FORM OF SAFETY CERTIFICATE FOR PASSENGER SHIPS

PASSENGER SHIP SAFETY CERTIFICATE

This Certificate shall be supplemented by a Record of Equipment for Passenger Ship Safety (Form P)

(Official seal) | (State)

for an/a short1 international voyage

Issued under the provisions of the INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1988 relating thereto

under the authority of the Government of

(name of the State)

by

(person or organization authorized)

Particulars of ship2

Name of ship .....

Distinctive number or letters .....

Port of registry .....

Gross tonnage .....

Sea areas in which ship is certified to operate (regulation IV/2)3

IMO number

Date of build:

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 regulation I/7 of the Convention.

2 | That the survey showed that:

2.1 | the ship complied with the requirements of the Convention as regards:

.1 | the structure, main and auxiliary machinery, boilers and other pressure vessels;

.2 | the watertight subdivision arrangements and details;

.3 | the following subdivision load lines:

Subdivision load lines assigned and marked on the ship’s side amidships (regulation II-1/18)5 | Freeboard | To apply when the spaces in which passengers are carried include the following alternative spaces

P1 | ..... | .....

P2 | ..... | .....

P3 | ..... | .....

2.2 | the ship complied with part G of chapter II-1 of the Convention using ..... as fuel/N.A1);

2.3 | the ship complied with the requirements of the Convention as regards structural fire protection, 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 in accordance with the requirements of the Convention;

2.6 | the ship complied with the requirements of the Convention as regards radio installations;

2.7 | the provision and 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 not1 subjected to an alternative design and arrangements in pursuance of regulation(s) II-1/55/II-2/17/III/381 of the Convention;

2.12 | a Document of approval of alternative design and arrangements for machinery and electrical installations/fire protection/life-saving appliances and arrangements1 is/is not1 appended to this Certificate.

3 | That an Exemption Certificate has/has not1 been issued.

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 authorized official issuing the certificate)

(Seal or stamp of the issuing authority, as appropriate)

Endorsement where the renewal survey has been completed and regulation I/14(d) applies

The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14(d) of the Convention, be accepted as valid until .....

Signed: | .....

(Signature of authorized official)

Place: | .....

Date: | .....

(Seal or stamp of the authority, as appropriate)

Endorsement to extend the validity of the certificate until reaching the port of survey or for a period of grace where regulation I/14(e) or I/14(f) applies

This certificate shall, in accordance with regulation I/14(e)/I/14(f)1 of the Convention, be accepted as valid until .....

Signed: | .....

(Signature of authorized official)

Place: | .....

Date: | .....

(Seal or stamp of the authority, as appropriate)

1) Delete as appropriate.

2) Alternatively, the particulars of the ship may be placed horizontally in boxes.

3) For a ship certified to operate in sea area A3, indicate the recognized mobile satellite service in brackets.

4) For ships constructed before 1 January 2009, the applicable subdivision notation “C.1, C.2 and C.3” should be used.

RECORD OF EQUIPMENT FOR PASSENGER SHIP SAFETY (FORM P)

RECORD OF EQUIPMENT FOR COMPLIANCE WITH THE INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, AS AMENDED

1 | Particulars of ship

Name of ship .....

Distinctive number or letters .....

Number of passengers for which certified .....

Minimum number of persons with required qualifications to operate the radio installations .....

2 | Details of life-saving appliances

1 | Total number of persons for which life-saving appliances are provided .....

Port side | Starboard side

2 | Total number of lifeboats | ..... | .....

2.1 | Total number of persons accommodated by them | ..... | .....

2.2 | Number of partially enclosed lifeboats (regulation III/21 and LSA Code, section 4.5) | ..... | .....

2.3 | Number of self-righting partially enclosed lifeboats(regulation III/431)) | ..... | .....

2.4 | Number of totally enclosed lifeboats (regulation III/21 and LSA Code, section 4.6) | ..... | .....

2.5 | Other lifeboats | ..... | .....

2.5.1 | Number | ..... | .....

2.5.2 | Type | ..... | .....

3 | Number of motor lifeboats (included in the total lifeboats shown above) | .....

3.1 | Number of lifeboats fitted with searchlights | .....

4 | Number of rescue boats | .....

4.1 | Number of boats which are included in the total lifeboats shown above | .....

4.2 | Number of boats which are fast rescue boats | .....

5 | Liferafts | .....

5.1 | Those for which approved launching appliances are required | .....

5.1.1 | Number of liferafts | .....

5.1.2 | Number of persons accommodated by them | .....

5.2 | Those for which approved launching appliances are not required | .....

5.2.1 | Number of liferafts | .....

5.2.2 | Number of persons accommodated by them | .....

6 | Number of marine evacuation systems (MES) | .....

6.1 | Number of liferafts served by them | ......

6.2 | Number of persons accommodated by them | .....

7 | Buoyant apparatus | .....

7.1 | Number of apparatus | .....

7.2 | Number of persons capable of being supported | .....

8 | Number of lifebuoys | .....

9 | Number of lifejackets (total) | .....

9.1 | Number of adult lifejackets | .....

9.2 | Number of child lifejackets | .....

9.3 | Number of infant lifejackets | .....

10 | Number of immersion suits | .....

11 | Number of anti-exposure suits | .....

12 | Number of thermal protective aids2) | .....

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 | .....

1.4 | Recognized mobile satellite service ship earth station | .....

2 | Secondary means of initiating the transmission of ship-to-shore distress alerts | .....

3 | Facilities for reception of MSI and search and rescue related information | .....

4 | EPIRB | .....

5 | Two-way VHF radiotelephone apparatus | .....