Annual declaration form for the carriage of Heavy Fuel Oil
For the period 20 February 2016 to 19 February 2017 - To be returned to Gard by 11.10.2017.
This form only applies to vessel’s carrying Heavy Fuel Oil (HFO)* as defined below.
All members of the International Group of P&I Clubs, including Gard, are committed to recording vessels carrying HFO. Furthermore, the International Group and its members are required to carry out condition surveys of vessels trading HFO. Please list below your vessels that have carried HFO during this period:
Name of vessel: / IMO no.: / Exempted : yes/noConditions of exemption:
A. The vessel has been the subject of a condition survey by the P&I club in the last 12 months**:
B. The vessel has completed a Class Special Survey in the last 6 months**:C. The vessel has CAP 1***or CAP 2 rating (as defined by the vessels classification society):
D. The vessel has been the subject of a condition survey due to carriage of HFO within the last three years:
E. The vessel is less than 10 years old:
As agreed within International Group the vessel will be exempted from a condition survey if any of the above questions in answered “yes”. If the vessel is not exempted it will be subject to a condition survey.
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Signed by the Member (if not signed by Member must be signed by authorised signatory of Member)
* (ITOPF) By Heavy Fuel Oil is meant a residual fuel with a kinematic viscosity of 380 centipoiseswhen measured at 50 degrees Celsius by Test Method ISO 3104.
** By last 12 month is meant 12 months from and including date of last unloading. By last 6 months is meant 6 months from and including date of last unloading.
*** By CAP is meant the Condition Assessment Program rating issued by vessels Classification Society.
Contact: Bjarne Augestad, Email ,
Gard AS, PO Box 789 Stoa, 4809 Arendal, Tel +47 370 19 100.