Tug and Barge Part A 2014

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Part A

Condition Survey Report Form


Tugs and Barges
This is a: Preliminary report Final report Follow-up report

Date survey completed:

Survey Port:

Surveyor:

Surveying company:

Surveyor's Ref. number:

Order club:

Club ref: No:

This report, and any accompanying documentation or photographs, has been compiled for the sole use of the Association for insurance purposes only and
should not be discolsed to third parties without prior written permission from the Association. The information contained in this report, and any
accompanying documentation or photographs, is not exhaustive as to the general condition of the ship and should not be relied upon by members or by
any other party as any assurance, representation or warranty as to the condition of the ship and nothing herein shall prejudice the Club's rights under the
insurance policy in the event of a dispute between the Club and the member relating to the condition of the ship.

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
1. Vessel's particulars
1.1 PARTICULARS

1.1.1

1.1.2 Ex. names

1.1.3

1.1.4 Flag state:

1.1.5 Builder:

1.1.6 Year of Build:

1.1.7 Class Society:

1.1.8 Class notations:

1.1.9 Brief description of vessel:

1.1.10 GT:

1.1.11 DWT:

1.1.12 Last docking:

1.1.13 Last Class / Authority renewal:

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
Crew Matrix

Rank Master Chief Officer

Nationality

Class of Certificate of
Competency

Endorsements as appropriate

Years in Rank

Years this type of vessel

Years at sea

Years with vessel operator

Rank Chief Engineer Second Engineer

Nationality

Class of Certificate of
Competency

Endorsements as appropriate

Years in Rank

Years this type of vessel

Years at sea

Years with vessel operator

Has a copy of full crew list Yes No


been included?

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
2. Circumstances of survey
(Describe in brief the circumstances under which the survey was carried out, such as - but not limited to - the date and the time the
survey commenced and date and time of completion, if the Master was aware of the visit, the operational status of the vessel at the
time, type of cargo handled if applicable, and particular observations or information the Surveyor may consider to be of interest for
the Club.

Comment

Areas not inspected


Areas not covered during the current inspection and any items marked NI (giving details of item number and description), including
the reason for not carrying out a full inspection, should be stated below.

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
2.1 Ship's trading pattern:

2.2 Type of cargo normally carried:

2.3 Master's name:

2.4 Technical manager, company name:

2.5 Name of owner's representative:

2.6 Time under present management:

2.7 Ballast tanks inspected:

2.8 Cargo holds/tanks inspected:

2.9 Was a tightness test of hatch covers carried out? Yes No N/A

3. Executive summary
3.1 Survey summary

Following the completion of the survey, and based on the surveyor's overall impression of the vessel, the surveyor is requested to rate
the following areas (1=excellent 2=good 3=fair 4=poor 5=very poor)

Rating

Shipboard management:

Safety:

Fire safety:

Life saving appliances:

Pollution and environmental awareness:

Navigation:

Apparent structural condition:

Machinery:

Cargo worthiness:

Maintenance and housekeeping:

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
3.2 Surveyor's summary
Advise on the subjects which give rise to the most concern regarding safety of crew, vessel or cargo:

Comment

Surveyor / Company

Place Date

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014
List of additional enclosures, supporting documentation, scanned images and photo albums.

Description

International Group of P&I Clubs - Ship Technical Committee Condition Survey Report - Version 8.0 - Date 21.05.2014

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