| STATEMENT OF COMPLIANCE FUEL OIL CONSUMPTION REPORTING AND
OPERATIONAL CARBON INTENSITY RATING
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| Issued under
the provisions of the Protocol of 1997, as amended, to amend the
International Convention for the Prevention of Pollution from Ships, 1973,
as modified by the Protocol of 1978 relating thereto (hereinafter referred
to as the Convention) under the authority of the Government of:
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|
.
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| (full designation of the country)
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| by...........................................................................................................................
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| (full designation of the competent person or organization
authorized under the provisions of the Convention)
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| Particulars of shipfootnote
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| Name of
ship
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| Distinctive
number or letters
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| IMO
Numberfootnote
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| Port of
registry
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| Gross
tonnage
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| Deadweight.
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| Type of
ship
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| THIS IS TO
DECLARE:
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| 1 the ship
has submitted to this Administration the data required by regulation
27 of Annex VI to the Convention, covering ship operations from
(dd/mm/yyyy) to (dd/mm/yyyy);
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| 2 the data
was collected and reported in accordance with the methodology and processes
set out in the ship's SEEMP that was in effect over the period from
(dd/mm/yyyy) to (dd/mm/yyyy);
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| 3 the
attained annual operational CII of the ship from (dd/mm/yyyy) through
(dd/mm/yyyy) was:
pursuant to regulations 28.1 and 28.2 of Annex VI of the Convention, for ships to
which regulation 28 applies;footnote
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| 4 the annual
operational carbon intensity of the ship in this period is rated as
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| 5 a
corrective action plan has been developed and included in the SEEMP (for a
ship to which regulation 28 applies, rated as D for three
consecutive years or rated as E)*
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| This
Statement of Compliance is valid until (dd/mm/yyyy)
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| Issued
at:
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| (place of issue of the Statement)
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| (dd/mm/yyyy)
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| (date of
issue)
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(signature of duly authorized
official issuing the Statement)
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(seal or stamp of the authority, as appropriate)
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