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									          Application / Permit For Use of Public Property in
        Martin County, Stuart, Sewall’s Point and Jupiter Island

Applicant:

Representative / Title

Address

City / State / Zip

Telephone                                Fax                             Pager


Project Title


 Local Address / Hotel

 Local Telephone                                            # of Room Nights


Type of Production::

      Feature Film             TV Movie/Special            TV Series or Pilot            TV Commercial

      Film               Industrial/Documentary           Infomercial            Video           Stills

      Other (Please Explain)


Dates for Filming

Locations in Martin County (Unincorporated)

Locations in Stuart

Sewall’s Point

Jupiter Island


Assistance Requested:
      Street Closing(s) at the following location(s)

      Traffic Control           Parking (# of spaces required)

       Other
Unusual Activities:

     Stunts             Animals                Explosives/Fireworks                    Firearms                  Fires

     Vehicles              Aircraft/Helicopters             Watercraft               Other
Explain Activity




 The following information is requested for local and state records on production in Florida to track the
 economic impact of the industry. If exact figures are not available, please estimate.

Size of Cast           Size of Crew               Number of locals hired               Number of Shooting Days
Use of Local Businesses (Please check all that may apply)

      Catering             Restaurants               Boat Rental               Car Rental               Lumber/Hardware

      Dry Cleaners/Laundry               Stores for Props/Supplies               Production Equipment Rental

      Other Equipment Rental                Other


Insurance Amount       $                                On File            Sending

       By submitting this application, the applicant acknowledges and agrees to the insurance and indemnification provisions:
Evidence of insurance issued by companies satisfactory to the county and/or municipalities in which filming will be
conducted as additional insureds, in the minimum amount of $1,000,000 for general liability and vehicle liability, and
workman compensation insurance as required by Florida statutes, must be provided with the application and $5,000,000 if the
use of one or more of the following is planned: pyrotechnics, some stunts, stunts involving vehicles and animals. Some
municipalities or activities may require additional insurance.
       The applicant agrees to indemnify and save harmless the county and/or municipalities in which activities are conducted,
their agents, servants, and employees from and against any and all claims, liability, losses, and/or cause of any action which
may arise from any negligent act or omission of the applicant, its agents, servants, or employees.
       The applicant further agrees to indemnify, save harmless and defend the county and/or municipalities in which
activities are conducted, their agents, servants and employees from and against any claims, demands, or causes of action of
whatsoever kind or nature arising out of any conduct or misconduct of the applicant not included in the paragraph above and
for which the county or municipality, their agent, servants, or employees are alleged to be liable.
       The applicant agrees to immediately pay the county and/or municipalities for any services provided by them at their
usual rates. The Martin County Film Commission will provide coordination and advise the applicant of estimated costs.


Production Company / Applicant

By Name / Title

Additional Requirements or Services:




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