Client Questionnaire- ISPS Code

(Information for Preparation of Estimate)

For a quick response, this questionnaire may be faxed or e-mailed directly to:

Fax: 1-281-877-6001 (Americas)
Email: / Fax: 30-210-9403610 (Europe)
Email: / Fax: 65-6275-0258
(Pacific)
Email: / Fax: 86-21-6322-9649 (Greater China)
Email:

1. General Information

PHYSICAL ADDRESS / .
Company Name / Company IMO Number[1]
Address
City / State or Country / Postal Code
Contact Person / Title
Phone / Fax / Email
BILLING/INVOICING ADDRESS / ☐ SAME AS PHYSICAL
Address
City / State or Country / Postal Code
Contact Person / Title
Phone / Fax / Email
CORRESPONDENCE ADDRESS / ☐ SAME AS PHYSICAL
Address
City / State or Country / Postal Code
Contact Person / Title
Phone / Fax / Email

2. Fleet Breakdown by Vessel Type and “Sister Vessels”: Please indicate total number of vessels per vessel type and the number of vessels that are similar in design. This information will assist ABS in estimating the duration of plan reviews & assessments, preparing an accurate estimate and identifying any special requirements for your company’s fleet. A fee reduction may be offered to the second and subsequent sister vessel of each vessel type.

Sister Vessels (vessels similar in design)
Vessel Type / Total No. / Type 1. / Type 2. / Type 3. / Type 4. / Type 5. /
Type 6.
/
Type 7.
/
Type 8.
/
Type 9.
/ Type 10.
Passenger Vessels *
Cargo Vessels **
OSV’s / Towing Vessels
Mobile Offshore Drilling Units

* Including Passenger High Speed Craft

** Including Oil Tankers, Chemical Tankers, Gas Tankers, Bulk Carriers, Cargo High Speed Craft, Container, General & Other Cargo Vessels

3. Fleet Breakdown by Flag: (please indicate number of vessels by flag). This will assist ABS in preparing an accurate estimate for your company’s fleet, based upon any additional flag requirements.

Flag of Registry / / / / / /
No. of vessels

4. Fleet Breakdown by Class Society:

Society
/ ABS / BV / CCS / DNV / GL / KR / LR / NK / RINA / RS / Others
No. of vessels

5. Planning Information:

Projected Date:
Ship Security Plan Review:
Pre-assessment (optional):
Certification Assessment:

6. Fleet Vessel Information: The information provided will assist ABS in estimating the fees associated with SSP reviews and shipboard verifications, as well as identifying any special requirements that may apply. Please complete table below or attach separate sheet(s).

Vessel Name / Vessel Type / Vessel IMO No. / Class No. /

7. CERTIFICATION TO ABS GUIDE FOR SHIP SECURITY

ABS also offers certification to the ABS Guide for Ship Security in conjunction with ISPS Code certification. The Ship Security Guide is designed to meet or exceed the requirements of the ISPS Code (Parts A & B). Upon certification, ABS issues SEC Notation to ABS classed vessel to indicate that the vessel complies with the requirements of Part A & B, and the ABS Guide for Ship Security:

In addition to mandatory ISPS Code Certification (Part A & relevant sections of Part B), does your Company want certification to the ABS Guide for Ship Security? / Yes ☐ / No ☐

8. Additional Information or comments (if any):

ABS Use Only / Received By: / Reviewed By:

MSC Administration

SWZ-122-01-P01 Form B – Rev. 0 Page 4 of 4

[1] Lloyd’s Register Fairplay issues unique Company Identification Numbers. For more information on obtaining this identification number visit http://imonumbers.lrfairplay.com