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HomeMy WebLinkAboutRadical Media for Dish Network Page 1 of 1 Cooper, Linda From: Flatley, Martin Sent: Friday, September 14, 2012 8:51 AM To: Cooper, Linda Cc: Blasko, Regina Subject: RE: Film Permit follow-up Linda, we used a Traffic Control Officer for(8) hours assigned to this filming permit on Beckwith Avenue in Southold.Their pay is$16.46/hr which totals$131.68. Martin Flatley Chief of Police Southold Town Police Department 41404 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 From: Cooper, Linda Sent: Thursday, September 13, 2012 1:36 PM To: Kruszeski, Frank; Flatley, Martin Cc: Blasko, Regina Subject: Film Permit follow-up Whenever it is convenient I will need a statement regarding the actual cost to the town for providing police or TCO coverage at the filming on Beckwith Ave. on Wednesday, September 12. Thank you. Linda T Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life may not be the party we hoped for, but as long as we are here, we might as well dance! The difference between try and triumph is a little"umph"! 9/14/2012 ELIZABETH A.NEVILLE,MMC ti� Gy Town Hall,53095 Main Road TOWN CLERK p P.O. Box 1179 CA Z Southold,New York 11971 REGISTRAR.OF VITAL STATISTICS 2 • yC Fax(631)765-6145 MARRIAGE OFFICER 'J� RECORDS OF MANAGEMENT OFFICER ��,� .�`�� Telephone n.no 7 fork. 0 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD September 14, 2012 Radical Media Inc 435 Hudson St., 6`" F1 New York NY 10014 INVOICE FOR POLICE COVERAGE Radical Media for Dish Network Commerical Police coverage was for 1 Traffic Control Officer for 8 hours @ $16.46 per hour. 8 @ $16.46 Total amount charged $131.68 Remitted for police coverage (Check No. 060816) $1000.00 Refund to be issued 9/26/12* $868.32 *The refund has to go through the Town Board audit at a town board meeting. The next meeting is 9/25 so the refund check will go out 9/26. Should you have any questions concerning this matter, please do not hesitate to contact me. Linda J. Cooper Deputy Town Clerk StiFFO(,��o ELIZABETH A.NEVILLE,MMC may► Gy Town Hall,53095 Main Road TOWN CLERKp P.O.Box 1179 CA Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS O Fax(631)765-6145 MARRIAGE OFFICERO! �aO� Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southoldtown.northfork.net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT Issued to: Radical Media for Dish Network Date(s), Time(s) and Location Wednesday, September 12, 2012 7:00 am to 6:00 pm Beckwith Avenue, Southold New York Permit No. 033 Issue Date: September 11,2012 Elizabeth A. Neville Southold Town Clerk (Town Seal) Page I of 1 Cooper, Linda From: Cooper, Linda Sent: Thursday, September 13, 2012 1:36 PM To: Kruszeski, Frank; Flatley, Martin Cc: Blasko, Regina Subject: Film Permit follow-up Tracking: Recipient Read Kruszeski, Frank Flatley, Martin Read:9/13/2012 1:43 PM Blasko, Regina Whenever it is convenient I will need a statement regarding the actual cost to the town for providing police or TCO coverage at the filming on Beckwith Ave. on Wednesday, September 12. Thank you. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life may not be the party we hoped for,but as long as we are here, we might as well dance! The difference between try and triumph is a little"umph"! 9/13/2012 Town of Southold P.O Box 1179 Southold, NY 11971 (631) 765-1800 RECEIPT #33 a 09/12/2012 Radical, Media Inc 435 Hudson St, 6th FI New York, NY 10014 Received $ 100.00 for Daily Filming Permit, on 09/12/2012. Thank you for stopping by the Treasurer's Office. As always, it is our pleasure to serve you. Elizabeth A. Neville Southold Town Clerk Page 1 of 2 Cooper, Linda From: Cooper,Linda Sent: Tuesday, September 11,2012 8:45 AM To: Kruszeski,Frank Subject:RE:[New Sender-J-TV Commercial Permit request for Dish Network Update-Message is from an unknown sender I didn't receive Mr.Fincher's email yesterday(my email address was incorrect). The request about parking is all up to you,I have no opinion,one way or another. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Lire may not be the party we hoped for,but as long as we are here,we might as well dance! The difference between try and triumph is a little"umph"! From:Kruszeski,Frank Sent:Tuesday, September 11,2012 7:43 AM To:Cooper,Linda Subject:FW: [New Sender-] TV Commercial Permit request for Dish Network Update-Message is from an unknown sender Hi Linda Do you know what the status of this request is?We haven't received any info from your office or the board and I will have to try and schedule traffic control if it is going to take place. Please let me know. Thanks Capt. Frank Kruszeski #820 Executive Officer Southold Town Police Dept. 41405 Rt.25 P.O.Box 911 Peconic,N.Y.11958 (631)765-2671 From:les fincher[mai Ito:Iesfincher@mac.com] Sent:Monday,September 10,2012 10:43 AM To:linda.cooper@southouldtown.northfork.net;Kruszeski,Frank Cc:LES FINCHER;Jeanine Brand;Alexis Carleslmo;Sara Bailin;Dave Cox Subject: [New Sender-]-TV Commercial Permit request for Dish Network Update-Message is from an unknown sender Les Fincher Location Manager 917-796-1411 lesfincher@mac.com radical media 435 Hudson Street 6th Floor New York,NY 10014 212-462-1500:Office 212.462-1600:Fax radicalmedia.com RE:Update of Location Status Clearance Dear Town Clerk Cooper and Captain Kruszeski, After we spoke on Friday,I spoke to everyone on Beckwith Ave about our requested film shoot.All residents,the Professional Building and the Main Street Cafe are on board with the project.We will fumish a Certificate of Insurance to each home owner and business.The houses on the street are being compensated. We have secured parking in the large lot behind the Main Street Grill for our working vehicles and a few personal cars while leaving room in the lot for the Historical Society parking and Beckwith Ave regulars.We ask your suggestion for our 20 extra personal cars parking.Would you suggest the Municipal Lot on Travelers St,across from the Train Station?Or could we request a permit to park in the wide south side of Travelers St at Beckwith Ave? Our requested start time is 7AM on site.We expect to be finished by approximately 4PM.filming.The load up and exit should take around one hour.We will set up and serve a 30 min catered lunch in the parking lot.We have permission to overnight the working trucks in the large parking lot on Tuesday.This will make our morning arrival seamless and efficient. Please refer to th a enclosed production map of our intentions.I will edit the map with your feedback about personal car parking. Thank you.Please contact me with any questions. 9/11/2012 BEGKWITH AVE SOUTHOLD ,,V„* � NY WORKING TRUCKS PARK IN „ NORTH END of LOT BEHIND Jenks Main Street Grill ��NAL 54195 Route 25(Main St) °;� , Personal cars pari at Municipal at corner of Travelers St and Youngs Ave �” 01,p r � u, 511 E�3 ► s Page 1 of 2 Cooper, Linda ..--- ......... From: Cooper,Linda Sent: Tuesday, September 11,2012 8:27 AM To: Kruszeski,Frank Subject: RE:[New Sender-]-TV Commercial Permit request for Dish Network Update-Message is from an unknown sender I faxed everything to your office on 9/7/12. 1 told Regina it was coming over and I have the transmittal that it went through okay. Please check with Regina and if she doesn't have it I'll relax. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life may not be the party we hoped for,but as long as we are here,we might as well dance! The difference between try and triumph is a little'umph'! 1111. ...—_111.111,111.1111,............... 1111_.. 1111..... 1111.._.......... 1111....... 1111...... 1111..... _._.. 1111...... ........1111... From:Kruszeski,Frank Sent:Tuesday,September 11,2012 7:43 AM To:Cooper,Linda Subject:FW: [New Sender-] TV Commercial Permit request for Dish Network Update-Message is from an unknown sender Hi Linda Do you know what the status of this request is?We haven't received any info from your office or the board and I will have to try and schedule traffic control if it is going to take place. Please let me know. Thanks Capt. Frank Kruszeski#820 Executive Officer Southold Town Police Dept. 41405 Rt.25 P.O.Box 911 Peconic,N.Y.11958 (631)765-2671 From:les fincher[mal Ito:Iesfincher@mac.com] Sent:Monday,September 10,2012 10:43 AM To:linda.cooper@southouldtown.northfork.net;Kruszeski,Frank Cc:LES FINCHER;Jeanine Brand;Alexis Carlesimo;Sara Bailin;Dave Cox Subject: [New Sender-] TV Commercial Permit request for Dish Network Update-Message is from an unknown sender Les Fincher Location Manager 917-796-1411 lesfincheremac.com radical media 435 Hudson Street 6th Floor New York,NY 10014 212-462-1500:Office 212-462-1600:Fax radicalmedia.wm RE:Update of Location Status Clearance Dear Town Clerk Cooper and Captain Kruszeski, After we spoke on Friday,I spoke to everyone on Beckwith Ave about our requested film shoot.All residents,the Professional Building and the Main Street Cafe are on board with the project.We will fumish a Certificate of Insurance to each home owner and business.The houses on the street are being compensated. We have secured parking in the large lot behind the Main Street Grill for our working vehicles and a few personal cars while leaving room in the lot for the Historical Society parking and Beckwith Ave regulars.We ask your suggestion for our 20 extra personal cars parking.Would you suggest the Municipal Lot on Travelers St,across from the Train Station?Or could we request a permit to park in the wide south side of Travelers St at Beckwith Ave 7 Our requested start time is 7AM on site.We expect to be finished by approximately 4PM.filming.The load up and exit should take around one hour.We will set up and serve a 30 min catered lunch in the parking lot.We have permission to overnight the working trucks in the large parking lot on Tuesday.This will make our morning arrival seamless and efficient. Please refer to th a enclosed production map of our intentions.I will edit the map with your feedback about personal car parking. Thank you.Please contact me with any questions. 9/11/2012 BECKWITH AVE SOUTHOLD NY .A.� WORKING TRUCKS PARK IN ,. y NORTH END of LOT BEHIND Jeni;s Main Street Grill PERSONAL��� � 54195 Route 25(Maim St) �. Personal cars park a9 Municipal at corner of Travelers St and Youngs Avco 7fl , `, '` o,S%3FF01,fc� ELIZABETH A.NEVILLE,MMC �� G.j, Town Hall,53095 Main Road TOWN CLERKp P.O.Box 1179 CO2 Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS O •F Fax(631)765-6145 MARRIAGE OFFICEROl �a0�' Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southoldtown.northfork.net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Flatley, Southold Town Police Mike Verity, Building Department Bob Fisher, Fire Marshal Damon Rallis, Code Enforcement Officer Peter Harris, Superintendent of Highways James McMahon, Dept of Public Works From: Linda J. Cooper, Deputy Town Clerk Dated: September 11, 2012 Re: Filming Permit No. 033 In accordance with Town Code you are being notified that a Film Permit was issued to Radical Media for Dish Network. See following pages for a copy of the permits and applications. Page 1 of 1 Rudder, Lynda From: Kruszeski, Frank Sent: Tuesday, September 11, 2012 1:13 PM To: Rudder, Lynda Subject: film crew Hi Linda I have gotten several calls from Les Fincher regarding tomorrows filming at Beckwith. We have been waiting for Linda to request a cost analysis and our approval and she apparently is waiting for us to just forward them. We do not have any problem with Mr. Fincher filming tomorrow. The cost analysis will have to follow as the Chief does those and he will not be in until later this afternoon. In any case the cost should not be more than about$200.00. Mr. Fincher should be advised to make any future requests in a more timely manner. If you could pass this along to Linda Cooper that would be great. Thanks Capt. Frank Kruszeski #820 Executive Officer Southold Town Police Dept. 41405 Rt. 25 P.O. Box 911 Peconic, N.Y. 11958 (631)765-2671 9/11/2012 • � y TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments must be cash or certified check Applicant: Date Received: Completed application $100 nonrefundable application fee i-� 6 0 �C'l`f Certificate of insurance that evidences a public liability insurance policy covering the town as an additional insured in the amount of$1,000,000 (one million dollars) per occurrence for the duration of the filming or still photography. Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of said filming or still photography. Forward completed application to Chief of Police for approval or disapproval and determination if Traffic Control Fee is required Approved Disapproved No Fee Required Fee in the amount of$ required Forward certificate of insurance and indemnification agreement to Town Attorney for approval Approved Disapproved COLLECT FEES AS FOLLOWS: Permit Fees (Prior to issuance of permit): Film Fee - $100 per day of each day covered by the permit /Cleanup deposit: Separate certified check for $250 for each day covered by the permit. Traffic control fee - $1000 for each day covered by the permit if required by the Chief of Police. NOTE: Additional funds may be required by Police if it is determined that $1000 per day fee will be expended prior to the termination of the permit period. Beach Parking fee - $10 per vehicle, per day between May 1 and September 30. ISSUED PERMIT Countersign application Issue permit with name of applicant, locations(s), date(s), and time(s) NOTIFICATION of ISSUED PERMIT Chief of Police Chief Building Inspector Fire Marshal Code Enforcement Officer Superintendent of Highways Superintendent of Parks and Recreation REQUEST FOR EXTENSION OF PERMIT Forward extension permit request to Chief of Police If granted, collect additional $100 per day filming fee Amend permit to indicate granted extension period COMPLETION OF PERMIT PERIOD Chief of Police to provide applicant with statement of cost for providing Traffic Control and police coverage. (Refund overpayment or collect for additional costs within 30 days of termination of permit) Superintendent of Highways inspections locations listed on permit and determine if cleanup efforts by town personnel is required. *If cleanup is required, Superintendent will provide Town Clerk with a statement of actual costs. (Refund overpayment or collect for additional costs within 30 days of termination of permit) *If not cleanup is required, Superintendent of Highways will notify Town Clerk and Town Clerk will remit the $250 certified check to applicant. Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 09/07/12 Receipt#: 142010 Transaction(s): Reference Subtotal 1 1 Application Fee- Non-Refund 033 $100.00 Check#: 60814 Total Paid: $100.00 Name: Radical, Media Inc 435 Hudson St, 6th FI New York, NY 10014 Clerk ID: LINDAC Internal ID:033 o�oS�FFo[,��o ELIZABETH A.NEVILLE,MMC �� G.f, Town Hall,53095 Main Road TOWN CLERKp P.O.Box 1179 COD Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p • .1C Fax(631)765-6145 MARRIAGE OFFICERO! ���� Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southoldtown.northfork.net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK C TOWN OF SOUTHOLDU v FrAnk 1 %-vszesk� P To: Chief Flatley, Southold Town Police From: Linda J. Cooper, Deputy Town Clerk Dated: September 7, 2012 Re: Filming Permit ` Transmitted herewith is the application of Radical Media filming/photo shoot permit. In accordance with Section 139.0 of the Town Code please review the .application and advice of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. 07/09 '12 FRI 12:28 FAX 631 765 6145 SOUTHOLD TOWN CLERK Z001 xc TX REPORT xcxe TRANSMISSION OK TX/RX NO 2301 CONNECTION TEL 7342315 CONNECTION ID PD Administ ST. TIME 07/09 12:27 USAGE T 01'43 PGS. SENT 5 RESULT OK Cp ELIZABETH A NEVILLE,MMC �� 'lawn 11all,53095 Main Road TOWN CLERK g P.O.Box 1179 rA Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER � Vt �9 Q Telephana(6:31)765-1,800 RECORDS OF MANAGEMENT OFFICER �d �� FREEDOM OF INFORMATION OFFICER southoldtown_northfark.net OFFICE OF TATE TOWN CLERK TOWN OF SOUTHOLD To: Chief Flatley, Southold Town Police From: Linda J. Cooper, Deputy Town Clerk Dated: September 7, 2012 Re: Filming Permit Transmitted herewith is the application of Radical Media filming/photo shoot permit. In accordance with Section 139.0 of the Town Code please review the application and advice of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. @ radical.media LLC City National Bank 435 HUDSON STREET N�' 0 6 0 814 1-1395/260 NEW YORK,NY 10014 AMOUNT DATE 09/06/12 CHECK NO. 060814 PAY One Hundred Dollars and 00/100 DOLLARS TO SOUTHOLD TOWN HALL THE 53095 MAIN ROAD ORDER P.0 BOX 1179 OF SOUTHOLD, NY 11971 Ila0608 4L.0 1:0260139S131: 6GS"109856711' Qradical.media LLC City National Bank nIo. 080815 435 HUDSON STREET 1-1395/260 NEW YORK,NY 10014 AMOUNT DATE09/06/12 CHECK NO. 060815 PAY Two Hundred Fifty Dollars and 00/100 F 7DOLLARS TO SOUTHOLD TOWN HALL THE 53095 MAIN ROAD ORDER P.0 BOX 1179 OF SOUTHOLD, NY 11971 - Nv Ila 060815Ila 1:0 260 1 39 581: 66S...098567iI • _ —, _ �.. @radical.media LLC City National Bank 435 HUDSON STREET N�• 0 5 0 816 1-1395/260 NEW YORK,NY 10014 09/06/12 060816 ❑ AMOUNT DATE CHECK NO. $ PAY One Thousand Dollars and 00/100 DOLLARS TO SOUTHOLD TOWN HALL THE 53095 MAIN ROAD ORDER P .0 BOX 1179 OF SOUTHOLD, NY 11971 ---c- W 111060816ii' 1:0 260139581: •665111098567ii' RECEIVED SEP - 7 2012 Southold Town r►erI, APPLICATION FOR FILMING/STILL PHOTOGRAPHY PERMIT NO: Please Print or Type q APPLICATION DATE: I 1 Z NAME OF APPLICANT: �A >k c r>1 Ao:> `C t"CA�2, L 0c A wm M/�n�0e►e�,�a , MAILING ADDRESS: 35 H'i b-3 � S7 , NY NY I oQ 1� PHONE: BUSINESS: 2 lZ A to 2 -IS O Q HOME: NAME OF ORGANIZATION/COMPANY: �ADi C \ ��, ►S� N e�h,`►a►�-� MAILING ADDRESS: 43-7� -Hvp,5c , ST , r w�Y 1 Gd 1 L} PHONE: 21 Z FAX: -1Z . 14 U,Z , I (p DESCRIBE TYPE OF ACTIVITY(e.g. Motion Picture, Commercial, Television. Catalog,Magazine, etc.): Ty rUel1�t0-` 4�61ZD !�A °a)� �--T /J6 S 5��� ix,,o SAt\RQ-T DATE(S)AND TIME(S) OF PROPOSED FILMING/PHOTOGRAPHY: Se,P-F 12, l2, 1n1 �r�s���! 7N PROPOSED LOCATIONS) OF FILMING/PHOTOGRAPHY: (attach additional sheet,if necessary) _ _----.ST�ccTA��,� - �.�w►-i-H -�v�,��n�\ � ���-e�� (�1a�N �`T��y�2 NAME OF PERSON IN CHARGE AT SITE: akm { cA-�L �1 �� q n--16 14 1) NUMBER OF PERSONS AT LOCATION(cast&crew included): Cj O -1-— NUMBER AND TYPE OF VECHILES AT LOCATION: W6 V�tlVjerute p�iJ� �,�,z�,,u well . *�`�` Seuu e_ - ZyFf TYPE OF SPECIAL EQUIPMENT: ANY SPECIAL REQUIREMENTS: t4D Gtr � R Signature Return to: Southold Town Clerk Southold Town Hall 53095 Main Road r! P,O. Box 1179 M�� �.�-�,� C p,q�b Southold,NY 11971 radical media 435 Hudson Street 6th Floor Les Fincher New York, NY 10014 LOCATION MANAGER 212-462-1500 :Office FILM AND PHOTOGRAPHY 212-462-1600 :Fax / 7.796, 141 1 radicalmedia.com LESFINCHER@MAC.COM Les Fincher WWW.LESFINCHERCOM Location Manager - -- 917-796-1411 lesfincher@mac.com lesfincher.com 8-4-2012 RE: Filming Location for Dish Network TV Commercial Dear Resident, Our company is scouting locations for an upcoming TV Commercial for Dish Network. We are looking for rural setting to stage a neighborhood,i wO Pn'�,vv parade. We wish to consider your place. The filming is exterior only and is scheduled to shoot on September 12. We will furnish a Certificate of Insurance and Location Fee payment. We will secure all local Film Permits. We look forward to hearing from you. Thank you for considering this project. Les Fincher Location Manager INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT The Applicant shall indemnify and hold harmless the Town from and against all suits, claims, demands or actions for any damage and/or injury sustained or alleged to be sustained by any party or parties in connection with the performance of filming or still photography by the Applicant, his employees or agents or any subcontractor and in case of any such action brought against the Town, the applicant shall immediately take charge of and defend the same at his own cost and expense. In addition, the Applicant will name the Town as an additional insured on any applicable policies. (ca A Signature � Date L� Printed name Title `C DATE(MM/DDIYY A� CERTIFICATE OF LIABILITY INSURANCE 9/6/2012 �) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Bridget Hickey Taylor & Taylor Ltd. PHONE (212)490-8511 pXC.No; (212)490-7236 16 East 40th Street E-MAIL .bhickey@taylorinsurance.com 11th Floor INSURERS AFFORDING COVERAGE NAIC# New York NY 10016-0113 INSURERA:Federal Insurance Company 0261 INSURED INSURER B: INSURER C: @ radical.media, LLC INSURER D: 435 Hudson Street INSURER E: New York NY 10014 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD1YYYY LICY EFF POLICY EXP LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE IUKhNll:U X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ Included A CLAIMS-MADE a OCCUR 79350612 /30/2012 /30/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ Included X POLICY JFCT PRO LOC $ AUTOMOBILE LIABILITY Ea acB.c,d.n, IN E LIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED 9406605 /30/2012 /30/2013 AUTOS AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 11,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 11,000,000 DED I X I RETENTION$ 10,000 79373164 /30/2012 /30/2013 $ A WORKERS COMPENSATION X WC STATU- OTH- LIMIT AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ N/A E.L.EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? 9956977 (Mandatory In NH) /8/2011 /8/2012 FIE.L.DISEASE-EA EMPLOYE $ 11000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 A PRODUCTION PACKAGE INCL. 79595756 /30/2012 /30/2013 LIMITS SEE ATTACHED HIRED AUTO PHYS. DAMAGE DEDUCTIBLES SEE ATTACHED DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate Holder is included as Additional Insured on the General Liability Policy with respect to claims arising out of the negligence of the Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold Town Hall ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Main Road P.O. BOX 1179 AUTHORIZED REPRESENTATIVE Southold, NY 11971 Bridget Hickey/NICOLE ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD radical media 435 Hudson Street 6th Floor Les Fincher New York, NY 10014 212-462-1500 :Office LOCATION MANAGER 212-462-1600 :Fax FILM AND PHOTOGRAPHY radical media.corn 917.796. 141 1 LESFINCHER@MAC.COM Les Fincher WWW.LESFINCHERCOM Location Manager 917-796-1411 lesfincher@mac.com lesfincher.com 8-4-2012 RE: Filming Location for Dish Network TV Commercial Dear Resident, Our company is scouting locations for an upcoming TV Commercial for Dish Network. We are looking for rural setting to stage a neighborhood i Ivo P(f,e5.JA1 parade. We wish to consider your place. The filming is exterior only and is scheduled to shoot on September - 12. We will furnish a Certificate of Insurance and Location Fee payment. We will secure all local Film Permits. We look forward to hearing from you. Thank you for considering this project. Les Fincher Location Manager