CERTIFICATE OF FITNESS
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(Official seal)
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Issued
under the provisions of the
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CODE FOR
THE TRANSPORT AND HANDLING OF HAZARDOUS AND NOXIOUS LIQUID SUBSTANCES IN
BULK ON OFFSHORE SUPPORT VESSELS (OSV CHEMICAL CODE) (resolution
[A.
(30)])
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under the
authority of the Government of
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(full
official designation of country)
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by
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(full
designation of the competent person or organization recognized by the
Administration)
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Particulars of vesselfootnote
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Name of vessel
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.......................................................................................
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Distinctive number or letters
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......................................................................................
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IMO numberfootnote
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......................................................................................
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Port of registry
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......................................................................................
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Gross tonnage
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......................................................................................
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Date on which keel was
laid or on which the vessel was at a similar stage of construction or (in
the case of a converted vessel) date on which conversion to offshore support
vessel was commenced
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The vessel also complies
fully with the following amendments to the Code:
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The vessel is exempted
from compliance with the following provisions of the Code:
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THIS IS TO CERTIFY:
1 That the vessel has been surveyed in accordance with the provisions of 1.4 of the
Code;
2 That the survey showed that the construction and equipment of the vessel and the
condition thereof are in all respects satisfactory and that the vessel complies with the
relevant provisions of the Code;
3 That the vessel has been provided with a Manual in accordance with appendix 4 of
Annex II of MARPOL as called for by regulation 14 of
Annex II, and that the arrangements and equipment of the vessel prescribed in the Manual
are in all respects satisfactory;
4 That the vessel meets the requirements for the carriage in bulk of the following
products, provided that all relevant operational requirements of the Code and MARPOL
Annex
II are observed:
Product
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Conditions of carriage (tank
numbers, etc.)
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Pollution Category
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Continued on
attachment 1, additional signed and dated sheets.footnote
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Tank numbers
referred to in this list are identified on attachment 2, signed and dated
tank plan.
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5 That, in accordance with 1.3, the provisions of the Code are modified in respect of
the vessel in the following manner:
6 That the vessel should be loaded:
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.1 in accordance with the loading conditions provided in the approved loading
manual, stamped and dated........................ and signed by a responsible
officer of the Administration, or of an organization recognized by the
Administrationfootnote;
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.2 in accordance with the loading limitations appended to this Certificate.footnote
Where it is required to load the vessel other than in accordance with the above
instruction, the necessary calculations to justify the proposed loading conditions
should be communicated to the certifying Administration who may authorize in writing the
adoption of the proposed loading condition.footnote
This Certificate is valid
until (dd/mm/yyyy)
...
footnote
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subject to
surveys in accordance with 1.4 of the Code.
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Completion date of the survey on which this
certificate is based:
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..............................................
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(dd/mm/yyyy)
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Issued at
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(Place of issue of certificate)
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(Date of
issue)
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(Signature of
authorized official issuing the certificate)
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(Seal or stamp of the
authority, as appropriate)
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Notes on completion of Certificate:
1 The Certificate can be issued only to vessels entitled to fly the flags of States
which are both a Contracting Government to SOLAS and a Party to MARPOL.
2 Products: products listed in 1.1.9 of the Code, or which have been evaluated by the
Administration in accordance with 1.1.10 of the Code should be listed. In respect of the
latter "new" products, any special provisions provisionally prescribed should be noted.
3 Products: the list of products the vessel is suitable to carry should include the
noxious liquid substances of category Z which are not covered by the IBC Code and should
be identified as "IBC Code chapter 18 Category Z".
ENDORSEMENT FOR ANNUAL AND INTERMEDIATE SURVEYS
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THIS IS TO CERTIFY that
at a survey required by 1.5.2 of the IBC Code the vessel was found to comply
with the relevant provisions of the Code.
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Annual survey:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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Annual/Intermediatefootnote survey:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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Annual/Intermediatefootnote survey:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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Annual survey:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ANNUAL/INTERMEDIATE SURVEY IN ACCORDANCE
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WITH
1.5.6.8.3 OF THE IBC CODE
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THIS IS TO CERTIFY
that, at an annual/intermediatefootnote survey in accordance with 1.5.6.8.3 of the
IBC Code, the vessel was found to comply with the relevant requirements
of the Convention:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID
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FOR
LESS THAN 5 YEARS WHERE 1.5.6.3 OF THE IBC CODE APPLIES
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The vessel complies
with the relevant requirements of the Convention, and this Certificate
should, in accordance with 1.5.6.3 of the IBC Code, be accepted as valid
until .......................
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN
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COMPLETED AND 1.5.6.4 OF THE IBC CODE APPLIES
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The vessel complies
with the relevant requirements of the Convention, and this Certificate
should, in accordance with 1.5.6.4 of the IBC Code, be accepted as valid
until .......................
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Annual survey:
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE
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UNTIL REACHING THE PORT OF SURVEY OR FOR A PERIOD
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OF
GRACE WHERE 1.5.6.5 OR 1.5.6.6 OF THE IBC CODE APPLIES
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This Certificate
should, in accordance with 1.5.6.5/1.5.6.6footnote of the IBC Code, be accepted as valid until
.......................
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE
1.5.6.8
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OF
THE IBC CODE APPLIES
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In accordance with
1.5.6.8 of the IBC Code, the new anniversary date is
.......................
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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In accordance with
1.5.6.8 of the IBC Code, the new anniversary date is
.......................
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Signed
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(Signature of duly authorized
official)
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Place
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Date (dd/mm/yyyy)
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(Seal or stamp of the Authority, as
appropriate)
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ATTACHMENT 1 - TO THE CERTIFICATE OF FITNESS
Continued list of products to those specified in section 4, and their conditions of
carriage.
Products
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Conditions of carriage (tank
numbers, etc.)
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Pollution Category
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Date
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(dd/mm/yyyy)
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(Signature of official
issuing the Certificate
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(as for
Certificate)
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and/or seal of issuing
authority)
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ATTACHMENT 2 - TO THE CERTIFICATE OF FITNESS
Name of vessel:
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Distinctive number or
letters:
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Date
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(dd/mm/yyyy)
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(Signature of official
issuing the Certificate
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(as for
Certificate)
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and/or seal of issuing
authority)
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