InformationParks Filming Permit Application Form1. ApplicationsIn order to obtain approval for filming on locations which involve Regional District of Nanaimo park properties, an application must be made to the Regional District of Nanaimo parks office. Any filming involving extraordinary requirements (e.g., stunts, special effects) should be submitted for approval at least 3 (three) weeks in advance. The application will be circulated to appropriate Regional District of Nanaimo departments if required, which will provide input and assistance to ensure that the needs of both the production company and the Regional District of Nanaimo are satisfied.The production company must complete a Regional District of Nanaimo Parks Filming Application Form and Hold Harmless Agreement. The application form must include sufficient detail to identify the requirements of the production company and must include dates and names of individuals responsible for the filming.2. Liability InsuranceIt will be the responsibility of the production company to submit all required insurance documents with the Regional District of Nanaimo Parks Filming Application prior to the commencement of filming activities. The applicant shall obtain and maintain until filming is complete commercial general liability insurance that names the Regional District of Nanaimo as an “Additional Insured". This policy must also include a limit of at least $5 million (in Canadian funds) and provide: that the Regional District is protected notwithstanding any act, neglect or misrepresentation of the named insured;that it is primary and non-contributing with respect to any policies carried by the Regional District of Nanaimo and that any Regional District of Nanaimo policy of insurance is excess coverage’ and that all rights of subrogation or recourse against the Regional District of Nanaimo are waived.The Regional District’s Manager of parks Services may, in the Manager of Parks Services’ sole discretion, require the applicant to provide further liability insurance from time to time.3. DepositA damage deposit will be established by the Regional District of Nanaimo. The amount will depend upon the specific nature of the film project, location, etc.Deposits are required to cover any potential damage to Regional District of Nanaimo facilities, equipment, landscape etc.Deposits will be submitted to the Regional District of Nanaimo Recreation and Parks Office or designate in the form of cash or an automatically renewing letter of credit satisfactory to the Regional District of Nanaimo’s Manager of Parks Services.Deposits, or the remaining portion thereof, will be refunded upon completion of filming activities based on an inspection by the Regional District of Nanaimo. Any required repairs, clean up, restoration, ect. Will be undertaken by the production company. If the Regional District of Nanaimo deems repairs or restoration unsatisfactory the production company will remediate to the satisfaction of the Regional District of Nanaimo and deduct the costs of doing so from the deposit.4. Fees and ChargesAll fees associated with filming are based on cost recovery plus applicable taxes and administrative charges for the services provided by the Regional District of Nanaimo.Necessary fees must be submitted to the Regional District of Nanaimo Recreation and Parks Office at least one working day prior to undertaking filming. Special Use Category 2 Filming, audio or video recording and photographyFilming audio or video photographyApplication FeePermit FeeMinimum Damage DepositInsuranceMinor$100/permit$75/day/park$500$5 millionMajor$100/permit$500/day/park$2000$5 million Minor means no temporary disturbance of other park users or natural park features. Major means normal park uses or access by others will be temporarily disrupted or restricted or some natural park features or facilities will be disturbed.Applicant Information Name / Location Manager Date Parent Company / Name of Production Phone Number(s) Mailing Address Cellular Number(s) Email Other Location Contacts (Optional) Phone Number(s) (Optional) Cellular Number(s) (Optional) Dates of Filming From To Hours of Filming From To RDN Park or Trail Requested Specific Locations of FilmingLocationDate(s) or rangeStart / End time location date time location date time location date time Total # people expected on site Total # vehicle expected on site Please describe types Do you have catering services? Yes No Will you be using a generator? Yes No Description of scenesDescription of Scenes Proposed Activities: (check all that apply) May require referral to additional agencies. Gun Fire Car Stunt Stunts Rain or Snow Tow Shots Animals Fire Drive Up/Away Exterior Set Construction Helicopter Drive By Walk and Talk Explosions Road Wet Downs Use of Actors under the age of 18 Park and or Trail Road Closure Park Traffic Control Other Special Effects Proposed Actions Other Attach additional information, including maps, to assist the Regional District of Nanaimo Parks Office in processing your request Maximum 10 files.32 MB limit.Allowed types: jpg jpeg png pdf doc docx.Terms and ConditionsInsuranceAll applications must include proof of commercial general liability insurance coverage in the minimum amount of $5,000,000, inclusive per occurrence, for bodily injury and property damage. The insurance shall also provide:that the Regional District of Nanaimo is named as an additional insured; that the Regional District is protected notwithstanding any act, neglect or misrepresentation of the named insured;that it is primary and non-contributing with respect to any policies carried by the Regional Districts of Nanaimo and that any Regional District of Nanaimo policy of insurance is excess coverage; and that all rights of subrogation or recourse against the Regional District of Nanaimo are waived.The Regional District ‘s Manager of Parks Services may, in the Manager of Parks Services’ sole discretion, require the applicant to provide further liability insurance from time to time. I have read, understand and agree to the insurance requirements (Initials Required) Indemnity AgreementIf the filming permit is granted to you by the Regional District of Nanaimo, you and your organization must indemnify and save harmless the Regional District of Nanaimo, its officers, employees and agents from any claim, lawsuit, liability, debt, demand, loss or judgment (including all legal costs, on a solicitor and own-client basis, and interest) whatsoever and howsoever arising either directly or indirectly as a result of, or in any way related to, the granting of the permit or the use of the Regional District of Nanaimo property or facilities.You also agree to waive all rights of subrogation or recourse against the Regional District of Nanaimo as a result of the granting of the permit or the use of the Regional District of Nanaimo property or facilities. I have read, understand and agree to the indemnity agreement requirements (Initials Required) Signature info***A temporary sign may be requested that explains the event and its disruptions to the public using the park***Filming must follow the Regional District of Nanaimo Park Use Regulations Bylaw 1801, as amended from time to time. I hereby certify that all information provided in this application is true and correct. Signature Date Note: the person signing this application should be the person referred to in the provided insurance and is responsible for ensuring that all conditions are met.If you have any questions, please contact Parks Services at 250-248-4744. Please allow up to six weeks for application approval.Information collected on this form is done so under the general authority of the Freedom of Information and Protection of Privacy Act (FOIPPA) and is protected in accordance with FOIPPA. Information provided will only be used to process the application form. Questions regarding the collection of your personal information may be referred to the Legislative Services Department at foi@rdn.bc.ca CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.