Application Form

Date of application: 23/10/2017

General:
Last name: BERNARD First name: Nicolas

Date of birth: 06/10/1987 Place of birth: Versailles, France

Address: 2, rue d'Argoat City: 22360 Langueux

Country: France Nationality: French

Telephone: +33664897594 Mobile:

E-mail: nicolas.bernard@supmaritime.fr Skype ID: imjustnico

Position applying for: Vessel Operator

Available from: 01/01/2018

Sea history:
Vessel name Vessel Flag Rank DWT Maker, From Until Y/M/D Company
type model, (dd/mm/yyyy) (dd/mm/yyyy)
BHP/KW

Adfines Star Chemical Malta 2nd 19131 MAK 7M43C, 09/07/2017 18/11/2017 132 ABC Maritime
Tanker Officer 6300 kW days

Anuket Topaz Chemical Malta 2nd 9596 MAK 9M32C 08/05/2016 30/08/2017 115 ABC Maritime
Tanker Officer days

ELISA Accomm St 2nd 914 4x Baudoin 06/08/2015 11/11/2015 97 days ABC Maritime
odation Vincent Officer 12M26SR V-
Barge & Type, 2284
Grenadin kW
es

ELISA Accomm St 2nd 914 4x Baudoin 18/02/2015 17/05/2015 87 days ABC Maritime
odation Vincent Officer 12M26SR V-
Barge & Type, 2284
Grenadin kW
es

Klara-D Fast St 2nd 4x 26/08/2014 26/11/2014 92 days ABC Maritime

Support Vincent Officer 365,5 Caterpillar
Intervent & 3516B, 7091
ion Grenadin kW
Vessel es
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Krysia Fast St 2nd 365,5 4x 26/03/2014 10/07/2014 106 ABC Maritime
Support Vincent Officer Caterpillar days
Intervent & 3516B, 7091
ion Grenadin kW
Vessel es

Le Boréal Cruise France Polyvalen 1441 4x Warstila 20/03/2013 20/09/2013 6 Compagnie du

Vessel t Cadet 8L32 months Ponant

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Documents:
Document name: Country: Number: Place of issue: Date of issue: Expiry date:

Passport: France 16AA88837 France

Seamans book: France PF05898 France 09/10/2009 Permanent

Others:

Maritime education:
Grade: School: Country: Date (from – to):

Master's Degree in Merchant Ecole Nationale Supérieure France September 2016 - June 2017
Marine Maritime

Bachelor in Merchant Marine Ecole Nationale Supérieure France September 2009 - September
Maritime 2012

Visa:
Date of issue: Expiry date:

US Visa (C1/D)

Schengen visa

YES/NO Year* Rank** Yes/No Year* Rank**

Chemical Products Chemical Products

Aromatics: Perchlorethylene - -
Styrene - - Trichlorethylene - -
Toluene - - MDI/TDI - -
Benzene - - Ethylene/Methylene Dichloride - -
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Xylene Yes 1 2/O Styrene Monomer - -
Alcohols & Glykols - - MethylTert-Butyl Ether (MTBE) - -
Methanol - - Butyl Acetate - -
Ethanol - - Acetone - -
Iso-propyl Alcohol (IPA) - - Acrylonitrile - -
Butyl /Isobutyl Alcohol - - Caustic Soda - -
2-Ethylhexanol (Octanol) - - Chloroform - -
Mono Ethylene Glycol (MEG) - - Phenols - -

Molasses - - Propylene Oxide - -

Acids: Vinyl Acetate Monomer (VAM) - -
Phosphoric - - Urea Ammonia Nitrate - -
Sulphiric - - Dowanol - -
Acrylic - - - -
Acetic - - Clean Petroleum Products (CPP):

Paraffins: Gasoil /Diesel Oil Yes 1 2/O

Slack Wax - - ULSD - -
Hexane - - Gasoline Yes 1 2/O
Cyclohexane - - Naphta - -
Vegoils: Fuel Oil Yes 1 2/O
Such as Crude Palm Oil, - - Luboils (Base oils / White Oils) Yes 1 2/O
Rapeseed Oil, Soyabean Oil,
Sunflower Oil, etc.

Parcel Trade Exp. (max. no during single voyage):

Cargo Pumps Experience Tank’s Coating Type Experience

Deepwell: - Expoxy Yes

Framo 12 Zinc Silicate -

Marflex (electrical driven) - Marineline Yes

Centrifugal 5 Stainless Steel -

Screw 5 Tank’s Passivation Experience -

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Steam Turbine - Wall Wash Experience -

Vetting Inspections (indicate which) Total, Suncor, Lukoil

CDI Inspection (indicate date of last inspection) 12/09/2017, Mississauga Canada

OCIMF Inspection (indicate date of last inspection) 28/08/2016, Durban, South Africa

USCG Inspection (indicate date of last inspection)

Dry Dock Experience (indicate shipyard) Dormac (Durban, ZA), Carena (Abidjan, CI)
Experience in Delivery of New Buildings

Trading Area (indicate areas) West Africa, South Africa, Madagascar, Mauritius, Canada, Europe
Ice Navigation Experience (indicate areas) Greenland, Spitsbergen
Ship-to-Ship Experience (indicate areas) South Africa, Mozambique Channel, Madagascar, Mauritius.