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Production Company
Project Name
Contact Name
Phone Number
Email Address
How did you hear about us?
Start Date
Duration of Project
Type of Project
Theatre Crew Film Commercial Other
If Other:
Talent Information Crew Information
Union      Non-Union Union      Non-Union
       
Union Name Union Name and Local
Union Contract Union Contract
Union Representative Union Representative
How many people? How many people?
State? State?
Gross Payroll Amount? Gross Payroll Amount?
Start date if different from above Start date if different from above
Do you or will you have liability insurance coverage? Yes No
  *** NPI requires liability insurance coverage naming NPI as additionally insured before payroll services can be provided - please be prepared to provide a certificate of coverage.
Do you require NPI to provide Workers Compensation Insurance? Yes No
  *** If no, NPI requires proof of Workers Compensation Insurance before providing payroll services - please be prepared to provide a certificate of coverage.
NPI requires the address of all shooting locations, including city, state and zip. Please provide this below:
Please describe all actions performed by Talent/Crew (stunts, acrobats, fight scenes, water scenes, etc.)
Please note: NPI will not carry Workers Compensation for volunteers or interns. Please contact your liability insurance carrier to provide you with Auxiliary coverage.
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