THIS IS TO CERTIFY that a survey required in accordance with [Regulation 1(1)(b) of Annex 4 to the Convention and] point 2.1 of Annex I to Regulation (EC) No 782/2003 of the European Parliament and of the Council of 14 April 2003 on the prohibition of organotin compounds on ships found that the ship was in compliance with the Regulation
Details of anti-fouling system(s) applied
Type(s) of anti-fouling system(s) used:
Date(s) of application of anti-fouling system(s):
Name(s) of company(ies) and facility(ies)/location(s) where applied:
Name(s) of anti-fouling system manufacturer(s):
Name(s) and colour(s) of anti-fouling system(s):
Active ingredient(s) and their Chemical Abstract Services Registry Number(s) (CAS number(s):
Type(s) of sealer coat, if applicable:
Name(s) and colour(s) of sealer coat applied, if applicable:
5. that the security system and any associated security equipment of the ship has been verified in accordance with section 19.1 of part A of the ISPS Code;
6. that the verification showed that the security system and any associated security equipment of the ship is in all respects satisfactory and that the ship complies with the applicable requirements of chapter XI-2 of the Convention and part A of the ISPS Code;
7. that the ship is provided with an approved ship security plan.
Date of initial/renewal verification on which this Certificate is based the ____ day of _________________, 20 ___
This certificate is valid until the ____ day of _________________, 20 ___ subject to verifications in accordance with section 19.1.1 of Part A of the ISPS Code.
Issued at _________________ on the the ____ day of _________________, 20 ___
(Signature of authorized
official issuing the certificate)
ENDORSEMENT for intermediate verification
THIS IS TO CERTIFY that at an intermediate verification required by section 19.1.1 of part A of the ISPS Code the ship was found to comply with the relevant provisions of chapter XI-2 of the Convention and part A of the ISPS Code.
Intermediate verification
Place __________________________ Date ___________________
ADDITIONAL VERIFICATION in accordance with section A/19.3.7.2 of the ISPS Code
THIS IS TO CERTIFYthat at an additional verification required by section 19.3.7.2 of part A of the ISPS Code the ship was found to comply with the relevant provisions of chapter XI-2 of the Convention and part A of the ISPS Code.
Place __________________________ Date ___________________
ENDORSEMENTto extend the certificate if valid for less than 5 years where section A/19.3.3 of the ISPS Code applies
The ship complies with the relevant provisions of part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.3 of part A of the ISPS Code, be accepted as valid until ___________________________
Place __________________________ Date ___________________
ENDORSEMENT where the renewal verification has been completed and section A/19.3.4 of the ISPS Code applies
The ship complies with the relevant provisions of part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.4 of part A of the ISPS Code, be accepted as valid until ___________________________
Place __________________________ Date ___________________
ENDORSEMENTto extend the validity of the certificate until reaching the port of verification where section A/19.3.5 of the ISPS Code applies or for period of grace where section A/19.3.6 of the ISPS Code applies
This Certificate shall, in accordance with section 19.3.5/19.3.6*/2 of part A of the ISPS Code, be accepted as valid until ___________________________
Place __________________________ Date ___________________
Приложение № 51а към чл. 64, ал. 1 (Изм. - ДВ, бр. 54 от 2010 г., изм. - ДВ, бр. 7 от 2015 г.)
R E P U B L I C O F B U L G A R I A
MINISTRY OF TRANSPORT,
INFORMATION TECHNOLOGY AND COMMUNICATIONS
MARITIME ADMINISTRATION
AMENDMENTS TO THE CONTINUOUS SYNOPSIS RECORD (CSR)
DOCUMENT No. ______ FOR THE SHIP WITH
IMO NUMBER: ___________
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR SAFETY OF LIFE AT SEA 1974 as amended
The amendments are shown in the table. Indicate N/C for all items not being changed. Dates should be in the format yyyy/mm/dd.
Information
1
This document applies from (date):
2
Flag State:
3
Date of registration with the State indicated in 2:
4
Name of ship:
5
Port of registration:
6
Name of current registered owner(s):
Registered address(es):
7
Registered owner number (voluntary until 01.01.2009)
8
If applicable, name of current registered bareboat
Charterer(s):
Registered address(es):
9
Name of the Company (International Safety Management):
Registered address(es):
Address(es) of its safety management activities:
10
Company identification number (voluntary until 01.01.2009)
11
Name of all classification societies with which the ship is classed:
12
Administration /Government/ Recognized Organization which issued Document of Compliance:
Body which carried out audit (if different):
13
Administration /Government/ Recognized Organization which issued Safety Management Certificate:
Body which carried out audit (if different):
14
Administration /Government/ Recognized Security Organization which issued International Ship Security Certificate:
Body which carried out audit (if different):
15
Date on which the ship ceased to be registered with the State indicated in 2:
16
Remarks (insert relevant information as appropriate)
THIS IS TO CERTIFY THAT this record is correct in all respects
Issued by the Company or Master: ________________________
Date of issue: ____________________________________________
Signature of authorized person: ___________________________
Name of authorized person: _______________________________
Приложение № 51б към чл. 64, ал. 1 (Изм. - ДВ, бр. 7 от 2015 г.)
R E P U B L I C O F B U L G A R I A
MINISTRY OF TRANSPORT,
INFORMATION TECHNOLOGY AND COMMUNICATIONS
MARITIME ADMINISTRATION
INDEX OF AMENDMENTS TO CSR DOCUMENT No ___
FOR THE SHIP WITH IMO No ______
After this CSR document was issued, the following amendments to entries on the document have been made by the Company or the master, have been attached to the ship’s CSR file and have been notified to the Administration:
Date of application of Amendments:
Amendment to CSR Information (2 - 13)
Date amendment form attached to the ship’s CSR file:
