?

Where is equipment being moved?

Where is equipment being returned to after use is completed?

5. Type of equipment used? (rolling cars, engines or other equipment.) Please provide a detailed list.

6. Describe activities involving the railroad equipment and personnel

7. How many people will be “on board”?

8. Distances and speed of equipment:

9. Any stunts? Yes No If so, please list:

10. Will main line tracks be used during filming days? Yes No

11. What security measures are being taken to keep public away from the railroad cars?

12. Will there be an interruption of regular service? Yes No

13. Will the train be under the direction of the production company or will it maintain it’s normal routes, speeds, schedule etc.

14. Is the train being brought from another location to the filming location? Yes No

Provide full details of how the railroad equipment will be transported. Include the addresses of the locations and the distance.

Who is responsible for it while in transit?

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Foreign Questionnaire

General InformationProduction Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

*** Countries listed on U.S. State Dept Travel Warning current Travel Warning Listing are excluded from coverage.  

Please refer to the following website for a current list of excluded countries (www.state.gov) Please contact  

Aon/Albert G Ruben immediately if filming is planned in any of these countries. **** COUNTRIES WITH US EMGARGO SANCTIONS ARE NOT COVERED UNDER ANY INSURANCE AND AON CANNOT PROVIDE ANY INSURANCE OF ANY 

KIND AS RESPECTS THESE COUNTRIES 

If your filming activities take you out of the United States and Canada, its territories and possessions, special insurance may be required. Please provide the following prior to filming:

Dates of travel

Locations:

Number of US hires travelling abroad (If applicable)

FILMING DATES:

Number of weeks outside US (if applicable)

Any local hires? Yes No

Contact, outside US Name Phone No.

Will you be subcontracting with a local production company? Yes No

If so, please provide Name, Address, Telephone and Fax Numbers:

Name Telephone

Address Fax

Maximum number of people traveling in any one conveyance at any one time:

Description of filming operations.

Any stunts or pyrotechnics? Yes No

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Fine Arts, Jewelry, Furs, Questionnaire

General InformationProduction Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number: Fine Arts, Jewelry, Furs and expensive antiques carry a sub-limit of $750,000. Whenever the production plans on utilizing these items, the following information must be provided prior to filming:

1. Dates

2. Location

3. Provide a detailed list of Fine Arts, Jewelry, Furs, etc:

4. Value of each item:

5. Description of use:

6. Who is being held responsible for property during transit to and from location?

7. If filming for more than one day, where will Fine Arts, etc. be stored and/or guarded when not being used for filming. Security details required.

8. What type of security is used while Fine Arts, Jewelry, Furs are being used?

9. Who is responsible for the items while they are in transit?

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Stunt Questionnaire

General InformationProduction Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number: In order to properly evaluate the hazards involving stunts and to determine the need for additional coverage, This information must be submitted and must be approved prior to filming.

1. Describe type of scenes being filmed:

2. List stunts by type, location and date:

Stunt Type Location Date

3. Describe safety measures used to protect participants, public and equipment

4 Who is employer of record of person(s) performing stunt(s):

5. How many people involved in stunt scene?

6. Provide a bio/resume for each stunt person, including stunt coordinator.

Note: We recommend that you advise your equipment vendor about how the equipment will be used, i.e. taken into hazardous environment, camera taken down waterslide, etc. Any recommendations suggested by the vendor to protect the equipment should be adhered to insure proper care.

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Risk Assessment

Contact Name: Phone # Email Address Fax # Agency: Advertiser:

Job Title: Job Number: LOCATION FILMING DATES:

LOCATIONS: Title: Name: Contact Number: Production Manager Line Producer F/X Coordinator Production Safety Advisor Stunt Coordinator

Written description of action covered by this RA:

HAZARD CHECKLIST

Continued on next page

General InformationProduction Company:

No. Tick No. Tick

1 Access / egress 26 Night operations 2 Alcohol 27 Noise / high sound levels 3 Animals 28 Practical fire / flame / flambeaux 4 Any special prop under direct control of artistes 29 Radiation 5 Audience safety / seating 30 Scaffolds / rostra / platforms / practical staircase /

walkways on set

6 Compressed gas/cryogenics 31 Scenery / flats over 12ft x 10 ft 7 Confined space 32 Scenic/ set materials (toxic / fire retardant / glass) 8 Derelict buildings / dangerous structures 33 Smoking on set / studio 9 Diving operations 34 Special ‘flying’ / technical rigs 10 Explosives / pyrotechnics 35 Special needs / children / elderly / disabled 11 Fatigue / long hours / physical exertion 36 Special visual effects: rain / snow / fire /

smoke / steam / dry ice / heat / rock fall

12 Fire Prevention / Evacuation procedures 37 Scenery / props storage 13 First Aid 38 Stunts / dangerous activities 14 Flammable materials 39 Technical facilities (handhelds / camera cables / camera

movement / jimmy jib / special cable runs / scanners / PSC / OB’s etc

15 Flying (aircraft, balloons, parachutes) 40 Vehicles / motorcycles / speed 16 Freelance crews and contractors to be advised of safety

procedures 41 Water / proximity to water / tanks

17 General public – arrangements for safety 42 Welfare Facilities 18 Hazardous substances 43 Weapons / knives / firearms 19 Heat / cold / extreme weather 44 Work at height: zip-up/ ladders / aerial lifts 20 Heavy loads 45 Working on grid 21 L.P.G./ bottled gases 46 Working / storage under seating 22 Lasers / strobes 47 Rehearsal Space 23 Lifting equipment 48 Lone working 24 Live electrical equipment / tools 49 Filming on Working Airport 25 Manual handling

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Risk Assessment continued Hazard Number

& Level of risk

Main Risks Identified Describe the risks and the people affected. State if you consider them to Be High (H) Medium (M) or Low (L) before any controls are introduced.

Controls to Minimize Risk Describe the controls you intend to introduce to and indicate the risk state after control initiatives are introduced. i.e. (H/M/L) Ensure persons responsible for taki

owing action in the control procedure are named and a copy of this assessment is given to them

COMPLETED BY: (print) POSITION: SIGNATURE: DATE: REVIEWED BY: (print) POSITION: SIGNATURE: DATE: I am satisfied that the above constitutes a proper and adequate risk assessment in respect of this production: HEALTH & SAFETY ADVISER (print) SIGNATURE: DATE:

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Animal Questionnaire

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number: Animal mortality coverage up to $500,000 on an “Accident Only” basis is automatically provided under this insurance program. Additional information is required for sickness/illness coverage to apply. Please provide the following information prior to filming:

1. Dates

2. Location

3. Provide list of animals (kind of animals and names), their value and their use:

Animal Name Value Use in production

4. Trainer:

Name: Telephone No.

Address:

5. How are the animals being transported? Is the Production Company responsible for the animals while being transported? Yes No

6. Provide a current Veterinary Certificate for each animal.

Note: If sickness coverage is required, we must have a current veterinary certificate, prior to filming.

General InformationProduction Company:

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Cast Insurance Questionnaire

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

Please provide the following prior to filming:

1. Name of Artist:

2. Age:

3. Dates of Filming:

4. Location of Filming:

Is Artist traveling to location via Non-Commercial Aircraft?

5. Description of role:

Any Stunts and/or hazardous activity planned?

6. Does Artist know of any illness or injury of any immediate family member that may prevent him/her from performing on

scheduled shoot dates?

Please note Any health impairment or condition of any insured person(s) as defined that may affect that person’s ability to 

continue or complete an insured production is excluded from coverage unless endorsed to the policy and approved by Underwriters. 

7.

Production Costs for each day Artist is filming: ______________________________________

Coverage subject to all Policy Limits, terms, conditions, definitions and exclusions

General InformationProduction Company:

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Pyrotechnics Questionnaire

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

1. Location(s) of shoot:

Give a full description of Pyrotechnics being performed and attach storyboard

A What are they doing?

B How is it being done?

C How many people are on the set when it is being done?

D Describe Surrounding Location & Precautions taken for public & cast members

2. Who is in charge? 3. How many Pyrotechnics are needed? 4. Are they licensed? Yes No. If "Yes" are they: State Lic. Federal Lic.

5. What is their employment status with you? Employee Subcontractor 6. If they are subcontractors, do they have equal or higher limits of General Liability with No

Pyrotechnics Exclusions? Yes No 7. Are they providing Certificates of Insurance naming the Insured as an Additional Insured for this

project? Yes No

8. Are members of the required Fire Department standing by? Yes No 9. Have the required permits been obtained? Yes No 10. # Of days of Pyrotechnics?

11. Date(s) of shooting involving Pyrotechnics: 12. 13.

Are any Railroads, Trains or Planes involved? Yes No If yes, give details: Are any Weapons being used? Yes No If yes, give details:

General InformationProduction Company:

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AUTOMOBILE QUESTIONNAIRE

PRECISION DRIVING OR STUNT ACTIVITY Damage to any vehicles involved in racing, chase scenes, or stunts is excluded. Precision Driving is covered unless:

A. Any or all wheels of the vehicle leave the driving surface; B. When tire traction is broken; C. The driver’s vision is impaired or, D. The speed of the vehicle(s) is greater than normally safe for the condition of the driving surface. E. There is NO Insurance coverage for any claims due to mechanical breakdown and/or malfunction

of any vehicle. F. INTENTIONAL AND/OR EXPECTED DAMAGE IS EXCLUDED

In order to properly evaluate the hazards involving automobiles used in filming, please provide the following information: 1. Describe scene to be filmed with automobiles (Including how fast Autos will be driven) & DATE(S): ____________________________________________________________________________________________________________________________________________________________________________________ 2. Describe filming location & conditions (i.e. snow, ice, dirt roads, etc): __________________________________________________________________________________________ __________________________________________________________________________________________ 3. Provide vehicle information as follows:

Year Make / Model VIN VALUE DRIVER

e

4. Describe safety measures used to protect participants, public and equipment: ________________________________________________________________________________________ ________________________________________________________________________________________ 5. Who is employer of record of person(s) performing precision driving and/or stunt(s): _____________________________________________________________________________________ 6. How many people involved in automobile stunt scene? _____________________________________________________________________________________

General InformationProduction Company:

Contact Name: Phone # Fax # Email Address Agency: Advertiser:

Job Title: Job Number:

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CCLLAAIIMM RREEPPOORRTTIINNGG PPRROOCCEEDDUURREESS

All losses, thefts and accidents must be reported to Aon/Albert G Ruben IMMEDIATELY. See Claims contacts on page 3.

For all types of claims, please fill out the attached “FIRST NOTICE OF CLAIM” form and forward that form with:

- Rental agreement if the claim involves rented equipment, vehicle or location;

- Certificate of Insurance issued to vendor/claimant;

- If claim involves an auto accident, please fill out and include the attached “AUTOMOBILE ACCIDENT REPORTING FORM”;

- If claim involves theft or auto accident, please include police report and photos of damage.

Forward all the above documentation to: Maria Clark - CLAIMS DEPT.

EMAIL: [email protected] DIRECT FAX: 847-953-0892

If you are unsure a loss would be covered, please contact the claims department of Aon / Albert G Ruben IMMEDIATELY.

IN THE EVENT OF A CATASTROPHIC CLAIM RESULTING IN SERIOUS INJURY OR DEATH CONTACT THE AON/ALBERT G RUBEN CLAIMS DEPARTMENT IMMEDIATELY.

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FIRST NOTICE OF CLAIM

PRODUCTION COMPANY: ADDRESS: AGENCY : ADVERTISER: TITLE OF PRODUCTION & AGENCYJOB#: CONTACT: TELEPHONE: EMAIL: DATE OF LOSS: LOSS CONTACT: COMPLETE DESCRIPTION OF LOSS: ESTIMATE OF LOSS: $

CLAIMANT INFORMATION

NAME: ADDRESS: TELEPHONE: CONTACT:

HOW TO SUBMIT A CLAIM Please include the following when submitting a claim: Completed First Notice of Claim Rental Agreement (If claim involves rented equipment. vehicle or location.) Certificate of Insurance issued to vendor/claimant *Please note: All checks will be made payable to both the Production Company AND the Claimant

unless proof is submitted that claimant has been paid.

**IF CLAIM INVOLVES THEFT OR AUTO ACCIDENT, PLEASE INCLUDE POLICE REPORT.** PLEASE FORWARD THE ABOVE INFORMATION TO:

Maria Clark - CLAIMS DEPT.

EMAIL: [email protected] FAX: 847-953-0892

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AUTOMOBILE ACCIDENT REPORTING FORM Include this form when reporting an auto accident. DATE OF ACCIDENT: Name of Production Company’s Driver: Make Body Type

Year Vehicle License No.

Name of Rental Co.

Telephone No.

Address of Rental Company Description of Damage to Rental Vehicle Estimate of Repair Costs Other Vehicle Information Vin Number Make Body Type

Year Vehicle License No.

Name of Driver

Driver’s License No.

Address of Driver

Work and/or Home Telephone No.

Name of Registered Owner

Telephone No.

Address of Registered Owner Description of Damage: Estimate of Repair Costs:

Location of Accident

Police Report No.

State Briefly How Accident Occurred

Was a Citation Given?

To Whom What was the Violation?

Witness:

Address

Telephone No.

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OVERVIEW OF INSURANCE COVERAGE

Named Insured:  Production Company/Photographer  Additional Insured:  Advertiser (Client)  Coverage                 Limit of Liability Each Loss  Cast Insurance         

Family Bereavement                                               

$5,000,000 $1,000,000  

Negative Film and Faulty Stock Coverage 

Negative Film 

Faulty Stock 

Operator Error 

Library Stock 

 $5,000,000 $5,000,000 $     250,000 $     250,000 

   Props, Sets and Wardrobe  $  2,000,000 

Furs/Jewelry/Fine Arts  $     750,000 

   

Miscellaneous Property  $  3,000,000 

Vehicle Physical Damage       

Office Contents/Equipment 

Personal Property (Employees, Talent & 

Directors) 

Money & Currency  

$  1,000,000 $     100,000 $       25,000  $     250,000 

   Property Of Others                                                                         

$  1,000,000  

   Extra Expense  $  5,000,000 

Civil Authority 

Adverse Weather Shipping/Transit 

Strike Coverage 

Any Accident (Coverage C) 

Death or Injury on Site                                                Coverage Notes: 

$  1,000,000 $  1,000,000 $  1,000,000 $     250,000 $     250,000 

Stunts, aircraft, weather, railroad, watercraft and/or any other special coverage and/or hazardous activity must be reviewed and approved by Underwriters prior to binding coverage. These are not automatically covered and additional costs may apply. 

Off premises power interruption coverage is included. 

Negative/Videotape is covered until completion of editorial process 

Producer’s Package coverage is Worldwide 

Animal Mortality: $500,000 

Production Company is NOT responsible for Deductible in the event of covered claim     

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 Continued…   COMMERCIAL GENERAL LIABILITY  Coverage              Limit of Liability Each Occurrence                                                                                $1,000,000 General Aggregate (Per Production)                             $2,000,000 Products/Completed Operations Aggregate                  $1,000,000 Personal and Advertising Injury        $1,000,000 Damage to Premises Rented To You                                              $1,000,000  NON‐OWNED AND HIRED AUTOMOBILE  LIABILITY  Coverage              Limit of Liability Bodily Injury/Property Damage        $1,000,000      Combined Single Limit Per Occurrence   COMMERCIAL UMBRELLA/EXCESS  LIABILITY  Coverage                         Limit of Liability Per Occurrence            $19,000,000 Aggregate (Per Production)                          $19,000,000   GUILD/UNION TRAVEL ACCIDENT  Coverage                                        Limit of Liability Per Guild and Union Requirements                           $10,000,000 Aggregate Limit  

 FOREIGN COMMERCIAL GENERAL LIABILITY& AUTO LIABILITY (if required)  Coverage                                                                     Limit of Liability Bodily Injury & Property Damage / Each Occurrence              $1,000,000 Automobile Liability                                                               $1,000,000 Bodily Injury & Property Damage / Each Occurrence   Production Company must obtain local Insurance coverage as required by local law if applicable 

     NON‐OWNED AIRCRAFT LIABILITY  Bodily Injury/Property Damage         (ADDITIONAL INFORMATION MUST BE SUBMITTED AND APPROVED BY UNDERWRITERS PRIOR TO COVERAGE BEING BOUND AND 

ADDITIONAL PREMIUM WILL APPLY)  

 ERRORS & OMISSIONS:                                                                                                                                                                                                     $3,000,000 – Limit of Liability    

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The following applies ONLY to Independent Production Companies retained by The Interpublic Group of Companies Inc.: 

 WORKERS COMPENSATION 

The Agency Insurance Program DOES NOT include Workers Compensation OR Employers Liability Coverage. The Agency contract and Insurance Addendum requires the production company to 

provide evidence of such coverage.  Workers Compensation & Employers Liability insurance including: Broad Form All States; Longshoreman and Harbor workers’ Act and; Jones Act endorsement(s), where applicable, as well as coverage meeting all state and local requirements applicable to and in the state of hire and the state(s) in which the production will occur.  Production Company’s coverage must include all independent contractors, loanouts or others hired by Production Company for the production contemplated under the Production Contract, or Production Company must establish that such individuals are otherwise covered elsewhere, except as otherwise permitted by law.  A certificate of insurance evidencing such insurance coverage shall be provided to Agency and the certificate shall provide that such insurance may not be materially altered or canceled on less than thirty (30) days prior written notice to Agency and Advertiser with a copy to Aon/Albert G. Ruben (“Aon)”, AON/ALBERT G. RUBEN 171 Madison Avenue, Suite 401 New York, New York 10016  

If Workers Compensation is provided through a Payroll Company or a Payroll Leasing Company the Payroll Company or Payroll Leasing Company must provide a Certificate of Insurance  with all appropriate language as referenced in “A” above and must include a policy endorsement attached to the Certificate of Insurance  evidencing that the Production Company is  the “alternate employer  If the Production Company is domiciled outside of the United States, the local U.S. equivalent of Workers Compensation, as well as Employers Liability Coverage.  A certificate of insurance evidencing such insurance coverage shall be provided to Agency and the certificate shall provide that such insurance may not be materially  altered or  canceled on  less  than  thirty  (30) days prior written notice  to Agency with  a  copy  to Aon/Albert G. Ruben, (“Aon”) 171 Madison Avenue, Suite 401 New York, New York 10016 . 

 

This document is furnished to you as a matter of information ONLY.  It is a summary of coverage provided and DOES NOT reflect the actual terms and conditions or exclusions of such coverage. The information contained in this document is an illustration of the coverage as of the effective date(s) of the coverage and does not include any subsequent changes. This document is not an insurance policy and does not amend, alter or extend the coverage afforded by the listed policies. The insurance afforded by the listed policies is subject to all the terms, exclusions and conditions of such policy. 

  

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SUMMARY OF COVERAGES – EXPLANATION OF COVERAGE TYPE

PRODUCTION PACKAGE POLICY  

Props, Sets & Wardrobe:  

Covers owned property and property of others for which the Producer is legally liable against direct physical loss or damage to props, sets, scenery, costumes, wardrobe and similar property. EXCLUDES:  Mysterious disappearance and damage caused intentionally or at the direction of the insured. 

 

Extra Expense  

Reimburses the out‐of‐pocket expenses incurred as a result of interruption, postponement or cancellation of the production directly resulting from damage to facilities, or property which were intended for use in production   (Example: Fire damage to a location site.) 

 

Third Party Property Damage  

Pays for damage to the property of others while it is in the care, custody or control of the Production Company.  Legal liability for Loss of Use is also covered here.  (Example:  Rental charges while a hired vehicle is being repaired.)   EXCLUDES:  Damage caused intentionally or at the direction of the insured. 

 

Miscellaneous Equipment  

Covers camera, sound and lighting equipment in the same manner as the Props coverage above, subject to certain exclusions such as mechanical breakdown. 

 

Negative Film  

Reimburses the Production Company for additional out‐of‐pocket expenses which are incurred in re‐shooting only the portion which is unacceptable as a result of damage to negative film, video tape, sound tracks, work prints and tapes.  EXCLUDES:  Loss caused by faulty processing, faulty camera or faulty stock (see below). 

 

Faulty Stock  

Same as above when loss is caused by faulty raw stock, faulty camera or lenses, or faulty processing by the lab.  

Cast Insurance 

This coverage reimburses any extra expenditure incurred by the producer in completing principal photography when extra expense results from the inability of the scheduled artist to perform whether due to accident or sickness, subject to certain exclusions regarding hazardous activities, stunts, and flying on a non‐commercial basis. **Coverage is subject to all policy terms, conditions, limits and exclusions***  

Hired Auto Physical Damage   

This coverage provides comprehensive and collision coverage for any Hired vehicle used in connection with the production and for which the insured is legally liable. 

 

COMMERCIAL GENERAL LIABILITY  

This coverage is required prior to filming on any city or state roads, or on any location sites requiring filming permits or      Certificates.  It protects the producer against claims for Bodily Injury and Property Damage arising out of the filming of the production.  Third party claims involving the use of vehicles are processed under the Automobile Liability portion of the policy. 

 

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NON‐OWNED HIRED AUTOMOBILE LIABILITY  

This coverage protects the Production Company against claims for Bodily Injury and/or Property Damage to third parties arising out of the use of Non‐owned or Hired Automobiles.  Please note the policy will not cover vehicles owned by the Production Company, unless they were specifically declared to the policy. 

  FOREIGN GENERAL & AUTOMOBILE LIABILITY (When Applicable) 

 

Required if the Production Company will have any foreign activities, defined as activities outside of the United States or its territories and possessions, Canada or Puerto Rico.  Local insurance must be placed to meet local requirements if applicable. 

  UMBRELLA/ EXCESS LIABILITY   

 

Provides additional limits of liability above the General Liability, Automobile Liability, Third Party Property Damage Liability, Non‐Owned Aircraft (if applicable) and Foreign General Liability primary coverage’s. Most filming permits require $1,000,000 combined single limit, which is the minimum limit. 

  GUILD (UNION) TRAVEL ACCIDENT   

 

This coverage is necessary if any member of the cast or crew belongs to any Guild or Union involved with the Entertainment Industry.  Coverage is blanket and the terms are designed to meet with signatory requirements.  

NON‐OWNED AIRCRAFT LIABILITY (When Applicable and additional premium will apply)  

Non‐Owned Aircraft coverage is required when a plane or helicopter is rented, leased or borrowed for use as a picture aircraft, aerial photography, scouting or chartering purposes.  Hull coverage physical damage to the aircraft (itself) may be necessary as well.  

PROTECTION & INDEMNITY (When applicable and additional premium will apply)  

This coverage may be required if the Production Company hires watercraft on a bareboat charter basis; without master or crew or when employees are working over navigable waters.  It may also be required if the Production Company is contractually obligated to insure the watercraft. 

  POLITICAL RISK & WAR RISK (Optional / SUBJECT TO AVAILABILITY) 

 

This coverage should be considered when filming in certain unstable or unpredictable political environments.  

WEATHER INSURANCE (Optional / SUBJECT TO AVAILABILITY)  

If film is shot mainly exterior without possible cover sets, this coverage should be considered. AT LEAST 10 DAYS ADVANCE NOTICE IS REQUIRED IN ORDER TO PROVIDE QUOTE 

  RAILROAD PROTECTIVE LIABILITY (When applicable and additional premium will apply) 

 

If filming activities take place on railroad property, this special coverage may be required.  This coverage provides an insurance policy in the name of the Railroad covering third Party Liability, Physical Damage to the Railroad and Federal responsibility to Railroad personnel. 

      

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ANIMAL MORTALITY COVERAGE    

When the production involves the use of animals, Animal Mortality (death only) coverage can be arranged.  This coverage reimburses the Owner for the value of their animal when the animal dies arising out of filming activities.  The value of the animal must be agreed to in advance.  Accident Only coverage can be bound immediately and sickness/illness can be included only upon receipt of a current Veterinary Certificate.  

This insurance document is furnished to you as a matter of information for your convenience. It only summarizes the listed proposed policy(ies) and is not intended to reflect all the terms and conditions or exclusions of such proposed policy(ies). Moreover, the information contained in this document reflects proposed coverage as of the effective date(s) of the proposed policy(ies) and does not include subsequent changes. This document is not an insurance policy and does not amend, alter or extend the coverage afforded by the listed proposed policy(ies). The insurance afforded by the listed proposed policy(ies) is subject to all the terms, 

exclusions and conditions of such policy(ies). 

  

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Interpublic Group

Aon / Albert G. Ruben  • Contacts:  LOS ANGELES:  Kristi Jones • [email protected]   • Phone: 818‐742‐0840 • Fax: 847‐953‐0885 

NEW YORK: Anthony Catanzaro Anthony.Catanzaro.com    Phone : 212‐337‐4352   Fax:  847‐953‐7503 

2013 Production Insurance Program

Production / Print Declaration Form

1. Agency: _________________________________________________________________

2. Date Job Awarded:_________________________

3. Production Details:

a. Advertiser: __________________________________________________________________

b. Title of Production: ______________________________________________________________

c. Job #: ________________________________________________PO#_________________

d. Type of Production: □Commercial □Industrial □Educational □ Print □Other: _________

e. Is this an In-House Agency Production? □Yes □No

f. Type of Medium: □Print □Film □ Video □ Digital Filming □ Digital □ Other

g. If this is a Digital Production does it include any of the following or similar components?

Interactive content

Personalization of content

Delivery of content to mobile applications

Satellite transmission of content or Live Streaming

Development of proprietary or original source code

If you can answer YES to any of the above questions immediately contact your service representative at Aon/Albert G.

Ruben. The Wrap-Up Insurance program does not contemplate transmission failure or the unsuccessful operation of a web-

site, performance interactivity or the diminished value of the production due to the failure of such products or services to

perform to contractual standards.

4 Production Company Details:

a. Broadcast: Name of Production Company __________________________________________

b. Print: Name of Photographer, Producer and Photographers Rep: ______________________

c. Address: _____________________________________________________________________

d. Production Contact information including:

Name: _____________________________ Email:_________________________________

Phone: _____________________________ Fax: _________________________________

5. Production location(s): ___________________________________________________________

Any Production taking place in Countries listed on the U.S. State Dept. Travel Warning Listing is NOT COVERED under this

Insurance Program. For a current list of countries Go to www.state.gov Contact your account representative at Aon/Albert G Ruben if a production takes place in any of these countries.

7. Start Date of Production:__________ Completion date of the Production:_______ Delivery Date:

8. Name of Post-Production Company: ___________________________________________

a.. Start and Completion dates of post-production: From: _____________ To: _____________

9. Production Cost (choose one only):

a. Live Action: “AICP” A-K + directors fee + editorial - mark-up $___________________ x 1.45 Rate*

b. Animation/CGI ONLY: Total CGI, animation & SPX costs $ ___________________ x 1.3129 Rate*

c. Print ONLY: The total of all expenses and fees $____________________x 1.319 Rate* D Edit ONLY: The total editorial costs: $____________________x 1.319 Rate*

*Rates shown are for the 2013 Program year and are for the standard Insurance coverages only. Rate does not include any

additional premiums that may be necessary for any additional insurance coverages that my be required including but not limited to

aircraft, watercraft, railroads, stunts, or any other unusual or hazardous activity.

Attach the following: □ PO □Storyboard and/or Script □AICP or Production budget □AICE or Editorial budget

Date: _____________ Completed by (name / title): __________________________________

Submit information to:  [email protected]