Appendix
Clasification Society 2024 - Version 9.40
Statutory Documents - IMO Publications and Documents - Resolutions - Maritime Safety Committee - Resolution MSC.343.(91) – Adoption of Amendments to the Protocol of 1978 Relating to the International Convention for the Safety of Life at Sea, 1974 – (Adopted on 30 November 2012) - Annex – Amendments to the Protocol of 1978 Relating to the International Convention for the Safety of Life at Sea, 1974, as Amended - Annex – Modifications and Additions to the Annex to the International Convention for the Safety of Life at Sea, 1974 - Appendix

Appendix

 The existing forms of the Cargo Ship Safety Construction Certificate and Cargo Ship Safety Equipment Certificate are replaced by the following:

Parent topic: Annex – Modifications and Additions to the Annex to the International Convention for the Safety of Life at Sea, 1974

FORM OF SAFETY CONSTRUCTION CERTIFICATE FOR CARGO SHIPS

CARGO SHIP SAFETY CONSTRUCTION CERTIFICATE
   
(Official seal) (State)
   
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1978 relating thereto
   
under the authority of the Government of
   
_______________________________
(name of the State)
   
by _______________________________
(person or organization authorized)
   
Particulars of ship footnote
Name of ship........................................................................................................................
Distinctive number or letters ................................................................................................
Port of registry .....................................................................................................................
Gross tonnage .....................................................................................................................
Deadweight of ship (metric tons)footnote ........................................................................................
IMO Numberfootnote .........................................................................................................................
 
Type of shipfootnote
  Bulk carrier
  Oil tanker
  Chemical tanker
  Gas carrier
  Cargo ship other than any of the above
 
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/10 of the Convention.
2 That the survey showed that the condition of the structure, machinery and equipment as defined in the above regulation was satisfactory and the ship complied with the relevant requirements of chapters II-1 and II-2 of the Convention (other than those relating to fire safety systems and appliances and fire control plans).
3 That in implementing regulation I/6(b) the Government has instituted:
  – Mandatory annual surveys;
  – Unscheduled inspections.
4 That an Exemption Certificate has/has notfootnote been issued.
5 That the ship was/was notfootnote subjected to an alternative design and arrangements in pursuance of regulation(s) II-1/55 / II-2/17footnote of the Convention;
6 That a Document of approval of alternative design and arrangements for machinery and electrical installations/fire protectionfootnote is/is notfootnote appended to this Certificate.
 
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)
Intermediate Survey
(for tankers of 10 years of age and over)
This is to certify that at an intermediate survey required by regulation I/10 of the Convention, as modified by the 1978 Protocol, this ship was found to comply with relevant provisions of the Convention.
   
  Signed: .......................................................
  (Signature of authorized official)
  Place: .........................................................
  Date: ..........................................................
  (Seal or stamp of the Authority, as appropriate)
   
  Signed: .......................................................
  (Signature of authorized official)
  Place: .........................................................
  Date: ..........................................................
  (Seal or stamp of the Authority, as appropriate)
MANDATORY ANNUAL SURVEYS OR UNSCHEDULED INSPECTIONS
This is to certify that the ship has been surveyed in accordance with regulation I/6(b) of the Convention, as modified by the 1978 Protocol and the relevant recommendations of the Organizationfootnote.
1st mandatory annual surveyfootnote footnote Signed: ……………………………………………………
1st unscheduled inspectionfootnote Place: ……………………………………………….........
  Date: …………………………………………………….
  (Seal or stamp of the Authority, as appropriate)
2nd mandatory annual surveyfootnote footnote Signed: ………………………….…………………
2nd unscheduled inspectionfootnote Place: ……………………………………………...
  Date: .........................................................................
  (Seal or stamp of the Authority as appropriate)
3rd mandatory annual surveyfootnote footnote Signed: ………………………….…………………
3rd unscheduled inspectionfootnote Place: ……………………………………………….........
  Date: ……………………………………………………
  (Seal or stamp of the Authority, as appropriate)
4th mandatory annual survey footnote footnote Signed: ………………………….…………………
4th unscheduled inspectionfootnote Place: ……………………………………………….........
  Date: ……………………………………………………
    (Seal or stamp of the authority, as appropriate)
 

FORM OF SAFETY EQUIPMENT CERTIFICATE FOR CARGO SHIPS

CARGO SHIP SAFETY EQUIPMENT CERTIFICATE
   
This Certificate shall be supplemented by a Record of Equipment for Cargo Ship Safety (Form E)
   
(Official seal) (State)
   
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1978 relating thereto
   
under the authority of the Government of
   
_______________________________
(name of the State)
   
by _______________________________
(person or organization authorized)
   
Particulars of shipfootnote
Name of ship ........................................................................................................................
Distinctive number or letters ................................................................................................
Port of registry .....................................................................................................................
Gross tonnage .....................................................................................................................
Deadweight of ship (metric tons)footnote ........................................................................................
Length of ship (regulation III/3.12) ........................................................................................
IMO Numberfootnote .........................................................................................................................
 
Type of Shipfootnote
  Bulk carrier
  Oil tanker
  Chemical tanker
  Gas carrier
  Cargo ship other than any of the above
Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on which work for a conversion or an alteration or modification of a major character was commenced .........................................................................................................................................
   
THIS IS TO CERTIFY:
1 That the ship has been surveyed in accordance with the requirements of regulation I/8 of the Convention, as modified by the 1978 Protocol.
2 That the survey showed that:
2.1 the ship complied with the requirements of the Convention as regards fire safety systems and appliances and fire control plans;
2.2 the life-saving appliances and the equipment of the lifeboats, liferafts and rescue boats were provided in accordance with the requirements of the Convention;
2.3 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;
2.4 the ship complied with the requirements of the Convention as regards shipborne navigational equipment, means of embarkation for pilots and nautical publications;
2.5 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;
2.6 in all other respects the ship complied with the relevant requirements of the Convention;
2.7 the ship was/was notfootnote subjected to an alternative design and arrangements in pursuance of regulation(s) II-2/17 / III/38footnote of the Convention;
2.8 a Document of approval of alternative design and arrangements for fire protection/life-saving appliances and arrangementsfootnote is/is notfootnote appended to this Certificate.
3 That the ship operates in accordance with regulation III/26.1.1.1footnote within the limits of the trade area …………………………
4 That in implementing regulation I/6(b) the Government has instituted:
  - mandatory annual surveys;
  - unscheduled inspections.
5 That an Exemption Certificate has/has notfootnote 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)
   
Intermediate Survey
(for tankers of 10 years of age and over)
This is to certify that at an intermediate survey required by regulation I/8 of the Convention, as modified by the 1978 Protocol, this ship was found to comply with relevant provisions of the Convention.
  Signed: .......................................................
  (Signature of authorised official)
   
  Place: ..................................................................
  Date: ....................................................................
    (Seal or stamp of the Authority, as appropriate)
   
Mandatory Annual Surveys or Unscheduled Inspections
This is to certify that the ship has been surveyed in accordance with regulation I/6(b) of the Convention, as modified by the 1978 Protocol and the relevant recommendations of the Organizationfootnote.
mandatory annual surveyfootnote footnote Signed: …………………………………………..……
unscheduled inspectionfootnote Place: ………………………………………….…...
  Date: ……………………………………………
    (Seal or Stamp of the Authority as appropriate)
Under the provisions of regulation I/14 of the Convention, as modified by the 1978 Protocol, the validity of this Certificate is extended until ………………………………..........................................
  Signed: … ………………………………………
  Place: ………………………………
  Date: ............................................................................
    (Seal or stamp of the Authority as appropriate)
 
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