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Picture Vehicles
Students: Read and Complete This Entire Form
GENERAL INSTRUCTIONS:
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CAUTION: Using the ENTER key will automatically submit the form.

PLEASE REVIEW YOUR SUBMISSION BEFORE CLICKING "SUBMIT"
Distribution of Certificates
This is a SPECIAL INSURANCE REQUEST, it may take an additional one to two weeks to process your insurance, so start early.
PLAN ACCORDINGLY!!
GENERAL PRODUCTION INFORMATION

Have you submitted the "Production Registration Form"?:
Yes  No

If you answered "No" this will redirect you to the proper Production Registration Form.

Original Name of Production:

Director's Name (No nicknames. List name as registered with NYU!):
First Name:
Last Name:
Insurance Contact - Email Address:
Email address must be an NYU issued email.
Must end in @nyu.edu. All others will be rejected, and your form will have to be resubmitted.

The University Production Insurance Plan has limited coverage for those incidents resulting in injury to others (general public) when they are not a part of the production. Any injury that stems from the use of rented or personally owned vehicles that are used in a shoot or used to transport equipment and crew or when used as a drive-through (i.e. a vehicle driving through the scene) is NOT covered.

The University's Production Insurance does NOT provide coverage for any vehicles, except when used as a stationary prop, and not self-propelled. Only in these stationary prop cases, when the vehicle owner drives the vehicle to set, no cast or crew moves the vehicle between takes, and the vehicle owner removes the vehicle from set, you must provide the following to the Insurance & Risk Management Department: a copy of the vehicle registration (vehicle must be legally registered) and insurance card. Submit the information, as pdf attachments, to insurance.student.film@nyu.edu.
Otherwise, in the cases of moving vehicles, it is the responsibility of the student to purchase coverage for general liability and physical damage to such vehicles to be purchased directly from auto / truck rental company.

VEHICLE INSURANCE REQUIREMENT:
$1,000,000.00 Liability Limit

Students must provide the Insurance & Risk Management Department with proof of current vehicle insurance and photos of all vehicles used in shoot. This information must be received by the Insurance & Risk Management Department as soon as the vehicle is secured. Photos and insurance documents must be emailed to the Insurance & Risk Management Department at insurance.student.film@nyu.edu.


You can list up to 4 Vehicles per Rental Agency. If you have more than 4,
you'll have to submit another request for the remaining Vehicles.

If you have Vehicle's from different Rental Agencies,
you'll have to submit a separate Request for each Rental Agency.


Name of Owner/Rental Agency for Vehicle:


Owner/Rental Agency Contact Phone Number:

How many Vehicles are you listing for this Owner/Rental Agency?:
1 2 3 4


Make and Model Number of Vehicle #1:


Vehicle #1 Replacement Value:


Number of Days Vehicle #1 is being used:

Describe how Vehicle #1 will be used for this production:



Make and Model Number of Vehicle #2:


Vehicle #2 Replacement Value:


Number of Days Vehicle #2 is being used:

Describe how Vehicle #2 will be used for this production:



Make and Model Number of Vehicle #3:


Vehicle #3 Replacement Value:


Number of Days Vehicle #3 is being used:

Describe how Vehicle #3 will be used for this production:



Make and Model Number of Vehicle #4:


Vehicle #4 Replacement Value:


Number of Days Vehicle #4 is being used:

Describe how Vehicle #4 will be used for this production:



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