CMF Application #:
DEVELOPMENT ENVELOPES
All Programs
Convergent Stream 2016-2017
Please note:
• For applications with development envelope funding, all eligible development fees may provide development envelope credit to the Broadcaster.
• Please ensure that the information on this form corresponds with the information submitted by the Applicant in the CMF application. If there are discrepancies, this form may be considered incomplete.
APPENDIX TO THE BROADCAST LICENCE
(one form per broadcaster) in connection with:
Cycle: between:
Independent production company and: who is a member of:
Terms of Trade: Yes No
Dated: (yyyy-mm-dd)
Episodes # to #
(“Television Component”)
(“Television Component Applicant”)
Broadcaster-affiliated production company
(“Broadcaster*”)
(“Broadcast Ownership Group”)
*Broadcaster refers only to eligible broadcasters as per the Guidelines.
If Yes (select one) : Fair market value Superlicence
CONVERGENT CRITERIA FOR ELIGIBLE PROJECTS
Please confirm which of the following Convergent Criteria is being met, as set out in Section 3.2 of the Development Program
Guidelines.
Convergent Criteria (Select only one)
Funded Digital Media Component with costs representing $10,000 and more
(select if Digital Media development costs represent $10,000 and more AND a Digital Media application is submitted)
Value-Added Digital Media Component with costs are below $10,000
(select when Digital Media development costs are included in the television budget)
Non-Funded Digital Media Component
The Television Component will be made available to Canadians by one or more CRTC-licensed video-on-demand
(VOD) services
The Television Component will be made available to Canadians by a Canadian entity via non-simulcast digital distribution
REGIONAL DEVELOPMENT PROJECT
Yes No Is the Television Component a Regional Development Project as defined in Section 2.1.1. of the 2016-2017
Development Program Guidelines?
GENRE
Children’s Youth Documentary Drama Variety Performing Arts
CREATIVE MATERIALS
Creative Materials to be completed and delivered for THIS PHASE OF DEVELOPMENT (e.g. Bible, Treatment, Draft Script etc.):
Please note: This information must accord with the broadcaster development letter and the information submitted by the Applicant in the CMF application.
Broadcaster Agreement Form 2016-2017
Convergent Stream - Development - TV CANADA MEDIA FUND
1

Development Budget ($):
(Must correspond to the amount of the development budget submitted with the application )
Budget Date (yyyy-mm-dd) :
FINANCIAL INFORMATION
A. Development Fee provided by the Broadcaster:
(This must meet the Development Fee Threshold as detailed in
Section 2.A.3 of the Development Program Guidelines.)
B. CMF Development Envelope Contribution provided by the Broadcaster ** :
** To a Maximum Contribution as detailed in Section 2.A.2 of the
Development Program Guidelines
C. Other contribution provided by the Broadcaster:
Please specify the contribution type:
DEVELOPMENT SCHEDULE
Stages
Projected Start Date for this Development Request:
Projected Completion Date for this Development Request:
Amount ($)
Date (yyyy-mm-dd)
The Broadcaster has reviewed the budget and the financing plan submitted with the CMF application for the Television
Component and finds the budget adequate, under normal circumstances, to sufficiently develop the Television Component.
The Television Component Applicant and the Broadcaster each hereby acknowledge that, should the development budget or the final development costs for the Television Component increase, in order to remain eligible for funding, the Television Component must have an eligible Canadian Development Fee sufficient to meet the CMF’s
Development Fee Threshold requirements in relation to the increased development budget or final development costs.
The Television Component Applicant and the Broadcaster each hereby acknowledge that advances from the Development
Envelope must be repaid on the earlier of: (a) the first day of commencement of official preparation for principal photography of the Television Component or any other use of the script, or (b) upon the transfer, sale, assignment or other disposition of the script.
The Television Component Applicant and the Broadcaster hereby each confirm that they have not entered into any oral or written agreement or “side deal” that conflicts with any of the provisions of this Broadcaster Agreement Form or the CMF 2016-2017
Development Program Guidelines.
The Broadcaster hereby authorizes the Television Component Applicant to apply to the CMF for a portion of the Broadcaster’s designated Development Envelope for the Television Component. The amount for which the Television Component
Applicant is entitled to apply for the Television Component is indicated on page two of this Broadcaster Agreement Form as the CMF Development Envelope Contribution. The application for the Television Component must be received at the CMF by the applicable deadline date in order for the Television Component to remain eligible for CMF funding.
The Broadcaster hereby confirms that its financing of the Television Component on the terms described herein is in compliance with the terms and conditions governing the use of its CMF Development Envelope.
All capitalized terms not defined herein shall have the meaning ascribed to them in the CMF 2016-2017 Guidelines.
Broadcaster Agreement Form 2016-2017
Convergent Stream - Development - TV CANADA MEDIA FUND
2

AGREED AND ACCEPTED BY:
For the Broadcaster
Signature:
Name:
(please print)
Title:
Date:
(yyyy-mm-dd)
For the Television Component Applicant
Signature:
Name:
Title:
Date:
(please print)
(yyyy-mm-dd)
Signature:
Name:
(please print)
Title:
Date:
(yyyy-mm-dd)
Signature:
Name:
(please print)
Title:
Date:
(yyyy-mm-dd)
For the Television Component Co-Applicant (if applicable)
Signature: Signature:
Name:
(please print)
Title:
Date:
(yyyy-mm-dd)
Name:
(please print)
Title:
Date:
(yyyy-mm-dd)
Broadcaster Agreement Form 2016-2017
Convergent Stream - Development - TV CANADA MEDIA FUND
3