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SOLAS-2012

Appendix, Certificates,

Appendix, Certificates, Part A Type of ship 4 Bulk carrier Oil tanker Chemical tanker Gas carrier SOLAS 74/78 page 35/83 Date of build: Cargo ship other than any of the above - Date of building contract ....... - Date on which keel was laid or ship was at similar stage of construction ........ - Date of delivery ........ - Date on which work for a conversion or an alteration or modification of a major character was commenced (where applicable) ..... All applicable dates shall be completed. THIS IS TO CERTIFY: 1 That the ship has been surveyed in accordance with the requirements of regulations I/8, I/9 and I/10 of the Convention. 2 That the survey showed that: 2.1 the condition of the structure, machinery and equipment as defined in regulation I/10 was satisfactory and the ship complied with the relevant requirements of chapter II-1 and chapter II-2 of the Convention (other than those relating to fire safety systems and appliances and fire control plans); 2.2 the last two inspections of the outside of the ship's bottom took place on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . and . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (dates) 2.3 the ship complied with the requirements of the Convention as regards fire safety systems and appliances and fire control plans; 2.4 the life-saving appliances and the equipment of the lifeboats, liferafts and rescue boats were provided in accordance with the requirements of the Convention; 2.5 the ship was provided with a line-throwing appliance and radio installations used in life-saving appliances in accordance with the requirements of the Convention; 2.6 the ship complied with the requirements of the Convention as regards radio installations; 4 Delete as appropriate.

Appendix, Certificates, Part A SOLAS 74/78 page 36/83 2.7 the functioning of the radio installations used in life-saving appliances complied with the requirements of the Convention; 2.8 the ship complied with the requirements of the Convention as regards shipborne navigational equipment, means of embarkation for pilots and nautical publications; 2.9 the ship was provided with lights, shapes, means of making sound signals and distress signals in accordance with the requirements of the Convention and the International Regulations for Preventing Collisions at Sea in force; 2.10 in all other respects the ship complied with the relevant requirements of the Convention. 2.11 the ship was/was not/ 4 subjected to an alternative design and arrangements in puruance of regulation II-2/17 of the Convention; 2.12 a Document of approval of alternative design and arrangements for fire safety is/is not/ 4 appended to this Certificate. 3 That an Exemption Certificate has/has not 4 been issued. This certificate is valid until . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 subject to the annual, intermediate and periodical surveys and inspections of the outside of the ship's bottom in accordance with regulations I/8, I/9 and I/10 of the Convention. Issued at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Place of issue of certificate) Completion date of the survey on which this certificate is based . . . . . . . . . . . . . . . (dd/mm/yyyy) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Date of issue) (Signature of authorized official issuing the certificate) (Seal or stamp of the issuing authority, as appropriate) 4 Delete as appropriate. 5 Insert the date of expiry as specified by the Administration in accordance with regulation I/14(a) of the Convention. The day and the month of this date correspond to the anniversary date as defined in regulation I/2(n) of the Convention, unless amended in accordance with regulation I/14(h).

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