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Proposal Form

 
Name of the vessel

Proposal Form

       Dosyayı indirmek için tıklayınız.    Proposal Form
 
Name of Ship Owners   :

Name of Ship Managers

   :
Business Website Address   :
Name of person in charge   :

Phone No. of person in charge

  :
E-mail address  of company and person in charge   :

Name of Charterer : (if applicable)

   :
 

VESSEL'S DETAILS
Vessel's name   :
IMO-No.   :
Built   :
Vessel's type   :
GT   :
DWT   :
Flag   :
Class   :
Freeboard during Transit   :
Laden  /  Ballast ?   :
Type of Cargo (if laden)   :
Max. speed   :
Average speed   :
Service speed   :
       

Number and Nationality of crew
Officers:   :
Crew-   :
Others (please state)   :

Voyage details
Port of Departure   :
1st Port of Call   :
2nd Port of Call (if applicable)   :

Return Voyage Details (if available)
Next Port of Call   :
2nd Port of Call (if applicable)   :

Will the vessel be registered with MSCHOA ?   (www.mschoa.eu)

Yes       No
 

UKMTO Dubai will be notified ?
Yes       No
 

Internationally Recommended Transit Corridor and the Group Transit system used (Will the vessel be a part of organized convoy) ?
Yes       No
 

Will the "Best Management Practices" (BMP) applied ?
Yes       No
 

Estimated dates

ETA (Estimated date of arrival) at excluded areas ( Lat. 15°  N / Long. 58° E / Long. 78° E / Lat. 12° S , whichever applicable)
Applicable Lat.  or  Long.   :
Date   :
Hour (UTC)   :
ETD (Estimated date of departure) from excluded areas (Lat. 15°  N / Long. 58° E / Long. 78° E / Lat. 12° S , whichever applicable)
Applicable Lat.  or  Long.   :
Date   :
Hour (UTC)   :

K&R (Kidnap & Ransom) INSURANCE

Is  Kidnap & Ransom Insurance available or required for the subject  transit ?
Yes       No

If yes;

 Limit of K&R insurance obtained / required;
a)     US$ 3,000,000                b)     US$ 5,000,000
(Please tick as applicable)
Is K&R Loss of Hire Cover required ?
Yes       No

If yes;

Daily Hire Amount required                                             

   :
Number of days to be covered (60,90,120,180)                :
SECURITY PRECAUTIONS       

1) Are the vessel's fitted with Ship Security Alert Systems (SSAS), in compliance with SOLAS XI - 2 Regulation 6?

   :

2) If yes please provide name and type of equipment.

   :

3) Is this equipment capable of real time tracking of your vessel through a graphical user interface (GUI) and web interface application?

   :

4) How many position reports does your SSAS transmit on a standard basis per 24 hours?

   :

5) What is the reporting frequency (number of minutes between each position report) of your SSAS units in alert mode?

   :

6) Who responds to your ship board alerts? CSO, Flag, or other RO.

   :

7) Does your vessel(s) have a valid International Ship Security Certificate (ISSC)?

   :

8) Does your vessel routinely carry large amounts of cash onboard? If yes how much?

   :

9) Where did your CSO, SSO and ship's crew receive their security training?

   :

10) Do your crew receive any formal training in counter - piracy measures or kidnap awareness?

   :

11) Do your shore managers receive any formal training in contingency planning for security incidents, including piratical attacks, or kidnap ?

   :

12) Do you have a corporate contingency plan for security incidents, including piratical attacks, or  incidents?

   :

13) Have your vessels been the victims or target of any piratical attack in the last 3 years, where the crew or vessel have been held hostage for more than 3 hours?

   :

14) In high-risk areas (such as the Malacca Strait, East and West Coast Africa, East Coast of South America and the Caribbean) what are your standard counter-piracy measures?

   :

15) Do you routinely employ security guards on board the vessel while in port, at anchor or at sea?

   :

16) If yes, how many are employed? Are they armed? Which company provides the security guards?

  :

17) Will the vessel be accopanied by a naval escort ? (no more than 3 vessels per warship for the whole length of the transit through the dangerous zone) ?

   :

18) Is the vessel registered with SSRS ? www.ssrs.org

   :

19) Will the vessel be carrying military personnel from a recognised navy force on board during the whole length of the transit through the dangerous zone ?

   :

20) Is the vessel fitted with razor wire around guard  rails on low lying deck areas ?

   :

21) Do the master and crew have a plan to retreat to a secure citadel onboard their vessel if boarded by pirates ?

   :
Details of Anti Piracy Measures / Security Precautions taken on board (supported by pictures etc. if available)
     
THE UNDERSIGNED, IN HIS CAPACITY AS  AN AUTHORIZED OFFICER OF THE APPLICAN, HEREBY DECLARES  TO THE BEST OF HIS / HER KNOWLEDGE THAT THE INFORMATION SET FORTH HEREIN ARE TRUE AND NO INFORMATION HAS BEEN WITHHELD.
 

Signature

   Date
     
 
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