Name of Vessel Former Name IMO Number Gross Tonnage Year Built Date of Purchase by Current Owners Registered Owners Technical Managers Flag & Port of Registry Survey Company Name of Surveyor Place of Survey Date of Survey Name of Master Name of Owners Representative While every effort has been made to ensure accuracy in respect of the observations and opinions expressed in this report, it is provided without warranty, and neither the Surveying Company nor any of its employees, associated companies or divisions shall in any circumstances be liable to any person whatsoever for any act, omission or default in connection with this report s preparation and issuance howsoever arising. T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 1 -
Vessel Particulars 1.01 Type of vessel 1.02 Class society & notation 1.03 Major conversion details 1.04 1.05 No. of TEU / Passengers (if applicable) Number of hatches/ holds/ hatch cover type. For tankers number of tanks 1.06 Manufacturer of main engine 1.07 Main engine year built * (by ref. to M.E. builder s plate) 1.08 Trading area 1.09 Trading limits, if any imposed by flag or class 1.10 Cargoes carried within last 12 months *N.B. It is essential that the main engine builder s plate be inspected in the engine room to verify the date of manufacture and installation. This date must match the vessel s declared year of build. If it does not, then this fact must be declared as a deficiency pending provision of a proper explanation by owners. T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 2 -
Summary of Recommendations (Ref. No. in the following table refers to the left hand index number of each item in the Report) Ref No Deficiency Noted Remedial Action Required There are....(total number of requirements for corrective action) listed on... (Number of) pages. Issued by (Survey company): For receipt of behalf of vessel: Name: Surveyors name: Signature: Signature: Position: T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 3 -
Additional Defects (Continuation Page) Page Number: Ref No Deficiency Noted Remedial Action Required (If further space required, use additional copy pages as required and number 4A, 4B etc.) T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 4 -
2.0 Executive Summary Following 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- very good 2- good 3 fair 4 poor 5 very poor 2.01 Shipboard management 2.02 Safety and environmental awareness 2.03 Fire safety 2.04 Life saving appliances 2.05 Pollution prevention 2.06 Navigation 2.07 Apparent structural condition 2.08 Machinery 2.09 Cargo worthiness 2.10 Maintenance and housekeeping Would you be happy to sail on this ship? T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 5 -
3.0 Surveyor s Summary This survey report is issued by: (Survey Company) Name: Signature:... Date: Stamp: This entire report, together with its summary of defects and/ or recommendations for action (if any), has been prepared conditional upon the clear understanding that in no circumstances whatsoever shall the Insurer be held responsible and/ or liable for any inaccuracy in the report, or for any act, omission or negligence of its staff or its appointed surveyor howsoever arising and it is provided for the sole reference of the Insurer and without warranty as to the accuracy of any information or advice supplied therein. T+ 1 212 847 4600 info@eagleoceanmarine.com www.eagleoceanmarine.com - 6 -