| Model Form of Dynamic Positioning Verification Acceptance
Document
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| Dynamic Positioning Verification Acceptance Document
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| (Official
seal)
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(State)
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| Issued under the provisions of the
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Guidelines for vessels with dynamic positioning systems
(MSC.1/Circ.[…])
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| under the authority of the Government of
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| __________________________________________
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| (full designation of the State)
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| by
______________________________________________________________
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| (full official designation of the competent person or
organization authorized by the Administration)
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Distinctive identification (Name or
number)
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Type
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Port of registry
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IMO number
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| Date
on which keel was laid or vessel was at similar stage of
constructionfootnote or on which major conversion was
commencedfootnote
........................................................................
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| THIS
IS TO CERTIFY that the above-mentioned vessel has been duly
documented, surveyed and tested in accordance with the Guidelines
for vessels with dynamic positioning systems (MSC.1/Circ.[…]) and
found to comply with the Guidelines.
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| The
vessel is allowed to operate in DP Equipment Class
...................................... and in lower equipment
classes.
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| This
document is valid until
.....................................................................................
unless terminated by the Administration, provided that the vessel is
operated, tested and surveyed according to the provisions in the
Guidelines and the results are properly recorded.
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| Issued at
................................................................................................................
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| (Place of issue of document)
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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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| ……………………………………………………………….………………………………………
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| (Seal or stamp of the issuing authority, as
appropriate)
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| LIST OF EXEMPTIONS AND EQUIVALENTS
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| (refer to paragraphs 5 and 6 of the preamble of the
Guidelines)
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| LIST OF MAIN SYSTEMS AND COMPONENTS COVERED BY DPVADfootnote
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