Tampa Florida Vacation - Hotels, Restaurants, Beaches

PERMIT NUMBER

Permit Number:

For Internal Use Only

PRODUCTION COMPANY CONTACT INFO

Production Company:
First Name:
Last Name:
Title:
Address:

City:
State:
Zip:
Country:
Email:
Phone:
Cell Phone:
Fax:

CLIENT/AGENCY CONTACT INFO

Client/Agency Name:
Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Website:

TYPE OF PRODUCTION

	Feature Film
	Television
	Commercial
	Corporate/Industrial
	Music Video
	Student Project
	Still Photography

ADDITIONAL PRODUCTION INFORMATION

Production Title:	If feature film/television, list working title and submit script. Commercials, list product/service
Detailed Description of the Production: Please include number of crew members on site during filming
	Special Effects/Pyrotechnics Click All That Apply
	Animals
	Airplanes/Helicopters/Boats
	Stunts

LOCATION(S)

Location Name:
Location Date:
Location Time:
Location Name #2:
Location Date #2:
Location Time #2:
Location Name #3:
Location Date #3:
Location Time #3:

ADDITIONAL LOCATIONS

Please supply your additional location information, if using more than 3 locations. Parking fees may apply.
Additional Locations:

ADDITIONAL CITY/COUNTY ASSISTANCE

* An off-duty police officer is required for any type of closing at each end of the closure. Off-duty rates vary. **An additional permit is required when closing a street or sidewalk/walkway and must be approved by the City of Tampa, Hillsborough County, or appropriate municipality. The Film Office will assist you with this process.
	Off-duty police officer(s)*
	Street/Sidewalk Closing**
	Parking Required
	Fire Department

ECONOMIC IMPACT

Submitting the following information continues to make filming successful in Hillsborough County. While we are required by the County to report general numbers, your specific information is kept confidential. Thank you for filming with us!
Start Date:
Completion Date:
Total # of Production Days:
Total $ amount spent within Hillsborough County:	$
Total # Local Hires (talent,tech,etc.):
Approximate TOTAL Project Budget (Overall):	$

HOTEL/PROPERTY INFORMATION

Hotel/Property Names:
Total # of Rooms Booked:

INSURANCE

An Acord 25 certificate of insurance is required in the amount of $1,000,000 or more with the City of Tampa (411 N. Franklin St., Tampa, FL 33602) or Hillsborough County (601 East Kennedy Blvd., Tampa, FL 33602) listed as additionally insured. Other addresses may apply for additional municipalities. Insurance may be required for use of private property. Please contact the film office to identify the areas for which you are filming.

The applicant shall assume all risk in the use of City/County property in the permitted operation and shall be solely responsible and answerable in damages for all accidents and injury to person or property and shall indemnify and keep harmless the City/County and its officers and employees from any and all claims, suits, losses, damages or injury to person or property.

Insurance certificates should be emailed to DJacob@VisitTampaBay.com. Permits will not be issued without a certificate of liability insurance on file.

Production Company Representative:

Film Commission Representative:

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