Application for Surveys and Issue of Certificates Form 2A (Rev.

December 2009)

APPLICATION FOR SURVEYS AND ISSUE OF CERTIFICATES

To: NIPPON KAIJI KYOKAI
APPLICANT
Name Address Application Document No.

VERA-002/2011

Application Date

18.05.2011

VERA DENZCLK THALAT ve HRACAT LTD. STI.. .

TEL

Signature of Applicant Name in Block Capitals E-mail SAFFET YURTOGLU

+90 549 397 33 33

FAX

+90 216 545 23 10

info@verashipping.com

We hereby request that you carry out survey(s) and/or issue certificate(s) described below. This request is made on the basis that we accept the provisions of REGULATIONS FOR THE CLASSIFICATION AND REGISTRY OF SHIPS, CONDITIONS OF SERVICE FOR CLASSIFICATION OF SHIPS AND REGISTRATION OF INSTALLATIONS and REGULATIONS FOR THE ISSUE OF STATUTORY CERTIFICATES (as well as the provisions of REGULATINS FOR TECHNICAL SERVICES when requesting technical services) of NIPPON KAIJI KYOKAI. Whether surveys are completed or not, we agree to pay all survey fees and expenses incurred as a result of the above-mentioned survey(s) and/or issuance of relevant certificate(s) within the payment term designated on your invoice.

BILLING CONTACT Please complete the following on in cases where the billing contact and the above applicant are different.
We ensure the payment of all survey fees and expenses incurred in the below-mentioned survey(s) and/or issue of relevant certificate(s). Name Address

VMV SHIPPING AND TRANSPORT CO. AJELTAKE ROAD, AJELTAKE ISLANDS, MAJURO MH 96960 MARSHALL ISLANDS
TEL +90 216 545 23 18 FAX +90 216 545 23 10

Signature Name in Block Capitals E-mail

SAFFET YURTOGLU
info@verashipping.com

Ships Name:
Shipowner: Flag: PANAMA Purpose of Ship:

EL CONDOR PAS

G.T.:

20157 Class No.: NK010025

VMV SHIPPING AND TRANSPORT CO. IMO No.: 9234202

Official No: 27756-01-C Call Sign: H3UK

BULK CARRIER

ervice Area: OCEAN GOING

Other Class(if any): -

1. Survey(s) to the be carried out (Please tick in the appropriate box(es)) (1)Class Maintenance Surveys Special Survey (SS) No. ( Intermediate Survey (IS) Annual Survey (AS) Docking Survey (DS) Propeller Shaft Survey (PS) Boiler Survey (BS) Planned Machinery Surveys (PMS) Continuous Hull Survey (CHS) Occasional Survey (OS): (Contents: (2) Installation Surveys Cargo Handling Appliances (CHG): Annual Thorough MC / Special Cargo Refrigerating Installations(RMC): Special Annual Special Navigation Bridge System (BRS): Special Special Integrated Fire Control Systems (IFC): Hull Monitoring System (HMS): Diving Systems (DVS): Special - Next Page Special Intermediate Preventive Machinery Maintenance Systems (PMM): Annual Annual Annual Annual Occasional Occasional Occasional Occasional Commence / Incomplete / Continuous (CRS) Intermediate Load Test M0. ( * A / B / C / D ) Annual Complete Occasional Annual Annual Occasional Occasional Occasional
(*Delete as appropriate)

: : : : : : : : )

Commence / Commence /

Incomplete /

Complete Complete In-Water Survey in lieu of Docking Survey Partial Survey Partial Survey

Incomplete /

Normal Docking Survey / No.1 No.2 No.1 Ordinary Survey / Ordinary Survey / No.2 No.3

Continuous Machinery Survey (CMS) Planned Machinery Maintenance Scheme (PMS) / Periodical Surveys (PS)

Automatic and Remote Control Systems(M0):

Occasional

Crew Accommodation Arrangement(CAA): (Applicable only to Japanese flag ships)

Application for Surveys and Issue of Certificates Form 2A (Rev. December 2009)

Ships Name

EL CONDOR PAS

Class No.

NK010025

(3) Statutory Surveys Load Line (LL) Safety Construction (SC) Safety Equipment (SE) Safety Radio (SR) Chemical Fitness Certificate Gas Fitness Certificate Dangerous Goods Fitness Certificate Oil Pollution Prevention (OPP) Noxious Liquid Substances in Bulk (NLS): Sewage Pollution Prevention (SPP): Air Pollution Prevention (APP): Anti-Fouling System (AFS)

(*Delete as appropriate)

* Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal * Initial / Renewal *Initial / Renewal * Initial / Renewal Initial Intermediate Intermediate Intermediate Intermediate Intermediate Intermediate *Intermediate / Periodical

Annual Annual Annual Periodical Annual Annual Annual Annual

Occasional Occasional Occasional Occasional Occasional Occasional Occasional Occasional Occasional Occasional

Annual Periodical

Occasional Occasional

Remarks: The above survey items apply for HSSC certificates. Please tick the equivalent survey items for Non-HSSC certificates. Regarding the Safety Radio Surveys for Japanese flag ships, the Japanese Government conducts surveys and issues certificate(s).

(4) Other Survey(s) Other Survey(s) (Contents : 2. )

Certificate(s) to be issued (Please tick in the appropriate box(es)) Classification Certificate LL Certificate Installation Certificate Cargo Gear Load Test Certificate SC Certificate Chemical Fitness Certificate OPP Certificate APP Certificate ) ITC (International Tonnage) Certificate Gas Fitness Certificate NLS Certificate AFS Certificate Other( ) SE

Certificate SR Certificate Dangerous Goods Fitness Certificate SPP Certificate Exemption Certificate (

Remarks: Please submit an APPLICATION FOR ISSUE OF CERTIFICATES (Form 4A) separately, if LL, SC, SE and AFS are to be issued to Japanese flag ships. For Statutory Certificates other than LL, SC, SE and AFS for Japanese flag ships, please apply to the Japanese Government.

3.

Date and Place of Survey (1) Place of Survey: PARANAGUA - BRAZIL (2) Date of Survey : 21-22.05.2011 ETA:
18.05.2011 ETD: 24.05.2011

(3) Name of Local Agent: Contact Person: Tel: 4.

Fortesolo Servios Integrados Ltda

Thiago Kesseli Celular (041) 7811-1010 Fax 55 (041) 3420-1607 E-mail: Group: agency@fortesolo.com.br : thiago@fortesolo.com.br

Tel. 55 (041) 3420-1648 Fax:

Message, if any

5. Supplementary note (1) This form is also available for Japanese flag ships. (2) Please attach a copy of latest SHIP INSPECTION CERTIFICATE in case of Japanese flag ships. - The End -