| This form is for Broward County cities that have adopted "one-stop permitting" for film, video, and still photography shoots. Please choose the city for which this permit is for: |
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| Commencement of activity under this permit by a permittee or its agents, employees or subcontractors constitutes acceptance of the terms and condition of this permit. The permittee shall further ensure that all cast, crew and guests of the production comply with the terms and conditions of this permit, and with County and Municipal Ordinances and the Laws of the State of Florida and United States of America. This permit may be revoked at any time.
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Production Company : | |
Address : | |
Address 2 : | |
City : | |
State/Province/Country : | |
Zip Code : | |
Representative : | |
Telephone (incl. area code) : | |
Fax (incl. area code) : | |
Email : | |
Permanent Address & Phone Number (if different from above) : | |
Production Title/Name of Product : | |
Budget : | |
Product : |
Shoot Date (Start) : | |
Shoot Date (Finish) : | |
| Shoot Time:
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From : | |
To : | |
Rain Date : | |
Exact Locations : | |
Briefly summarize scenes to be filmed or attach script excerpts : | |
Street Closed? | Yes
No |
Traffic Control? | Yes
No |
Any extraordinary circumstances: animals, firearms, explosives, helicopters, tents, bonfires? | Yes
No |
If yes, answer in further details : | |
Parking Needs
(# & type of vehicles (i.e., catering trucks, generators) : | |
Total # of Cast : | |
Total # of Crew : | |
Total # of Broward Room Nights : | |
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The permittee shall indemnify, defend and hold harmless Broward County and The Broward Alliance, their officers, agents and employees, from and against all claims, suits, actions, damages, liabilities, expenditures or causes of action of any kind, arising out of or occurring during the activities of permittee and resulting or occurring from any negligent act, ommission or error of permittee, resulting in or relating to injuries of the body, life, limb or property sustained in, about or upon the permitted premises or improvement thereto or arising from the use of said premises. |
| Do you accept the conditions stated above? |
Yes, I accept. |
