Motion picture / television declaration application for canadian productions



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MOTION PICTURE / TELEVISION DECLARATION APPLICATION FOR CANADIAN PRODUCTIONS


Named Insured:

Sony Pictures Entertainment Inc.

Policy No:

Allianz Canada MPT 07109978

Fireman’s Fund MPT 07109977






Production Name/Title:

LIZZIE BORDEN

Declaration Number:




(Insurance Company Use Only)

Production Entity:

Woodridge Productions, Inc. (U.S.) Lizzie Productions Inc. (owned by PSC – Rock Magic)




Address:

5285 Sackville Street

City:

Halifax

Province:

NS

Zip:

B3J 1K9

Phone:

(902) 446-4655

Fax:

(902) 446-4808






Director:

Nick Gomez

Producer:

Mike Mahoney

UPM:

Valarie Halman

Trans. Mgr.

Steve Murphy

Location Mgr.

Jason Van Houten

Prod. Coor.

Rob Chapman

Stunt Coor:

Randy Boliver

SF/X Spvsr:

Dylan Harris-McDonald

Vis. F/X Coor:

N/A

Production is:







Motion Picture for Theatrical Release

X

Television Movie




Television Special




Television Mini-Series







Television Series




Television Pilot







Other (Describe):






For Television, indicate production running time:

2 hr

Number of Episodes:







Production Type (Drama, Comedy, Musical, Western, etc.):

Drama




Storyline:

Based on the story of Lizzie Andrew Borden - an American woman who was tried and acquitted in the 1892 axe




murders of her father and stepmother.




Principal Photography:

Starts on:

6-27-13

Ends on:

7-22-13

Total Filming Weeks

4




At following locations:

All location in and around Halifax




Any hiatus periods contemplated (describe):

N/A

Describe all planned scenes with: animals, stunts, underwater filming, aircraft, RR cars or equipment, motorcycles, racing/chase scenes, fire sequences, explosives, watercraft or other hazardous activities:



Horses






Post Production Lab:

Digi Boz (dailies); Colorworks (finishing)

Location:

Nova Scotia; Sony lot




Estimated Date of Protection Print:

9-26-13




For Cast, any:




Tie-in deals between two or more artists




Pay-or-Play contract deals




Salary deferments

If yes, provide a copy of the contract(s)



Will any declared artists be involved in any stunt or hazardous activities:




yes




no

If yes, provide details:












Foreign currency rate of exchange declared at inception:

Country:




Exchange Rate:







Any special film processes, special effects, equipment




yes




no

If yes, details:













Describe any special locations, sets, props, wardrobe:

N/A

Alternate locations available:




Est. time to reconstruct or obtain alt. loc.:






Other information or comments concerning production:






This Declaration Application completed by:

Dawn Luehrs

Date:

June 27,2013




Title:

Director, Risk Management

Phone Number:

(310) 244-4230

Email:

Dawn_luehrs@spe.sony.com




Audit/Accountant Contact:

Colleen McMaster

Phone Number:

(902) 499-7772 (cell)


Email:

colleenmcmaster@yahoo.com




Fireman's Fund Insurance Companies Allianz Group

Entertainment Division



Revision Date: 5/31/16 9:44 a5/p5

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