CARGO SHIP SAFETY CONSTRUCTION CERTIFICATE
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(Official seal)
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(State)
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Issued under the provisions of the INTERNATIONAL
CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as amended
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under the authority of the Government of
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_______________________________
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(name of the State)
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by _______________________________
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(person or organization authorized)
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Particulars of ship
footnote
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Name of ship
........................................................................................................................
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Distinctive
number or letters
................................................................................................
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Port of
registry
.....................................................................................................................
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Gross
tonnage
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Deadweight
of ship (metric tons)footnote
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IMO
Numberfootnote
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Type of
shipfootnote
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Bulk carrier
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Oil tanker
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Chemical tanker
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Gas carrier
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Cargo ship other than any of the above
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Date of
build:
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Date of
building contract
....................................................................................
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Date on
which keel was laid or ship was at similar stage of construction
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Date of
delivery
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Date on
which work for a conversion or an alteration or modification of a major
character was commenced (where applicable)
...........................................................................................
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All applicable dates shall be completed.
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THIS IS TO CERTIFY:
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1 That the
ship has been surveyed in accordance with the requirements of regulation
I/10 of the Convention.
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2 That the
survey showed that the condition of the structure, machinery and equipment as
defined in the above regulation was satisfactory and the ship complied with the
relevant requirements of chapters II-1 and II-2 of the Convention (other than those relating to fire safety
systems and appliances and fire control plans).
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3 That an
Exemption Certificate has/has notfootnote been issued.
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4 That the
ship was/was notfootnote subjected to an alternative design and arrangements in
pursuance of regulation(s) II-1/55
/ II-2/17
footnote of the Convention.
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5 That a Document of approval of alternative design and arrangements
for machinery and electrical installations/fire protectionfootnote is/is notfootnote appended to this Certificate.
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This certificate is valid until
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Completion date of the survey on which this certificate
is based: .................................... (dd/mm/yyyy)
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Issued at
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(Place of issue of certificate)
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..............................................
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..........................................................
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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 issuing authority, as appropriate)
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