Annex 1 - Form of Safety Certificate for High Speed Craft
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Statutory Documents - IMO Publications and Documents - International Codes - HSC Code - International Code of Safety for High Speed Craft, 1994 – Resolution MSC.36(63) - Annex - International Code of Safety for High Speed Craft, 1994 - Annex 1 - Form of Safety Certificate for High Speed Craft

Annex 1 - Form of Safety Certificate for High Speed Craft

Form of Safety Certificate for High Speed Craft

HIGH SPEED CRAFT SAFETY CERTIFICATE
This Certificate should be supplemented by a Record of Equipment
(Official seal) (State)
Issued under the provisions of the
INTERNATIONAL CODE OF SAFETY FOR HIGH SPEED CRAFT
(Resolution MSC.36(63))
under the authority of the Government of
..................................................................................................
(full designation of the state)
by..................................................................................................
(full official designation of the competant person or organisation authorised by the Administration)
Particulars of craftfootnote
Name of craft ........................................................
Manufacturer's model and hull number ................
Distinctive number or letters.................................
IMO numberfootnote ......................................................
Port of Registry ....................................................
Gross Tonnage ....................................................
Design waterline corresponding to draughts at draught marks of...forward/...aft
Category category A passenger craft/category B passenger craft/cargo footnote
Craft Type air-cushion vehicle/surface effect ship/hydrofoil/monohull/multihull/other (give detail ...................................................)footnote
Date on which keel was laid or craft was at a similar stage of construction or on which a major conversion was commenced ...............................................................................................................
THIS IS TO CERTIFY :
1 That the above-mentioned craft has been duly surveyed in accordance with the applicable provisions of the International Code of Safety for High Speed Craft.
2 That the survey showed that the structure, equipment, fittings, radio station arrangements and materials of the craft and the condition thereof are in all respects satisfactory and that the craft 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 1.11 of the code , the following equivalents have been granted in respect of the craft:
paragraph ............................ equivalent arrangement ..............................
  ............................ ............................
This certificate is valid until............................................................................
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 authorised official issuing the certificate)
    ...................................................................................................................
    (Seal or stamp of the issuing authority, as appropriate)
       
Endorsement for periodical surveys
This is to certify that, at a survey required by 1.5 of the code, this craft, was found to comply with the relevant provisions of the Code.
Periodical survey: ......................................................... Signed: .............................................
      (Signature of authorized official)
      Place: ...............................................
      Date: .................................................
..................................................................................................................
(Seal or stamp of authority, as appropriate)
Periodical survey: ......................................................... Signed: .............................................
      (Signature of authorized official)
      Place: ...............................................
      Date: .................................................
..................................................................................................................
(Seal or stamp of authority, as appropriate)
Periodical survey: ......................................................... Signed: .............................................
      (Signature of authorized official)
      Place: ...............................................
      Date: .................................................
..................................................................................................................
(Seal or stamp of authority, as appropriate)
Periodical survey: ......................................................... 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 1.8.8 of the code applies
This craft complies with the relevant requirements of the Code, and this Certificate should, in accordance with 1.8.8 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 1.8.9 of the code applies
This craft complies with the relevant requirements of the code and this Certificate should, in accordance with 1.8.9 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 1.8.10 of the code applies
This Certificate should, in accordance with 1.8.10 of the code, be accepted as valid until .................
      Signed: .............................................
      (Signature of authorized official)
      Place: ...............................................
      Date: .................................................
..................................................................................................................
(Seal or stamp of authority, as appropriate)
       
Endorsement for the advancement of the anniversary date where 1.8.13 of the code applies
In accordance with 1.8.13 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 1.8.13 of the code, the new anniversary date is ......................................
      Signed: .............................................
      (Signature of authorized official)
      Place: ...............................................
      Date: .................................................
..................................................................................................................
(Seal or stamp of authority, as appropriate)

RECORD OF EQUIPMENT FOR HIGH SPEED CRAFT SAFETY CERTIFICATE

This Record shall be permanently attached to the High Speed Craft Safety Certificate
RECORD OF EQUIPMENT FOR COMPLIANCE WITH THE INTERNATIONAL CODE OF SAFETY FOR HIGH SPEED CRAFT
     
1 Particulars of craft  
Name of craft .........................................................................................................
Manufacturer's model and hull number ......................................................................
IMO Numberfootnote.........................................................................................................
Category: Category A passenger craft/category B passenger craft/cargo craftfootnote
Craft type: air cushion, surface effect ship, hydrofoil, monohull, multihull, other (give details ...................................................................................................................)footnote
Number of passengers for which certified ...................................................................
Minimum number of persons with required qualifications to operate this radio installations ...........................................................................................................
2 Details of life-saving appliances ......................
1 Total number of persons for which life-saving appliances are provided ......................
2 Total number of lifeboats ......................
2.1 Total number of persons accommodated by them ......................
2.2 Number of partially enclosed lifeboats complying with SOLAS regulation III/42 ......................
2.3 Number of totally enclosed lifeboats complying with SOLAS regulation III/44 ......................
2.4 Other lifeboat ......................
2.4.1 Number ......................
2.4.2 Type ......................
3 Number of rescue boats ......................
3.1 Number of boats which are included in the total lifeboats shown above  
4 Liferafts complying with SOLAS regulations III/38 to 40 for which suitable means of launching are provided  
4.1 Number of liferafts ......................
4.2 Number of persons accommodated by them ......................
5 Open reversible liferafts (Annex 10 of the Code)  
5.1 Number of liferafts ......................
5.2 Number of persons accommodated by them ......................
6 Number of Marine Evacuation System (MES) ......................
6.1 Number of persons served by them ......................
7 Number of lifebuoys ......................
8 Number of lifejackets  
8.1 Number suitable for adults ......................
8.2 Number suitable for children ......................
9 Immersion suits  
9.1 Total number ......................
9.2 Number of suits complying with the requirements for lifejackets ......................
10 Number of anti-exposure suits  
10.1 Total number ......................
10.2 Number of suits complying with the requirements for lifejackets ......................
11 Radio installations used in life-saving appliances  
11.1 Number of radar transponders ......................
11.2 Number of two-way VHF radiotelephone apparatus ......................
3 Details of radio facilities  
  Item Actual provision
1 Primary systems ..............................................
1.1 VHF radio installation: ..............................................
1.1.1 DSC encoder ..............................................
1.1.2 DSC Watch Receiver ..............................................
1.1.3 Radiotelephony ..............................................
1.2 MF radio installation: ..............................................
1.2.1 DSC encoder ..............................................
1.2.2 DSC watch receiver ..............................................
1.2.3 Radiotelephony ..............................................
1.3 MF/HF radio installation: ..............................................
1.3.1 DSC encoder ..............................................
1.3.2 DSC watch receiver ..............................................
1.3.3 Radiotelephony ..............................................
1.3.4 Direct-printing radiotelephony ..............................................
1.4 INMARSAT ship earth station ..............................................
2 Secondary means of alerting ..............................................
3 Facilities for reception of maritime safety information ..............................................
3.1 NAVTEX receiver ..............................................
3.2 EGC receiver ..............................................
3.3 HF direct-printing radiotelegraph receiver ..............................................
4 Satelite EPIRB ..............................................
4.1 COSPAS-SARSAT ..............................................
4.2 INMARSAT ..............................................
5 VHF EPIRB ..............................................
6 Ship's radar transponder ..............................................
7 Radiotelephone distress frequency watch receiver on 2, 182 khzfootnote ..............................................
8 Device for generating the radiotelephone alarm signal on 2, 182 khzfootnote ..............................................
     
4 Methods used to ensure availability of radio facilities (paragraphs 14.14.16, 14.14.7 and 14.14.8 of this Code)
4.1 Duplication of equipment ......................................................................................................................................................
4.2 Shore-based maintenance ...................................................................................................................................................
4.3 At-sea maintenance capability ...................................................................................................................................................
THIS IS TO CERTIFY that this Record is correct in all respects
(Place of issue of the record)
.............. ............................................................................................................................  
(Date of issue) (Signature of duly authorised official issuing the Record)  
........................................................................................................
(Seal or stamp of the issuing authority, as appropriate)
     
5 Details of navigational systems and equipment  
1.1 Magnetic compass ......................
1.2 Gyro-compass ......................
2 Speed and distance measuring device ......................
3 Echo-sounding device ......................
4.1 9 GHz radar ......................
4.2 Second radar (3 GHz/9 GHzfootnote) ......................
4.3 Automatic radar plotting aid (ARPA)/ Automatic tracking aid (ATA)footnote ......................
5 Receiver for global navigation satellite system/Terrestrial navigation system/Other means of position fixingfootnote,footnote ......................
6.1 Rate-of-turn indicatorfootnote ......................
6.2 Rudder angle indicator/Direction of steering thrust indicatorfootnote ......................
7.1 Nautical charts/Electronic chart display and information system (ECDIS)footnote ......................
7.2 Back up arrangements for ECDIS ......................
7.3 Nautical publications ......................
7.4 Back up arrangement for nautical publications ......................
8 Searchlight ......................
9 Daylight signalling lamp ......................
10 Night vision equipment ......................
11 Means to show the mode of the propulsion systems ......................
12 Automatic steering aid (Automatic pilot) ......................
13 Automatic identification system (AIS) ......................
14 Long-range identification and tracking system ......................
15 Voyage data recorder (VDR) ......................
  THIS IS TO CERTIFY that this Record is correct in all respects  
  ...................................................................................................  
  (Place of issue of the record)  
.................. ...................................................................................................  
(Date of issue) (Signature of duly authorised official issuing the Record)  
  ...................................................................................................  
  (Seal or stamp of the issuing authority, as appropriate)  
Parent topic: Annex - International Code of Safety for High Speed Craft, 1994
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