Appendix
Clasification Society 2024 - Version 9.40
Statutory Documents - IMO Publications and Documents - International Codes - 1989 MODU Code – Code for the Construction and Equipment of Mobile Offshore Drilling Units, 1989 – Resolution A.649(16) - Appendix

Appendix

Model form of Mobile Offshore Drilling Unit Safety Certificate (1989)
MOBILE OFFSHORE DRILLING UNIT SAFETY CERTIFICATE (1989)
(Official seal) (State)
       
       
Issued under the provision of the
IMO CODE FOR THE CONSTRUCTION AND EQUIPMENT OF MOBILE OFFSHORE DRILLING UNITS, 1989
as amended by resolution MSC.38(63)
under the authority of the Government of
.............................................................................................................................................................
(full designation of the State)
by ............................................................................................................................................................
(full official designation of the competent person or organization authorized by the Administration)
Distinctive identification
(name or number) 		Type
(1.3 of the Code) 		Port of registry
     
     
       
Date on which keel was laid or unit was at
a similar stage of construction or on which
a major conversion was commenced ______________________________________________________________
THIS IS TO CERTIFY:    

1 That the above-mentioned unit has been duly surveyed in accordance with the applicable provisions of the Code for the Construction and Equipment of Mobile Offshore Drilling Units, 1989.

2 That the survey showed that the structure, equipment, fittings, radio station arrangements and materials of the unit and the condition thereof are in all respects satisfactory and that the unit complies with the relevant provisions of the Code.

3 That the life-saving appliances are provided for a total number of ... persons and no more as follows:

4 That, in accordance with 1.4 of the Code, the provisions of the Code are modified in respect of the unit in the following manner:

5 That this unit has been issued with an approval for the continuous survey techniques under 1.6.4 of the Code in lieu of renewal and intermediate surveys in respect of:

Hull Machinery
   
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
signature and seal of approving authority date of continuous survey programme
approval
This Certificate is valid until the . . . . . . . . . . . . day of . . . . . . . . . . . . .19 . . . .
Completion date of the survey on which this certificate is based: . . . . . . . . . . . . . . . . . . . . . . .
  (dd/mm/yyyy)
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 intermediate surveys
This is to certify that, at a survey required by 1.6 of the Code, this unit was found to comply with the relevant provisions of the Code.
Annual survey: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  (Signature of authorized official)
  Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
         
Annual/intermediate survey: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Annual/intermediate survey: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Annual survey: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Annual/intermediate survey in accordance with 1.6.11.7.3 of the Code
Annual survey: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Endorsement for the drydock survey
This is to certify that, at a survey required by 1.6 of the Code, this unit was found to comply with the relevant provisions of the Code.
First inspection: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
Second inspection: Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Endorsement to extend the Certificate if valid for less than 5 years where 1.6.11.3 of the Code applies
This unit complies with the relevant requirements of the Code, and this certificate should, in accordance with 1.6.11.3 of the Code, be accepted as valid until . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  (Signature of authorized official)
  Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Endorsement where the renewal survey has been completed and 1.6.11.4 of the Code applies
This unit complies with the relevant requirements of the Code, and this certificate should, in accordance with 1.6.11.4 of the Code, be accepted as valid until . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Endorsement to extend the validity of the certificate until reaching the port of survey where 1.6.11.5 of the Code applies
This certificate should, in accordance with 1.6.11.5 of the Code, be accepted until . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
Endorsement for the advancement of the anniversary date where 1.6.11.7 of the Code applies
In accordance with 1.6.11.7 of the Code, the new anniversary date is . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
           
In accordance with 1.6.11.7 of the Code, the new anniversary date is . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        (Signature of authorized official)
        Place . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
        Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Seal or stamp of authority, as appropriate)
Parent topic: 1989 MODU Code – Code for the Construction and Equipment of Mobile Offshore Drilling Units, 1989 – Resolution A.649(16)
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