The Interpublic Group Of Companies

Blanket Production Insurance Program

Television / Print
Agency Production 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: aonrubenwp@aon.com

The Insurance Program does not provide Workers Compensation & Employers 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.
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















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
Kristi.Jones@aon.com



Anthony Catanzaro
Vice President - Entertainment

Office Phone:
Direct Fax:
Email:

(212) 337-4352
(847) 953-7503
Anthony.Catanzaro@aon.com


James Pedrick
Assistant (Certificates)

Office Phone:
Email:

(212) 337-4356
james.pedrick@aon.com


Emergency:
Laura Comerford
Sr. Vice President Entertainment
Account Executive

Direct Fax:
Email:

(847) 953-0886
Laura.Comerford@aon.com

CLAIM CONTACT


Maria Clark
Claims Manager

Office Phone:
Direct Fax:
Email:

(212) 463-5583
(847) 953-0892
Maria.Clark@aon.com



Page 4 of 31
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: aonrubenwp@aon.com
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 Maria.Clark@aon.com and
aonrubenwp@aon.com The Production Manual provides complete
instructions for Production Company and Agency to submit a claim if
needed.



Page 5 of 31
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 aonrubenwp@aon.com

Or mail to: Aon/AlbertGRubenNY
171MadisonAvenue,Suite401,NewYork,NewYork10016


WHEN CONTACTING AON / ALBERT G RUBEN PLEASE REFERENCE
THE CLIENT, JOB AND ADVERSTING AGENCY SO WE MAY BETTER ASSIST YOU.
Page 6 of 31
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 7 of 31
Special Coverage Checklist

General Information
Production Company:

Contact Name:

Phone #
Fax #
Email Address
Agency:

Advertiser:

Job Title:

Job Number:

Checklist
Aircraft(Helicopter,FixedWingScoutingorFilming,privatechartersoranyother
aircraftuse:
Yes No
MajorStunts: Yes No
Watercraft: Yes No
Pyrotechnics: Yes No
CastCoverage(IrreplaceableTalent&/orDirector): Yes No
RailroadLocations: Yes No
Animals: Yes No
WeatherCoverage: Yes No
ForeignLocation: Yes No
Jewelry,Furs,FineArts,Antiques: Yes No
AnyotherSPECIALRISKSasperitem5.SpecialRiskCoverageintheInsuranceAddendum?Ifyes,explainindetailandprovide
writtendocumentationandsupportingcontractswithanyvendors,suppliersandlocations.
Whatcontingencyplansareinplaceintheeventequipmentmalfunctionsorisdamagedwilladditionalequipmentbeavailable
toavoidshootdelay?Pleaseexplain.
Signature: PrintedName: Date:

1. Completethisformforeachnewproduction
2. Completeappropriatequestionnaireifyouansweredyestoanyquestionsaboveand
return10dayspriortofilmingactivities.
3. Emailorfaxthefollowing:
a. CompletedSpecialCoverageChecklist
b. Thecompletedpertinentquestionnaires

Aon/AlbertGRubenataonrubenwp@aon.com


Aon/Albert G Ruben
Page 8 of 31


InsuranceRequirementsAIRCRAFT

THEINSURANCEPROGRAMDOESNOTPROVIDEAUTOMATICECOVERAGEFORTHEUSEOFANYTYPEOF
AIRCRAFT.

Anyaircraftuseincludingbutnotlimitedto:fixedwingorrotor;anymilitaryaircraft;aerialstunts;airto
air,airtogroundorgroundtoairfilmingandor;aerialstuntsor;parachutingorskydivingactivitiesmust
bereportedtoyourAccountRepresentativewellinadvanceoftheplannedactivity.Theseactivitiesare
NOTautomaticallycoveredundertheAircraftInsuranceProgramandwillrequireadditionalinformation
andsufficientadvancenoticeinordertoconfirmcoverage(ifcoverageisavailable).Pleasenotethatin
somecasesInsurancecoveragemayNOTbepossibletoobtain.UltraLights,HangGliders,HotAir
BalloonsandHomeBuiltAircraftareEXCLUDEDFROMAIRCRAFTCOVERAGE.

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 companys 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 companys 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 - Greg.Rowan@interpublic.com Phone: (212) 704 1341 - Fax: (212) 704-2231
Jill Watson Jill.Watson@interpublic.com Phone: (212) 704 1342 - Fax: (212) 403-7664

Frenkel & Co., Inc.
Andrea Kim - akim@frenkel.com
Tel: 212-488-0456/ Cell: 201-208-7482 / Fax: 212-488-0220/

Copy:
Aon / Albert G Ruben Company
Kristi Jones - Kristi.Jones@aon.com / aonrubenwp@aon.com Phone: (818) 742-0840
Page 9 of 31
Aircraft Questionnaire
General Information
Production Company:

Contact Name:

Phone #
Fax #
Email Address
Agency:

Advertiser:

J ob 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. Owners 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 Owners 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 Companys Certificate must state that their
coverage is primary & non-contributory.

Note: Refer to attached sample wording as respects hold harmless agreements.
Page 10 of 31
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 and/or liability whatsoever arising in any way 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 11 of 31
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?

Page 12 of 31
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 13 of 31
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 its 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?
Page 14 of 31
Foreign Questionnaire
General Information
Production Company:

Contact Name:

Phone #
Fax #
Email Address
Agency:

Advertiser:

Job Title:
Job Number:

***CountrieslistedonU.S.StateDeptTravelWarningcurrentTravelWarningListingareexcludedfromcoverage.
Pleaserefertothefollowingwebsiteforacurrentlistofexcludedcountries(www.state.gov)Pleasecontact
Aon/AlbertGRubenimmediatelyiffilmingisplannedinanyofthesecountries.****
COUNTRIESWITHUSEMGARGOSANCTIONSARENOTCOVEREDUNDERANYINSURANCEANDAONCANNOTPROVIDEANYINSURANCEOFANY
KINDASRESPECTSTHESECOUNTRIES
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





Page 15 of 31
Fine Arts, Jewelry, Furs, Questionnaire
General Information
Production 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?




Page 16 of 31
Stunt Questionnaire
General Information
Production 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.
Page 17 of 31
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 Information
Production 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 / OBs 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
Page 18 of 31

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:
Page 19 of 31
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 Information
Production Company:

Page 20 of 31
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?
PleasenoteAnyhealthimpairmentorconditionofanyinsuredperson(s)asdefinedthatmayaffectthatpersonsabilityto
continueorcompleteaninsuredproductionisexcludedfromcoverageunlessendorsedtothepolicyandapprovedby
Underwriters.


7.




Production Costs for each day Artist is filming: ______________________________________



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


General Information
Production Company:

Page 21 of 31
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 Information
Production Company:

Page 22 of 31


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 drivers 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 Information
Production Company:

Contact Name:

Phone #
Fax #
Email Address
Agency:

Advertiser:
Job Title:
Job Number:

Page 23 of 31




C CL LA AI IM M R RE EP PO OR RT TI IN NG G P PR RO OC CE ED DU UR RE ES S

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: Maria.Clark@aon.com
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.

Page 24 of 31
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: Maria.Clark@aon.com FAX: 847-953-0892

Page 25 of 31
AUTOMOBILE ACCIDENT REPORTING FORM

Include this form when reporting an auto accident.

DATE OF ACCIDENT:

Name of Production Companys 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

Drivers 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.


Page 26 of 31

OVERVIEW OF INSURANCE COVERAGE

NamedInsured:ProductionCompany/Photographer
AdditionalInsured:Advertiser(Client)

Coverage LimitofLiabilityEachLoss

CastInsurance
FamilyBereavement
$5,000,000
$1,000,000

NegativeFilmandFaultyStockCoverage
NegativeFilm
FaultyStock
OperatorError
LibraryStock

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

Props,SetsandWardrobe $2,000,000
Furs/Jewelry/FineArts $750,000

MiscellaneousProperty $3,000,000
VehiclePhysicalDamage
OfficeContents/Equipment
PersonalProperty(Employees,Talent&
Directors)
Money&Currency
$1,000,000
$100,000
$25,000

$250,000

PropertyOfOthers

$1,000,000

ExtraExpense $5,000,000
CivilAuthority
AdverseWeatherShipping/Transit
StrikeCoverage
AnyAccident(CoverageC)
DeathorInjuryonSite

CoverageNotes:
$1,000,000
$1,000,000
$1,000,000
$250,000
$250,000
Stunts,aircraft,weather,railroad,watercraftand/oranyotherspecialcoverageand/or
hazardousactivitymustbereviewedandapprovedbyUnderwriterspriortobindingcoverage.
Thesearenotautomaticallycoveredandadditionalcostsmayapply.
Offpremisespowerinterruptioncoverageisincluded.
Negative/Videotapeiscovereduntilcompletionofeditorialprocess
ProducersPackagecoverageisWorldwide
AnimalMortality:$500,000
ProductionCompanyisNOTresponsibleforDeductibleintheeventofcoveredclaim

Page 27 of 31

Continued

COMMERCIALGENERALLIABILITY

Coverage LimitofLiability
EachOccurrence$1,000,000
GeneralAggregate(PerProduction) $2,000,000
Products/CompletedOperationsAggregate $1,000,000
PersonalandAdvertisingInjury $1,000,000
DamagetoPremisesRentedToYou $1,000,000

NONOWNEDANDHIREDAUTOMOBILELIABILITY

Coverage LimitofLiability
BodilyInjury/PropertyDamage $1,000,000
CombinedSingleLimitPerOccurrence

COMMERCIALUMBRELLA/EXCESSLIABILITY

Coverage LimitofLiability
PerOccurrence $19,000,000
Aggregate(PerProduction) $19,000,000

GUILD/UNIONTRAVELACCIDENT

Coverage LimitofLiability
PerGuildandUnionRequirements $10,000,000AggregateLimit

FOREIGNCOMMERCIALGENERALLIABILITY&AUTOLIABILITY(ifrequired)

Coverage LimitofLiability
BodilyInjury&PropertyDamage/EachOccurrence$1,000,000
AutomobileLiability $1,000,000
BodilyInjury&PropertyDamage/EachOccurrence

ProductionCompanymustobtainlocalInsurancecoverageasrequiredbylocallawifapplicable

NONOWNEDAIRCRAFTLIABILITY
BodilyInjury/PropertyDamage
(ADDITIONALINFORMATIONMUSTBESUBMITTEDANDAPPROVEDBYUNDERWRITERSPRIORTOCOVERAGEBEINGBOUNDAND
ADDITIONALPREMIUMWILLAPPLY)

ERRORS&OMISSIONS:
$3,000,000LimitofLiability

Page 28 of 31
ThefollowingappliesONLYtoIndependentProductionCompaniesretainedbyTheInterpublic
GroupofCompaniesInc.:

WORKERSCOMPENSATION
TheAgencyInsuranceProgramDOESNOTincludeWorkersCompensationOREmployersLiability
Coverage.TheAgencycontractandInsuranceAddendumrequirestheproductioncompanyto
provideevidenceofsuchcoverage.

WorkersCompensation&EmployersLiabilityinsuranceincluding:BroadFormAllStates;LongshoremanandHarborworkersActand;
JonesActendorsement(s),whereapplicable,aswellascoveragemeetingallstateandlocalrequirementsapplicabletoandinthe
stateofhireandthestate(s)inwhichtheproductionwilloccur.ProductionCompanyscoveragemustincludeallindependent
contractors,loanoutsorothershiredbyProductionCompanyfortheproductioncontemplatedundertheProductionContract,or
ProductionCompanymustestablishthatsuchindividualsareotherwisecoveredelsewhere,exceptasotherwisepermittedbylaw.A
certificateofinsuranceevidencingsuchinsurancecoverageshallbeprovidedtoAgencyandthecertificateshallprovidethatsuch
insurancemaynotbemateriallyalteredorcanceledonlessthanthirty(30)dayspriorwrittennoticetoAgencyandAdvertiserwitha
copytoAon/AlbertG.Ruben(Aon),AON/ALBERTG.RUBEN171MadisonAvenue,Suite401NewYork,NewYork10016

IfWorkersCompensationisprovidedthroughaPayrollCompanyoraPayrollLeasingCompanythePayrollCompanyorPayrollLeasing
CompanymustprovideaCertificateofInsurancewithallappropriatelanguageasreferencedinAaboveandmustincludeapolicy
endorsementattachedtotheCertificateofInsuranceevidencingthattheProductionCompanyisthealternateemployer

IftheProductionCompanyisdomiciledoutsideoftheUnitedStates,thelocalU.S.equivalentofWorkersCompensation,aswellas
EmployersLiabilityCoverage.

AcertificateofinsuranceevidencingsuchinsurancecoverageshallbeprovidedtoAgencyandthecertificateshallprovidethatsuch
insurance may not be materially altered or canceled on less than thirty (30) days prior written notice to Agency with a copy to
Aon/AlbertG.Ruben,(Aon)171MadisonAvenue,Suite401NewYork,NewYork10016.

ThisdocumentisfurnishedtoyouasamatterofinformationONLY.ItisasummaryofcoverageprovidedandDOESNOTreflect
theactualtermsandconditionsorexclusionsofsuchcoverage.Theinformationcontainedinthisdocumentisanillustrationofthe
coverageasoftheeffectivedate(s)ofthecoverageanddoesnotincludeanysubsequentchanges.Thisdocumentisnotan
insurancepolicyanddoesnotamend,alterorextendthecoverageaffordedbythelistedpolicies.Theinsuranceaffordedbythe
listedpoliciesissubjecttoalltheterms,exclusionsandconditionsofsuchpolicy.

Page 29 of 31
SUMMARY OF COVERAGES EXPLANATION OF COVERAGE TYPE

PRODUCTIONPACKAGEPOLICY

Props,Sets&Wardrobe:

CoversownedpropertyandpropertyofothersforwhichtheProducerislegallyliableagainstdirectphysical
lossordamagetoprops,sets,scenery,costumes,wardrobeandsimilarproperty.EXCLUDES:Mysterious
disappearanceanddamagecausedintentionallyoratthedirectionoftheinsured.

ExtraExpense

Reimbursestheoutofpocketexpensesincurredasaresultofinterruption,postponementorcancellationof
theproductiondirectlyresultingfromdamagetofacilities,orpropertywhichwereintendedforusein
production(Example:Firedamagetoalocationsite.)

ThirdPartyPropertyDamage

Paysfordamagetothepropertyofotherswhileitisinthecare,custodyorcontroloftheProductionCompany.
LegalliabilityforLossofUseisalsocoveredhere.(Example:Rentalchargeswhileahiredvehicleisbeing
repaired.)EXCLUDES:Damagecausedintentionallyoratthedirectionoftheinsured.

MiscellaneousEquipment

Coverscamera,soundandlightingequipmentinthesamemannerasthePropscoverageabove,subjectto
certainexclusionssuchasmechanicalbreakdown.

NegativeFilm

ReimbursestheProductionCompanyforadditionaloutofpocketexpenseswhichareincurredinreshooting
onlytheportionwhichisunacceptableasaresultofdamagetonegativefilm,videotape,soundtracks,work
printsandtapes.EXCLUDES:Losscausedbyfaultyprocessing,faultycameraorfaultystock(seebelow).

FaultyStock

Sameasabovewhenlossiscausedbyfaultyrawstock,faultycameraorlenses,orfaultyprocessingbythelab.

CastInsurance
Thiscoveragereimbursesanyextraexpenditureincurredbytheproducerincompletingprincipalphotography
whenextraexpenseresultsfromtheinabilityofthescheduledartisttoperformwhetherduetoaccidentor
sickness,subjecttocertainexclusionsregardinghazardousactivities,stunts,andflyingonanoncommercial
basis.**Coverageissubjecttoallpolicyterms,conditions,limitsandexclusions***

HiredAutoPhysicalDamage

ThiscoverageprovidescomprehensiveandcollisioncoverageforanyHiredvehicleusedinconnectionwiththe
productionandforwhichtheinsuredislegallyliable.

COMMERCIALGENERALLIABILITY

Thiscoverageisrequiredpriortofilmingonanycityorstateroads,oronanylocationsitesrequiringfilming
permitsorCertificates.ItprotectstheproduceragainstclaimsforBodilyInjuryandPropertyDamagearising
outofthefilmingoftheproduction.Thirdpartyclaimsinvolvingtheuseofvehiclesareprocessedunderthe
AutomobileLiabilityportionofthepolicy.

Page 30 of 31

NONOWNEDHIREDAUTOMOBILELIABILITY

ThiscoverageprotectstheProductionCompanyagainstclaimsforBodilyInjuryand/orPropertyDamageto
thirdpartiesarisingoutoftheuseofNonownedorHiredAutomobiles.Pleasenotethepolicywillnotcover
vehiclesownedbytheProductionCompany,unlesstheywerespecificallydeclaredtothepolicy.

FOREIGNGENERAL&AUTOMOBILELIABILITY(WhenApplicable)

RequirediftheProductionCompanywillhaveanyforeignactivities,definedasactivitiesoutsideoftheUnited
Statesoritsterritoriesandpossessions,CanadaorPuertoRico.Localinsurancemustbeplacedtomeetlocal
requirementsifapplicable.

UMBRELLA/EXCESSLIABILITY

ProvidesadditionallimitsofliabilityabovetheGeneralLiability,AutomobileLiability,ThirdPartyProperty
DamageLiability,NonOwnedAircraft(ifapplicable)andForeignGeneralLiabilityprimarycoverages.Most
filmingpermitsrequire$1,000,000combinedsinglelimit,whichistheminimumlimit.

GUILD(UNION)TRAVELACCIDENT

ThiscoverageisnecessaryifanymemberofthecastorcrewbelongstoanyGuildorUnioninvolvedwiththe
EntertainmentIndustry.Coverageisblanketandthetermsaredesignedtomeetwithsignatoryrequirements.

NONOWNEDAIRCRAFTLIABILITY(WhenApplicableandadditionalpremiumwillapply)

NonOwnedAircraftcoverageisrequiredwhenaplaneorhelicopterisrented,leasedorborrowedforuseasa
pictureaircraft,aerialphotography,scoutingorcharteringpurposes.Hullcoveragephysicaldamagetothe
aircraft(itself)maybenecessaryaswell.

PROTECTION&INDEMNITY(Whenapplicableandadditionalpremiumwillapply)

ThiscoveragemayberequirediftheProductionCompanyhireswatercraftonabareboatcharterbasis;without
masterorcreworwhenemployeesareworkingovernavigablewaters.Itmayalsoberequiredifthe
ProductionCompanyiscontractuallyobligatedtoinsurethewatercraft.

POLITICALRISK&WARRISK(Optional/SUBJECTTOAVAILABILITY)

Thiscoverageshouldbeconsideredwhenfilmingincertainunstableorunpredictablepoliticalenvironments.

WEATHERINSURANCE(Optional/SUBJECTTOAVAILABILITY)

Iffilmisshotmainlyexteriorwithoutpossiblecoversets,thiscoverageshouldbeconsidered.ATLEAST10
DAYSADVANCENOTICEISREQUIREDINORDERTOPROVIDEQUOTE

RAILROADPROTECTIVELIABILITY(Whenapplicableandadditionalpremiumwillapply)

Iffilmingactivitiestakeplaceonrailroadproperty,thisspecialcoveragemayberequired.Thiscoverage
providesaninsurancepolicyinthenameoftheRailroadcoveringthirdPartyLiability,PhysicalDamagetothe
RailroadandFederalresponsibilitytoRailroadpersonnel.

Page 31 of 31
ANIMALMORTALITYCOVERAGE

Whentheproductioninvolvestheuseofanimals,AnimalMortality(deathonly)coveragecanbearranged.
ThiscoveragereimbursestheOwnerforthevalueoftheiranimalwhentheanimaldiesarisingoutoffilming
activities.Thevalueoftheanimalmustbeagreedtoinadvance.AccidentOnlycoveragecanbebound
immediatelyandsickness/illnesscanbeincludedonlyuponreceiptofacurrentVeterinaryCertificate.

Thisinsurancedocumentisfurnishedtoyouasamatterofinformationforyourconvenience.Itonlysummarizesthelisted
proposedpolicy(ies)andisnotintendedtoreflectallthetermsandconditionsorexclusionsofsuchproposedpolicy(ies).Moreover,
theinformationcontainedinthisdocumentreflectsproposedcoverageasoftheeffectivedate(s)oftheproposedpolicy(ies)and
doesnotincludesubsequentchanges.Thisdocumentisnotaninsurancepolicyanddoesnotamend,alterorextendthecoverage
affordedbythelistedproposedpolicy(ies).Theinsuranceaffordedbythelistedproposedpolicy(ies)issubjecttoalltheterms,
exclusionsandconditionsofsuchpolicy(ies).

Interpublic Group
Aon/AlbertG.RubenContacts:
LOSANGELES:KristiJoneskristi.jones@aon.comPhone:8187420840Fax:8479530885
NEWYORK:AnthonyCatanzaroAnthony.Catanzaro.comPhone:2123374352Fax:8479537503
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): __________________________________

Submitinformationto:aonrubenwp@aon.com