UNITED STATES DEPARTMENT OF THE INTERIOR



NPS Form 10-932 National Park Service

OMB No. 1024-0026 Manhattan Sites

General Grant National Memorial

NEW 10/00 26 Wall Street

Expires 6/30/2013 New York, New York 10005

Telephone (212) 825-6990

Fax (212) 668-2899

Application for Commercial Filming/Still Photography Permit

Please supply the information requested below. Attach additional sheets, if necessary, to provide required information. Allow AT LEAST four (4) business days for processing. A non-refundable processing fee should accompany this application unless the requested use is an exercise of a First Amendment right. You will be notified of the disposition of the application and the necessary steps to secure your final permit. Your permit may require the payment of cost recovery charges, a location fee, and proof of liability insurance naming the United States of America as also insured.

|Applicant: |Company: |

|Social Security #: |Tax ID #: |

|Street/Address: |Street/Address: |

|City/State/Zip Code: |City/State/Zip Code: |

|Telephone #: |Telephone #: |

|Cell phone #: |Cell phone #: |

|Fax #: |Fax #: |

|E-mail: |E-mail: |

|Project name: |Producer: |

|Location manager: |Photographer: |

|Telephone #: |Director: |

|Cell phone #: |Insurance company: |

|E-mail: | |

TYPE OF PROJECT: ο Stills, editorial ο Stills, advertising ο stills, other ο stock photo/video/film ο Feature Film /TV Movie ο TV Series/Pilot ο Documentary/Travelogue ο Commercial ο Music Video ο Infomercial ο Industrial ο Public Service Announcement

ο Other, explain ________________________________________________

Will there be sound recording ο Yes ο No Night work: ο No ο Yes, explain

Detailed description of on-site activities

Talent comprise anyone in front of the camera and includes, but is not limited to, actors, hosts, correspondents, presenters, park visitors, cooperators, volunteers, National Park Service and concessioner staff, etc.

Do you intend to utilize talent? ο Yes ο No

If yes, provide a full description of who they are and how they will be utilized:

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LOCATION SCHEDULE:

|DATE |LOCATION |Start Time |End Time |Interior or Exterior |Film Strike Prep |# of cast |

| | | | | | |& crew* |

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*number in this column should include all individuals present at the location

How will individuals with access to the site be identified? (Identification tags are recommended.) _____________________________________________________________________________________

Electrical needs, explain ________________________________________________________ Generator: ο No ο Yes, size _______________ Lighting: ο None ο Reflectors only ο Yes (explain)

_____________________________________________________________________________________

Road Use: Date/time: ________________________

Road closure requested? No Yes

Running shots ο Driving shots ο Drive-bys ο Tow shots ο Drive-ups & Away ο Wet down road Camera/Equipment on Road Shoulder ο Camera/Equipment on median ο Other (explain) _____________________________________________________________________________________

_____________________________________________________________________________________

OPERATIONAL INFORMATION:

Vehicles:

Personal Cars _ Large Trucks _ Other Trucks Vans ______Motor homes ________

Semi-Tractor Trailers _______ Camera Car Picture Cars Dressing Rooms _______

Other Vehicles (explain) _______________________________________________________________

Large or oversized vehicles may not be able to be accommodated or additional steps may need to be taken to ensure that no damage to park resource occurs.

Vehicles to be parked on or need access to park property (attach additional sheets if necessary):

|MAKE |MODEL |COLOR |STATE |LICENSE PLATE # |

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Base Camp location (attach diagram if necessary): ____________________________________________

CATERING INFORMATION

Catering Co. Name Phone Number ___________________

On-site Manager _____________________________ Food License Information: ____________________

Equipment: ____________________________________________________________________________

SPECIAL ACTIVITIES:

Children: ο None ο Yes # of Children Age Range ___________________________ Animals: ο None ο Yes (explain)

Trainer Name: Phone #: ____________________________

Aircraft: ο No ο Yes (explain)

Special Effects: (identify)

Effects Technician Name: Phone # ____________________________

License # (if applicable) Permit # (if applicable) ________________

Stunts: (explain)

Coordinator____________________________________Phone #_____________________________

Any other unusual or hazardous activities? Explain

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Are you familiar with/ have you visited the requested area? Y N

Have your obtained a permit from the National Park Service in the past? Y N

(If yes, provide a list of permit dates and locations on a separate page.)

Do you plan to advertise or issue a press release before the event? Y N

ATTACH ADDITIONAL PAGES FOR INFORMATION NEEDED TO EVALUATE YOUR PERMIT REQUEST INCLUDING: set construction, parking, sanitary facilities, crowd control, emergency medical plan, off-road activity, trail use, or use of any building and site clean up. Include a proposed Site Plan(s).

CONTACTS:

Person on location responsible for adherence to all terms & conditions of the permit:

Name: ________________________________ Title: _______________________

Phone: ____________ Cell Phone: ____________

Person on location responsible for coordinating activities with the NPS:

Name: ________________________________ Title: _______________________

Phone: ____________ Cell Phone: ____________

Person at the company office to contact for follow up information and billing:

Name: _______________________________Title: _________________________Phone: _____________ ******************************************************************************

I hereby state that the above information given is complete and correct, and that no false or misleading information or false statements have been given. All estimates are reliable to the best of my knowledge and I have the full authority to represent the applicant/production company and the project described above.

Signature ______________________________ Title ______________________ Date ____________

Company Name _________________________________________________________

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Information provided will be used to determine whether a permit will be issued. Completed application must be accompanied by an application fee in the form of a cashiers check or money order in the amount of $50.00 made payable to National Park Service. Application charges are non-refundable. This completed application should be mailed to The National Park Service, 26 Wall Street, New York, New York 10005, Attention: Special Park Uses.

Note that this is an application only, and does not serve as permission to conduct any use of the park. If your request is approved, a permit containing applicable terms and conditions will be sent to the person designated on the application. The permit must be signed by the responsible person and returned to the park prior to the event for final approval by the Park Superintendent or the designated personnel.

NOTICES

Privacy Act Statement: The Privacy Act of 1974 (5 U.S.C. 552a) provides that you be furnished with the following information in connection with information required by this application. This information is being collected to allow the park manager to make a value judgment on whether or not to allow the requested use. Applicants are required to provide their social security or taxpayer identification number or activities subject to collection of fees by the National Park Service (31 U.S.C. 7701) Information from the application may be transferred to appropriate Federal, State, local agencies, when relevant to civil, criminal or regulatory investigations or prosecutions.

Paperwork Reduction Act Statement): This information is being collected subject to the Paperwork Reduction Act (44 U.S.C. 3501) to allow the park manager to make a value judgment on whether or not to allow the requested use. All applicable parts of the form must be completed. A Federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Estimated Burden Statement: Public reporting burden for this form is estimated to average 30 minutes per response including the time it takes to read, gather and maintain data, review instructions and complete the form. Direct comments regarding this burden estimate or any aspects of this form to the National Park Service, Special Park Uses Program Manager, 1849 C Street NW (2460), Washington, D.C. 2024

Upon approval of the permit application, the following conditions are applicable to the permit when issued. Additional conditions may be added depending on the nature of the activity.

1. The permittee shall exercise this privilege subject to the supervision of the Superintendent, and shall comply with all applicable laws and regulations of the area. The established First Amendment area for General Grant NM is North West steps. There is a limitation to the number of people allow on the steps. Any amplification of sound will require a permit from New York City Police Department.

2. Damages - The permittee shall pay the United States for any damage resulting from this use, which would not reasonably be inherent in the use that the permittee is authorized to make of the land described in this permit.

3. Benefit - Neither Members of, nor Delegates to Congress, or Resident Commissioners shall be admitted to any share or part of this permit or derive, either directly or indirectly, any pecuniary benefits to arise therefrom: provided, however, that nothing herein contained shall be construed to extend to any incorporated company, if the permit be for the benefit of such corporation.

4. Assignment - This permit may not be transferred or assigned without the consent of the Superintendent, in writing.

5. Revocation - This permit may be terminated upon breach of any of the conditions herein or at the discretion of the Superintendent.

6. The permittee is prohibited from giving false information; to do so will be considered a breach of conditions and be grounds for revocation [Re: 36 CFR 2.32(a)(4)].

7. Permittee will comply with applicable public health and sanitation standards and codes.

8. This permit may be terminated upon breach of any of the stated conditions.

9. The Permittee, in exercising the privileges granted by this permit, shall comply with the regulations of the Department of the Interior, the National Park Service, and all Federal, State, county and municipal laws, ordinances, or regulations which are applicable to the area of operations covered by this permit.

10. This permit may be revoked at the discretion of the Superintendent upon 24 hours notice, or without notice if damage to resources or facilities occurs or is threatened, notwithstanding any other term or condition of this permit to the contrary. Permittee will reimburse NPS for cleanup or repair of damages required to be made by NPS staff or contractor in conjunction with terminated permit.

11. Permit shall not be transferable to another party.

12. The Permittee will be required to reimburse the NPS for the recovery of costs incurred in conjunction with this permit. If additional costs are incurred during the course of this permit, the Permittee will be billed for the balance at the conclusion of the event through a Bill of Collections.

13. The Permittee agrees to notify the NPS of any delays or schedule changes at least 36 hours in advance. Should the Permittee fail to provide such advance notification, the Permittee agrees to pay any costs incurred by the NPS anytime during the application, permitting, or operational process, including those due to cancellation, moving, or rescheduling of the project. Such payment will include a non-refundable charge for each staff person scheduled for the affected activity. Such charges will, at a minimum, be the equivalent of two hours overtime for each employee assigned.

14. No Credit will be given to the National Park Service; Manhattan Sites, General Grant National

Memorial, National Park Service, U.S. Department of the Interior.

15. No endorsement by any Federal agency shall be stated or implied. Filming and photography of signs or fixtures identifying any Federal agency in affiliation with the event is prohibited.

16. Permittee shall own all rights of every kind in and to all photographs and recordings made by it in the park and shall have the right to use such photographs and/or recordings in any manner it may desire without limitation or restriction of any kind. The permit does not grant rights regarding the filming, photography or recording of individuals on NPS property. In addition, rights owned by other individuals or institutions are not impacted or changed by this permit.

17. The commercial filming or photo shoot will be well planned and scheduled. Last minute changes will not be accommodated unless the changes are contingent upon weather or other emergency conditions and approved by the NPS representative in charge.

18. The member of the park staff will supervise the event within the park boundaries. He or she will have the authority to make all supervisory decisions to assure compliance with the permit, applicable regulations, and NPS policy. The Permittee must comply with any special instructions received from this representative. Any additional information related to the privilege granted in this permit will be furnished upon request of the official in charge.

19. Any expenses incurred by NPS for such supervision will be borne by the Permittee but may be waived at the discretion OF THE SUPERINTENDENT.

20. No employee of the NPS may work for the Permittee in any capacity whatsoever while in uniform or if directly involved in supervision of the Permittee.

21. NPS employees may not perform, or appear to perform official duties for purposes of the event unless such performance has been approved by the NPS.

22. No personal gratuity of any nature whatsoever will be offered to any employee of the Government in connection with the exercise of the privilege granted.

23. Government equipment cannot be loaned or rented or diverted from normal use for purposes of the filming or photography.

24. This permit may be used between the hours and dates stated on the face of the permit. No activity, including arrival of vehicles and/or personnel is permitted before or after designated hours. All personnel, equipment and vehicles must be clear of NPS property by the expiration of the permit.

25. Nothing shall be attached to NPS facilities, structures, signs, or any other park properties and/or equipment including event signs, and guest lists. In addition:

a. Digging, scraping or moving natural or cultural features is prohibited.

b. Camouflaging or removing signs, fences or posts, etc., is prohibited.

c. Use of fire or combustible materials is prohibited.

26. Permittee will comply with state laws, county ordinances, regulations, and industry practices

concerning use and/or employment of minors. Permittee will provide a complete listing of such minors involved in the project, indicating numbers and age range.

27. A copy of this permit will be kept on site at all times and will be held by permittee. The permittee will have the full authority to make decisions and must remain on site at all times during the project. The permittee will be responsible for all individuals, groups, contractors, etc., involved with the permit activities.

28. Smoking is prohibited inside the building. Permittee will provide butt cans for smoking in designated areas. The Permittee will comply with all safety regulations.

29. The permittee’s staff and/or security personnel will follow guidelines provided by the Lead Park Ranger for instances in dealing with park visitors. Permittee’s staff will communicate with visitors in a courteous, knowledgeable and professional manner.

30. The permittee will schedule all requests for electricity or other utilities well in advance of need. All necessary safety precautions will be taken should generators be used. All necessary safety precautions will be taken should cabling of any distance be laid.

31. The permittee and staff may utilize public rest rooms; if available.

32. First aid and personal safety are the responsibility of the Permittee. In the case of any emergency, notify the New York City Police Department at Telephone #911.

33. Permittee is responsible for collecting and disposing of all trash and debris accumulated as a result of permit activities outside of the park’s normal trash collections. Areas utilized during and after the event must be cleared of all hazards.

a. Clean up of spills or accidents will be in accordance with 40 CFR and all applicable state environmental quality laws regarding disposal and hazardous/industrial wastes.

b. In case of spill or accident that may involve hazardous or industrial wastes, the district ranger and the New York City Police must be notified immediately.

34. All trash will be removed daily by the Permittee from all locations.

35. Food may not be consumed in any historic structure unless specifically designated.

36. Glass containers are prohibited.

37. Use of special effects or pyrotechnics is prohibited.

38. All walkways and means of egress must remain unobstructed to allow for reasonable use by park visitors and other pedestrians.

39. No fees may be collected, no donations solicited, no commercial activity conducted at the Park Site and no articles offered for sale.

40. Permittee is prohibited from selling food or beverages. The NPS contracted concessionaire is the only party officially authorized to sell food and beverages in the park.

41. Possession and consumption of alcoholic beverages are prohibited. The possession, consumption or other use of dangerous, intoxicating or illegal drugs is strictly prohibited.

42. Consumption of food is prohibited in the interior of the building and on the exterior portico.

43. There are no available indoor facilities for permittee and designated staff members or guests of the permittee.

44. Permittee agrees to carry general liability insurance against claims occasioned by the action or omissions of the permittee, its agents and employees in carrying out the activities and operations authorized by this permit. The policy shall be in the amount of $2,000,0000 aggregated and $1,000,000 per occurrence and underwritten by a United States company naming the United States of America as additionally insured. The permittee agrees to provide the Superintendent with a Certificate of Insurance with the proper endorsements prior to the effective date of the permit.

45. Permittee agrees to deposit with the park a bond in the amount of $(amount will determine if needed) from an authorized bonding company or in the form of cash or cash equivalent, to guarantee that all financial obligations to the park will be met, including the restoration and rehabilitation of the permitted area.

46. Bicycles are prohibited in the interior of the building and exterior portico, steps and plaza.

47. Bicycles are prohibited from the park property at all times.

48. Undressing is prohibited on park property, in any area of the interior of building and exterior steps, portico and plaza.

49. Staging is prohibited unless the Park Management approves it in advance in writing.

50. Permittee will be required to sign a Hold Harmless Clause if the application is approved.

ADDENDUM #1

HOLD HARMLESS CLAUSE

This Permit is made upon the express condition that the United States of America, its agents and employees shall be free from all liabilities and claims for damages and/or suits for or by reason of any injury to any person or property of any kind whatsoever, whether to the person of property of the permitee or third parties, from any cause whatsoever arising from any activities conducted pursuant to the terms of this Permit, and the permittee covenants and agrees to indemnify, defend, save, and hold harmless the United States of America, its agents and employees from all such liabilities, expenses and costs on account of or by reason of any injuries, deaths, liabilities, claims, suits or losses however occurring or damages arising out of the same.

The permittee shall prior to the effective date of this agreement provide the assigned ranger with a Certificate of Insurance evidencing that it has obtained and will maintain during the term of this agreement Comprehensive General Liability insurance against claims occasioned by the actions or omissions of the permittee or agents and employees in carrying out the activities and operations authorized hereunder. Such insurance shall be in the amount commensurate with the degree of risk and the scope and size of such activities hereunder, but in any event, the limits of liability shall not be less than one million ($1,000,000) dollars per occurrence and two million ($2,000,000) dollars in the aggregate. If claims reduce available insurance below the required per occurrence limits, the permittee shall obtain additional insurance to restore the required limits. An umbrella or excess liability policy, in addition to a Comprehensive General Liability Policy, may be used to achieve the required limits.

All liability policies shall either name the United States of America as a named insured or shall specify that the insurance company shall have no right of subrogation against the United States and shall have no recourse against the Government for payment of any premium or assessment.

Public Law 106–206 mandates the Department of the Interior, National Park Service to collect location fees for all commercial filming and/or still photography. The location fee schedule is:

Location Fee Schedule

National Park Service

|Motion Pictures/Videos |Still Photography |

|1 – 2 people, camera and tripod only |$0/day | | |

|1 - 10 people |$150/day |1 - 10 people |$50/day |

|11 - 30 people |$250/day |11 - 30 people |$150/day |

|31 - 49 people |$500/day |Over 30 people |$250/day |

|Over 50 people |$750/day | | |

All location fees must be paid in advance.

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