- Laws of Fiji

FSU14

Form of safety Equipment Certificate
For Cargo Ship
This certificate shall be supplemented by a record of Equipment
(Form E)
(FIJI seal)
Issued under the provisions of the
INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974,
As modified by the protocol of 1988 relating thereto
Under the authority of the Government of
FIJI
by
________________
(signature of Chief Executive Officer MSAF or authorised person)
Particulars of ship
Name of Ship .................................................................................
Distinctive number or letters .................................................................................
Port of registry .................................................................................
Gross Tonnage .................................................................................
Deadweight of ship (metric tons)¹⁷.................................................................................
Length of ship (regulation III/3.12 .................................................................................
IMO Number¹⁸.................................................................................
Type of ship¹⁹
Bulk carrier
Oil tanker
chemical tanker
Gas carrier
cargo ship other than any of the above
Date on which keel was laid or ship was at a similar stage of construction or, where applicable, date on which work for a conversion or an alternation or modification of a major character was commenced none .................................................................................
THIS IS TO CERTIFY:
1That the ship has been surveyed in accordance with the requirements of regulation 1/8 of the Convention
2That the survey showed that:
2.1The ship complies with the requirements of the Convention as regards structural fire protection, fire safety systems and appliances and fire control plan;
2.2The life-saving appliance and the equipment of the life boat, liferaft, and rescue boats were provided in accordance with the requirements of the Convention;
2.3The ship was provided with a line throwing appliance and radio installation used in life saving appliances in accordance with the requirements of the Convention;
2.4The ship complies with the requirements of the convention as regards shipborne navigational equipment means of embarkation for pilot and nautical publications;
2.5The ship was provided with lights, shapes and means of making sound signals and distress signals in accordance with the requirements of the convention and international regulation for preventing collisions at sea force;
2.6In all other respects the ship complies with the relevant requirements of the Convention;
2.7The ship was/was not²² subjected to an alternative design and arrangement in pursuance of regulation II-2/17 the Convention;
2.8A document of approval of alternative design and arrangement for fire safety is /is not²² appended to this certificate.
3That an exemption certificate has/has not²² been issued.

This certificate is valid until .................................................................................²⁰ subject to the annual and periodical surveys in accordance with regulation I/8 of the convention.
Issued at .................................................................................
(Place of issue of certificate)
Completion date of the survey on which this certificate is based:
................................................................................. dd/mm/yyyy)

.........................	.........................
(Date of Issue)	(signature of Chief Executive Officer MSAF or authorised person)

(MSAF seal or authorised organisation seal)
Endorsement for annual and periodic surveys
THIS IS TO CERTIFY that, at a survey required by regulation I/8 of the convention, the ship was found to comply with the relevant requirements of the Convention.

Annual survey:	Signed: ......................... (signature of Chief Executive Officer MSAF or authorised person)
	Place: ..........................
	Date: ..........................
(MSAF seal or authorised organisation seal)

Annual/Periodical²¹ survey
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................

(MSAF seal or authorised organisation seal)
Annual/periodical²⁴ survey:	Signed: ..........................
	(Signature of Chief Executive Officer MSAF or authorised person)

	Place: ..........................
	Date: ..........................
(MSAF seal or authorised organisation seal)
Annual survey:	Signed: ..........................
	(signature of Chief Executive Officer MSAF or authorised person)

	Place: ..........................
	Date: ..........................
(MSAF seal or authorised organisation seal)

Annual/periodical survey in accordance with regulation 1/14(h)(iii)
THIS IS TO CERTIFY that, an annual/periodical²⁴ survey in accordance with regulation 1/14(h)(iii) of the convention this ship was found to comply with the relevant requirements of the Convention.
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
Endorsement to extend the certificate if valid for less than 5 years where regulation 1/14(c) applies.
This ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation 1/14(d) of the Convention, be accepted as valid until
.................................................................................
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
Endorsement where the renewal survey has been completed and regulation 1/14(d) applies.
The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation 1/14(d) of the Convention, be accepted as valid until .................................................................................
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
Endorsement to extend the validity of the certificate until reaching the port of survey or for a period of grace where regulation 1/14(e) or 1/14(f)²² applies
The certificate shall, in accordance with regulation 1/14(e) or 1/14(f) of the Convention, be accepted as valid until..................................................................................
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
Endorsement for advancement of anniversary date where regulation 1/14(h) applies
In accordance with regulation 1/14(h) of the Convention, the new anniversary date is .................................................................................
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
In accordance with regulation 1/14(h) of the Convention, the new anniversary date is...................................................................................................................................................................
Signed:..................
(signature of Chief Executive Officer MSAF or authorised person)
Place:..................
Date:..................
(MSAF seal or authorised organisation seal)
RECORDS OF EQUIPMENT FOR THE CARGO SHIP SAFETY EQUIPMENT CERTIFICATE
(FORM E)
These records should be permanently attached to the Cargo ship safety equipment certificate
RECORDS OF EQUIPMENT FOR COMPLIANCE WITH THE INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, AS MODIFIED BY THE PROTOCOL OF 1988 RELATING THERETO
1. Particulars of ship
Name of ship .................................................................................
Distinctive number or letters .................................................................................
2. Details of life- saving appliances

1. Total number of persons for which lilfe saving appliances are provided				.........................
				Port Side	Starboard side
2.	Total number of life boats			.........................	.........................
	2.1	Total number of persons accommodated by them		.........................	.........................
	2.2	Number of totally enclosed lifeboats (regulation III/31 and LSA code, paragraph 4.6)		.........................	.........................
	2.3	Number of totally enclosed life boats (regulation III/31 and LSA code, paragraph 4.8)		.........................	.........................
	2.4	Number of fire protected lifeboats (regulation III/31 and LSA code, paragraph 4.9)		.........................	.........................
	2.5	Other lifeboats		.........................	.........................
		2.51	Number	.........................	.........................
		2.52	Type	.........................	.........................
	2.6	Number of freefall lifeboats		.........................
		2.61	Totally enclosed (regulation III/31 and LSA Code, paragraph 4.7)	.........................
		2.62	Self-contained (regulation III/31 and LSA Code, paragraph 4.8)	.........................
		2.63	Fire-protected (regulation III/31 and LSA Code, paragraph 4.9)	.........................
3.	Number of motor life boats (included in the total lifeboats shown above)			.........................
	3.1	Number of lifeboats fitted with searchlights.		.........................
4.	Number of rescue boats			.........................
	4.1	Number of boats which are included in the total lifeboats shown above		.........................
5.	Liferafts			.........................
	5.1	Those for which approved launching appliances are required		.........................
		5.11	Number of liferafts	.........................
		5.12	Number of persons accommodated by them	.........................
	5.2	Those for which approved launching appliances are not required		.........................
		5.2.1	Number of liferafts	.........................
		5.2.2	Number of persons accommodated by them	.........................
	5.3	Number of liferafts required by regulation III/31.1.4		.........................
6.	Number of lifebuoys			.........................
7.	Number of lifejackets			.........................
8.	Immersion suits			.........................
	8.1	Total number		.........................
	8.2	Number of suits complying with the requirements for lifejackets		.........................
9.	Radio installations used in life saving appliances			.........................
	9.1	Number of radar transponders		.........................
	9.2	Number of 2 way VHF radiotelephone apparatus		.........................

3. Details of navigational systems and equipment

Item		Actual provision
1.1	Standard magnetic compass⁵	.........................
1.2	Spare magnetic compass²⁶	.........................
1.3	Gyro-compass²⁶	.........................
1.4	Gyro-compass heading repeater²⁶	.........................
1.5	Gyro-compass bearing repeater²⁶	.........................
1.6	Heading or track control system²⁶	.........................
1.7	Pelorus or compass bearing device²⁶	.........................
1.8	Means of correcting heading and bearings	.........................
1.9	Transmitting heading device (THD)²⁶	.........................
2.1	Nautical charts/ Electronic chart display⁶ and information system (ECDIS)	.........................
2.2	Back up arrangements for ECDIS	.........................
2.3	Nautical publications	.........................
2.4	Back-up arrangements for electronic nautical publications	.........................
3.1	Receiver for a global navigation satellite system/ terrestrial radio navigation system.^{26, 27}	.........................
3.2	9 GHz radar²⁶	.........................
3.3	Second radar (3GHz/9GHz²⁷)²⁶	.........................
3.4	Automatic radar plotting aid (ARPA)²⁶	.........................
3.5	Automatic tracking aid²⁶	.........................
3.6	Second automatic tracking aid²⁶	.........................
3.7	Electronic plotting aid²⁶	.........................
4.1	Automatic identification system (AIS)	.........................
4.2	Long–range identification and tracking system	.........................
5.1	Voyage data recorder (VDR)²⁷	.........................
5.2	Simplified voyage data recorder (S-VDR)²⁷	.........................
6.1	Speed and distance measuring device (through the water)²⁶	.........................
6.2	Speed and distance measuring device (over the ground in the forward and athwartship direction)²⁶	.........................
6.3	Echo- sounding device²⁶	.........................
7.1	Rudder, propeller, thrust pitch and operational mode indicator²⁶	.........................
7.2	Rate of turn indicator²⁶	.........................
8.	Sound reception system²⁶	.........................
9.	Telephone to emergency steering position²⁶	.........................
10.	Daylight signalling lamp²⁶	.........................
11.	Radar reflector²⁶	.........................
12.	International Code of Signals	.........................
13.	IAMSAR Manual, Volume III	.........................

THIS IS TO CERTIFY that this Record is correct in all respects
Issued at..................................................................................
(Place of issue of the Record)

..........................	.........................
(Date of issue)	(signature of Chief Executive Officer MSAF or authorised person)

(MSAF seal or authorised organisation seal)

17For oil tankers, chemical tankers and gas carriers only.

18In accordance with IMO ship identification number scheme adopted by the Organisation by resolution A 600(15)

19Delete as appropriate

20Insert the date of expiry as specified by the Administration in accordance with Regulation 1/14(a) of the convention. The day and the month of this date correspond to the anniversary date, as defined in regulation ½(n) of the convention, unless amended in accordance with regulation ¼(h)

21Delete as appropriate

22Delete as appropriate

24In accordance with the IMO ship identification number scheme adopted by the Organisation by resolution A 600(15).

26Insert the date of expiry as specified by the Administration in accordance with regulation 1/14(a) of the Convention. The day and the month of this date correspond to the anniversary date as defined in regulation ½(n) of the Convention, unless amended in accordance with regulation 1/14(h).

27Delete as appropriate

5Delete as appropriate

6Delete as appropriate