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Watercraft
Students: Read and Complete This Entire Form
GENERAL INSTRUCTIONS:
Use the TAB key or MOUSE click to move from field to field.
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.

Name of Vessel:
Is Hull Coverage Required? Yes No
Is Charters' Liability Required?: Yes No
Is P & I Coverage Required? Yes No

Registry or Documentation Number:

Date(s) Vessel to be Used:

How Many Hours On The Vessel For Each Day You Use It?:


Is There A Rental Contract? Yes No
If YES, We will need to get a copy of the contract.
If you want to Deliver or Fax this contract you can.
Fax it to: (212-995-3555)
or Deliver it to: 838 Broadway, 4th Floor.
Please include your Production Name, and Director Name, on cover sheet!

 Vessel's Legal Owner or Lessor/Operator:

Vessel's Owner or Lessor/Operator Address:

Vessel's Owner or Lessor/Operator Phone Number:
Year of Vessel:

Length of Vessel:

Value of Vessel:

Vessel Make & Type:

Vessel Beam Width:

Where is Vessel Docked?:

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 Members of the Crew?: Owner NYU

Will The Vessel Be Used In The Water? Yes No
If The Answer To The Above Question is YES,
Please Answer The Questions In Red Below:
(If No, Please Skip To Next Section Of Questions)

Will Vessel be operated under its own power during filming: Yes No

Description of How the Vessel Will be Used. Please be Specific!:
(Where are you going? Where will Shoot Take Place?)

What Type of Body of Water is this?
Lake River Creek Ocean Pool

What is the Name of the Body of Water the Vessel is Being Used On?:
(Please Be As Specific As Possible)


Where is the Body of Water Located?:
(Please tell us the Town or City and State)

Will Any Vessel to be used out of the water?: Yes No

If Yes, please explain in detail:



Name of Owner or Lessor/Operator's Insurance Broker:

Contact Name(Agent):

Contact (Agent) Phone Number:

Contact (Agent) Address:


Any Waterskiing?: Yes No

If Yes, please explain in detail:


Any Stunts?: Yes No

If Yes, please explain in detail:


Other Vehicles to be towed?: Yes No

If Yes, please explain in detail:



Make a thorough inspection of the following items:
* Hull/Outside Paint, Scrapes, etc.
* Interior Wear & Tear, Mars & Burns
* Deck Scrapes, Wear & Tear, etc.
* Engine/Transmission, Take a Trial Run
* Equipment/Weathered, Damaged

Note any deficiencies or damage (in writing) on the Charter Agreement or other contract or agreement form, and have the Owner or Lessor/Operator initial the same to acknowledge the items noted. Photographs of the vessel to document the condition of the Vessel are 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 your use and a subsequent "off charter survey" promptly when filming is completed.

In what condition is this Vessel(please be specific)?:



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