Page 1 of 15 OFFSHORE SERVICE VESSEL DYNAMIC POSITIONING AUTHORITY FORM DPO-1-CV, TRAINING AND CERTIFICATION ACTIVITIES CONFIRMATION LETTER Operator and Individual Submitting Form. 1. Operator. Enrolled Operators need only to fill in their name and enrollment number, others must complete the entirety of Question 1. Operator Name: Corporate Mailing Address: OSVDPA Enrollment Number. Street Address Suite/Unit # City State ZIP Code If your address is outside the United States substitute your province (or other political subdivision) and Postal Code for State and Zip Code. 2. Name of the individual submitting this form See the Definitions and Instructions for who may submit this form. Name: OSVDPA Approval No. E.g. DPO Cert. Number, Auditor Number, etc. Those with an OSVDPA approval number and a signed Form P-2-CV, Participant Rights and Responsibilities Acknowledgement (Current Version) can skip to Question 3. Check here if your supervisor has signed a Form P-3-CV, the Participant Supervisory Rights and Responsibility Acknowledgment (Current Version) on your behalf. Those checking this box should skip to Question 3. Check this box if you do not work for an Enrolled operator and do not have an OSVDPA approval (see the Definitions and Instructions section for what else must be included in these cases. Title: Email Address: Mobile Phone: Include Country Code if outside U.S. Direct Dial: Include Country Code if outside U.S. DPO or Prospective DPO Information. 3. DPO or Prospective DPO Information. Include the below information about the DPO or Prospective DPO. Check the type of certificate being applied for (see the Definitions and Instructions Section): Full Name: Class A DPO Certificate, Class C DPO Certificate, or Class B DPO Certificate, Revalidation of an existing OSVDPA DPO Certificate. Date of Birth: First M.I. Last DPO Certificate Number or Prospective DPO Identification
Page 2 of 15 Experience. 4. Experience. Complete summarizes of each hitch listed in the DPO or Prospective DPO s logbook(s). Attach additional sheets if necessary. Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours
Page 3 of 15 Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours Hitch Start Date: End Date: Hours
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Page 12 of 15 Enhanced Verification. Operators must complete this portion if the DPO or Prospective DPO was the Master of the during any portion of completing their Activities or if the OSVDPA has required the Operator to complete this section due to a lack of properly certified DPO available to sign a DPOs or Prospective DPO s logbook. This section of the form must be signed by a Qualified on Board Assessor. 5. DPO or Prospective DPO Competency. (Please choose at least one (1) of the below options or write in alternative or additional steps taken to validate the applying DPO or Prospective DPO s competencies.) DPO or Prospective DPO s relevant assessment(s) were conducted by an independent Qualified on Board Assessor (QOBA) not employed by the Operator. (This QOBA cannot work for a Related Entity. DPO or Prospective DPO conducted the relevant assessment(s) at an OSVDPA-accredited Training Center operated by an independent Training Provider. This Training Provider cannot be a Related Entity to the Operator. DPO or Prospective DPO s relevant assessment(s) were conducted by a QOBA that has not served with the DPO or Prospective DPO for a period of more than two (2) years. An independent observation of the relevant assessment(s) was conducted by an individual with knowledge of DP operations (i.e., Operations Manager, Superintendent). The Operator has had the individual s logbook and assessment report form(s) reviewed by a QOBA that has not served with the individual for a period of more than two (2) years. The reviewing QOBA found the Activities and assessments were conducted according to the OSVDPA requirements. The Operator took other steps to ensure the competency of the DPO or Prospective DPO, such steps should be listed below. QOBA s Signature: Printed Name: Date: QOBA No. Note: For those required to complete this section, a signature is still required in the Operator Certification of Activities and Service Section.
Operator Certification of Activities and Service. See the Definitions and Instructions Section for who may sign this section and submit this form. We, certify that is/was employed by our company and served aboard our vessels. We have reviewed his or her logbook(s) against our records and verify that Sea Time and recorded therein, as detailed elsewhere in this form, is a true and accurate representation of his or her service. Further, this Sea Time and was conducted and recorded in accordance with the OSVDPA s requirements as listed in OSVDPA MPP-1-CV, the OSVDPA Manual of Policies and Procedures (Current Version). Signature: Printed Name: Date:
Confirmation Page 14 of 15 BoD: TAC: ED: Counsel: N/A Definitions and Instructions. Definitions. Auditor. An individual approved by the OSVDPA as capable of systematically and independently obtaining and objectively evaluating evidence for the purposes of determining if the asset or entity meets the criteria developed by the OSVDPA. Enrollment. The process of the OSVDPA approving a Operator in order for the OSVDPA to accept Phase 4 Assessments, Phase 5 Assessments, and Revalidation Assessments conducted by the Operator on its vessels.. An hour-based measurement of DP experience accrued when a DPO or prospective DPO is at the DP controls for at least one (1) hour during a 24-hour period while the vessel is conducting auto positioning operations, auto heading operations (including DP- or independent joystick-based autopilot), independent joystick operations, or other operations where the DP system is engaged. Up to six (6) hours of practical experience can be logged during a 24-hour period. All practical experience recorded by Prospective DPOs must be supervised and signed off by a DPO or the Master of the vessel. Principal. A representative of the training provider, vessel operator, or other OSVDPA partnering entity who is authorized to contractually obligate the entity. Qualified on Board Assessor (QOBA). A DPO certified by the OSVDPA, to conduct the Phase 4 and Phase 5 Assessments. In conducting these assessments, the QOBA utilizes criteria established by the OSVDPA to evaluate whether the DPO or Prospective DPO has passed the assessment. Related Entity. The OSVDPA utilizes the United States Internal Revenue Service definition for related entities. This definition, found at 26 United States Code, section 168(h)(4) states, that two entities are related if the following apply: (1) The two entities have (i) significant common purposes and substantial common membership or (ii) directly or indirectly substantial common direction or control; or (2) Either entity owns (directly or through one or more entities) a 50 percent or greater interest in the capital or profits of the other. For this purpose, entities treated as related entities under the preceding paragraph shall be treated as one entity. Sea Time. A day-based measurement of DP experience accrued when a DPO or prospective DPO is on watch while the vessel is conducting auto positioning operations, auto heading operations (including DP- or independent joystickbased autopilot), independent joystick operations, or other operations where the DP system is engaged for at least one hour during a 24-hour period. All sea time recorded by a Prospective DPO must be supervised and signed off by a certified DPO or the Master of the vessel. Instructions for completing this form. 1. This form is utilized by Operators to confirm the Sea Time and claimed by DPOs or Prospective DPOs as they seek their initial, upgrade, or revalidate their certificate. operators shall only include in this form the Sea Time and the DPO or Prospective DPO recorded on vessels in their fleet. Sea Time and recorded on other vessels, should be recorded by that vessel operator on a separate form. 2. Once completed, the form should be printed and signed, the Operator Certification of Activities and Service Section should be printed on the Operator s letterhead. 3. Once signed, the form should be provided to the DPO or Prospective DPO so they can include in their certification package. If that is not possible or practical, the form should be sent to the OSVDPA with reference to the DPO or Prospective DPO the form pertains to and when said DPO or Prospective DPO certification package was or will be submitted to the OSVDPA. The OSVDPA welcomes any questions or concerns of applicants. Questions may be directed to Ben.Berson@OSVDPA.org or made via phone at +1 (504) 528-9414.
Confirmation Page 15 of 15 BoD: TAC: ED: Counsel: N/A Who May Sign This Form: For Enrolled Operators: this form must be signed by someone who has registered with the OSVDPA and been approved by the OSVDPA to sign such forms via the submission and approval of Form P-2-CV, Participant Rights and Responsibilities Acknowledgement (Current Version) or the individual s supervisor has signed Form P-3-CV, Participant Supervisory Rights and Responsibility Acknowledgment (Current Version). For Operators not Enrolled in the OSVDPA, this form must be signed by an individual serving as a President, Vice President for personnel/human resources, Vice President for operations, Personnel Director, Marine Superintendent, or Operations Manager. This individual must have previously received permission from the OSVDPA to sign this form, the OSVDPA has his or her signature on file, and he or she has certified to the OSVDPA that they understand the OSVDPA s Certification Scheme and its requirements. Description of Other Forms Mentioned Herein: Form P-2-CV, the Participant Rights and Responsibilities Acknowledgement (Current Version). This form must is signed by individuals that have an OSVDPA approval (e.g. an OSVDPA DPO Certificate, auditor approval, QOBA approval, etc.) or are a Principal for an entity involved in the OSVDPA DPO Certification Scheme and seek to sign Form DPO-1-CV. The form states that the individual understands OSVDPA policies and procedures and agrees to abide by these procedures. Form P-3-CV, Participant Supervisory Rights and Responsibility Acknowledgment (Current Version). This form is for those that cannot sign a Form P-2-CV because they do not have an OSVDPA approval and are not a Principal but are required to submit information to the OSVDPA. The form is signed by an individual that is approved by the OSVDPA or is a Principal for an entity involved in the OSVDPA stating that the individuals listed on the form understand the OSVDPA s policies and procedures and will abide by these policies and procedures. OSVDPA Certificates: The OSVDPA provides mariners that have gained the requisite experience, passed the required classes, and passed the relevant assessments with a DPO certificate. The OSVDPA certificate requirements are based on international standards and industry best practices. Specifically, the OSVDPA provides three (3) types of certificates: Class A DPO Certificate: This certificate is equivalent to the traditional Unlimited DPO Certificate. According to the OSVDPA MPP-1-CV, the Class A DPO certificate is provided to those DPOs who have passed the Phase 4A or Phase 5 assessment after completion of the certification system either through Phase 4A or upgraded their Class B DPO certificate via Phase 5, in the process accruing at least 60 days of Sea Time and 180 hours of Practical Experience on a vessel with a DP class notation of DP-2 or higher as issued by a recognized classification society after the completion of the requirements of Phase 2 (Familiarization). Class B DPO Certificate: This certificate is equivalent to the traditional Limited DPO Certificate. According to the OSVDPA MPP-1-CV, the Class B DPO certificate is provided to those DPOs who have completed the OSVDPA Certification Scheme through Phase 4 (Watchkeeping) and passed the Phase 4B Assessment. Class B DPO certificate holders have recorded less than 60 days of Sea Time and 180 hours of on a vessel with a DP class notation equal to DP-2 or higher as issued by a recognized classification society. After completing the requirements of Phase 2 (Familiarization), Class B DPO Certificates can be upgraded to Class A DPO certificates if the holder completes Phase 5 (Upgrading) of the certification scheme. Class C DPO Certificate: An optional certificate awarded after successful completion of the OSVDPA Certification Scheme through Phase 3 (Simulator) Course and passage of the Phase 3 Assessment. The holder of a Class C DPO has proven they possess knowledge of the fundamental principles of dynamic positioning, demonstrated practical ability to operate a DP system, and is competent in switching the vessel from DP to manual mode in order to move the vessel away from an installation. Class C DPOs must be under direct supervision of a DPO at all times while gaining the experience and skills necessary to qualify as a DPO. It is important to note that this optional certificate follows the guidance offered by IMCA M 117, but it is not a full DPO Certificate. Holders of this certificate are still referred to as Prospective DPOs and must complete the rest of the DPO Certification Scheme before being a DPO.