Herewith we confirm that we provide the necessary insurance cover for the following event:

Title of project:

Shooting period:
Shooting location(s) (cities):

Name of Insurance Company:
Contact details:
Policy holder:
Policy number:

Name of Production Company:
Contact details:

…………..                                                                                        ……….
(Place)                                                                                         (Date)

………….
(Stamp and/or signature)