CarSafeq.doc

Form of Safety Equipment Certificate for Cargo Ships

CARGO SHIP SAFETY EQUIPMENT CERTIFICATE

This Certificate shall be supplemented by a Record of Equipment (Form E)

Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1988 relating thereto

under the authority of the Government of

(name of the State)

by

(person or organization authorized)

Particulars of ship

Name of ship

Distinctive number or letters

Port of registry

Gross tonnage

Deadweight of ship (metric tons)[1]

Length of ship (regulation III/3.12)

IMO Number[2]

Type of ship[3]

              Bulk carrier

              Oil tanker

              Chemical tanker

              Gas carrier

              Cargo ship other than any of the above

Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on which work for a conversion or an alteration or modification of a major character was commenced

THIS IS TO CERTIFY:

1              That the ship has been surveyed in accordance with the requirements of regulation I/8 of the Convention.

2              That the survey showed that:

2.1              the ship complied with the requirements of the Convention as regards fire safety systems and appliances and fire control plans;

2.2              the life-saving appliances and the equipment of the lifeboats, liferafts and rescue boats were provided in accordance with the requirements of the Convention;

2.3              the ship was provided with a line-throwing appliance and radio installations used in life-saving appliances in accordance with the requirements of the Convention;

2.4              the ship complied with the requirements of the Convention as regards shipborne navigational equipment, means of embarkation for pilots and nautical publications;

2.5              the ship was provided with lights, shapes and means of making sound signals and distress signals in accordance with the requirements of the Convention and the International Regulations for Preventing Collisions at Sea in force;

2.6              in all other respects the ship complied with the relevant requirements of the Convention.

3              That an Exemption Certificate has/has not[4] been issued.

This certificate is valid until [date][5] subject to the annual and periodical surveys in accordance with regulation I/8 of the Convention.

Issued at

(Place of issue of certificate)

(Date of issue)

(Signature of authorized official issuing the certificate)

(Seal or stamp of the issuing authority, as appropriate)

ENDORSEMENT FOR ANNUAL AND PERIODICAL SURVEYS

THIS IS TO CERTIFY that, at a survey required by regulation I/8 of the Convention, the ship was found to comply with the relevant requirements of the Convention.

Annual survey:

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

Annual/Periodical[6] survey:

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

Annual/Periodical6 survey:

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

Annual survey:

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

ANNUAL/PERIODICAL SURVEY IN ACCORDANCE WITH REGULATION I/14(h)(iii)

THIS IS TO CERTIFY that, at an annual/periodical[7] survey in accordance with regulation I/14(h)(iii) of the Convention, this ship was found to comply with the relevant requirements of the Convention.

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN 5 YEARS WHERE REGULATION I/14(c) APPLIES

The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14(c) of the Convention, be accepted as valid until [date]

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED AND REGULATION I/14(d) APPLIES

The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14(d) of the Convention, be accepted as valid until [date]

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE PORT OF SURVEY OR FOR A PERIOD OF GRACE WHERE REGULATION I/14(e) OR I/14(f) APPLIES

The certificate shall, in accordance with regulation I/14(e)/I/14(f)[8] of the Convention, be accepted as valid until [date]

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE REGULATION I/14(h) APPLIES

In accordance with regulation I/14(h) of the Convention, the new anniversary date is

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)

In accordance with regulation I/14(h) of the Convention, the new anniversary date is

Signed:

(Signature of authorized official)

Place:

Date:

(Seal or stamp of the authority, as appropriate)