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:
- .1 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); and
- .2 the ship complied with part
G of chapter II-1 of the Convention using ……. as
fuel/N.A4.
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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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