FORM OF PASSENGER SHIP SAFETY CERTIFICATE
ANNEX IISupplementary provisions
ANNEX II FORM OF PASSENGER SHIP SAFETY CERTIFICATE PASSENGER SHIP SAFETY CERTIFICATE (This Certificate shall be supplemented by a Record of Equipment (1) ) (Official seal) (State) Issued under the provisions of the … (Name of the relevant measure(s) introduced by the Flag State) and confirming compliance of the vessel hereafter with Directive 2009/45/EC of the European Parliament and of the Council on safety rules and standards for passenger ships under the authority of the Government of … (Full official designation of the Flag State) by … (Full official designation of the competent authority or organisation recognised under Directive 2009/15/EC) Particulars of ship Name of ship: Port of registry: Distinctive number or letters: IMO number (2) : Length Number of passengers: Gross tonnage: Date on which the keel was laid or the ship was at a similar stage of construction: Date of initial survey: Sea Areas in which the ship is certified to operate (SOLAS Regulation IV/2) A1/A2/A3/A4 (3) Class of ship in accordance with the sea area in which the ship is certified to operate, subject to following restrictions or additional requirements (4) : A/B/C/D (3) (1) Class A ships holding a valid SOLAS Passenger Ship Safety Certificate may be waived from this supplement. (2) IMO ship identification number in accordance with resolution A.1078(28), if any. (3) Delete as appropriate. (4) Record any restriction applicable by reason of either the route, area of operation or restricted period of operation or any additional requirement due to specific local circumstances as per Article 9(1) of Directive 2009/45/EC. Initial (1) /Periodical (1) survey This is to certify, 1. that the ship has been surveyed in accordance with Article 12 of Directive 2009/45/EC, 2. that the survey showed that the ship fully complies with the requirements of Directive 2009/45/EC, and 3. that the ship is, under the authority conferred by Articles 9(2) and (3) of Directive 2009/45/EC, exempted from and/or granted equivalency to the following requirements of the directive: … … Conditions on which the exemption and/or equivalency are granted: … … … 4. that the ship complies with Part G of Chapter II-1 using … as fuel/N.A. 1 5. that the following subdivision load lines have been assigned: Subdivision load lines assigned and marked on the ship’s sides amidships (SOLAS II-1/18) (2) Freeboard (in mm) Remarks with regard to alternative service conditions P.1 P.2 P.3 This certificate is valid until … in accordance with Article 13.2 of Directive 2009/45/EC. (Date of the next periodical survey) Place … Date … … (Signature and/or seal of issuing authority) If signed the following paragraph to be added: The undersigned declares that he is duly authorised by the said Flag State to issue this Passenger Ship Safety Certificate. … (Signature) (1) Delete as appropriate. (2) For ships built in accordance with the requirements of Annex I, Section 1, Chapter II-1, Part B-2, the applicable subdivision load line notations ‘C1, C2 and C3” should be used (regulation II-1/B/11). The Arabic numerals following the letter ‘C’ may be replaced by Roman numerals or letters if the Administration of the Flag State consider this necessary to distinguish them from the international subdivision load line notation. Endorsement to extend the validity of the certificate one month in accordance with Article 13.2 This certificate shall, in accordance with Article 13.2 of Directive 2009/45/EC of the European Parliament and of the Council, be accepted bis zum … as valid until Place … Date … … (Signature and/or seal of issuing authority) RECORD OF EQUIPMENT FOR THE PASSENGER SHIP SAFETY CERTIFICATE This Record shall be permanently attached to the Passenger Ship Safety Certificate RECORD OF EQUIPMENT FOR COMPLIANCE WITH THE PROVISIONS OF DIRECTIVE 2009/45/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL 1 Particulars of ship Name of ship: Distinctive number or letters: Number of passengers for which is certified: Minimum number of persons with required qualifications to operate the radio installations: 2 Details of life-saving appliances 1 Total number of persons for which life-saving appliances are provided Lifeboats and rescue boats Port side Starboard side 2 Total number of lifeboats 2.1 Total number of persons accommodated by them 2.2 Total number of lifeboats LSA Code 4.5 2.3 Total number of lifeboats LSA Code 4.6 2.4 Total number of other lifeboats 3 Number of motor lifeboats included in the total lifeboats shown above 3.1 Number of life boats fitted with search lights 4 Number of rescue boats 4.1 Number of boats which are included in the total lifeboats shown above 4.2 Number of boats which are fast rescue boats 5 Life rafts Port side Starboard side 5.1 Number of liferafts for which approved launching appliances are required 5.1.1 Number of persons accommodated by them 5.2 Number of liferafts for which approved launching appliances are not required 5.2.1 Number of persons accommodated by them 2 Details of life-saving appliances (continued) 6 Number of Marine Evacuation Systems (MES) 6.1 Number of liferafts served by them 6.2 Number of persons accommodated by them 7 Personal life saving appliances 8 Number of lifebuoys 9.1 Number of adult lifejackets 9.2 Number of child life jackets 9.3 Number of infant life jackets 10.1 Number of immersion suits 10.2 Number of immersion suits complying with the requirements for lifejackets 11 Number of anti-exposure suits 12 Number of thermal protective aids ( 1 ) 13 Radio life-saving appliances 13.1 Number of radar transponders 13.2 Number of two-way VHF radio telephone apparatus 14 Pyrotechnics 14.1 Line throwing appliance 14.2 Distress flares 3 Details of radio facilities 1 Primary systems 1.1 VHF radio installation 1.1.1 DSC encoder 1.1.2 DSC watch receiver 1.1.3 Radiotelephony 3 Details of radio facilities (continued) 1.2 MF radio installation 1.2.1 DSC encoder 1.2.2 DSC watch receiver 1.2.3 Radiotelephony 1.3 MF/HF radio installation 1.3.1 DSC encoder 1.3.2 DSC watch receiver 1.3.3 Radiotelephony 1.3.4 Direct printing radio telegraphy 1.4 Recognized mobile satellite service ship earth station 2 Secondary means of alerting 3 Facilities for reception of maritime safety information 3.1 NAVTEX receiver 3.2 EGC receiver 3.3 HF direct-printing radiotelegraph receiver 4 Satellite EPIRB 4.1 COSPAS-SARSAT 4.2 INMARSAT 5 VHF EPIRB 6 Ship’s search and rescue locating device 6.1 Radar search and rescue transponder (SART) 6.2 AIS search and rescue transmitter (AIS-SART) 4 Methods used to ensure availability of radio facilities (SOLAS IV/ 15.6 and 15.7) 7.1 Duplication of equipment 7.2 Shore-based maintenance 7.3 At-sea maintenance capability 5 Details of navigational systems and equipment 1.1 Standard magnetic compass ( 3 ) 1.2 Spare magnetic compass ( 3 ) 1.3 Gyro compass ( 3 ) 1.4 Gyro compass heading repeater ( 3 ) 1.5 Gyro compass bearing repeater ( 3 ) 1.6 Heading or track control system ( 3 ) 1.7 Pelorus or compass bearing device ( 3 ) 1.8 Means of correcting headings and bearings ( 3 ) 1.9 Transmitting heading device (THD) ( 3 ) 2.1 Nautical charts/Electronic chart display and information system (ECDIS) ( 2 ) 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 radionavigation system/multi-system shipborne radionavigation receiver ( 2 ) , ( 3 ) 3.2 9 GHz radar ( 3 ) 3.3 Second radar (3 GHz/9GHz) ( 2 ) , ( 3 ) 3.4 Automatic radar plotting aid (ARPA) ( 3 ) 3.5 Automatic tracking aid ( 3 ) 3.6 Second automatic tracking aid ( 3 ) 3.7 Electronic plotting aid ( 3 ) 4.1 Automatic identification system (AIS) 4.2 Long-range identification and tracking system (LRIT) 5 Voyage data recorder/Simplified voyage Data Recorder (VDR/S-VDR) ( 2 ) 6.1 Speed and distance measuring device (through the water) ( 3 ) 6.2 Speed and distance measuring device (over the ground in the forward and the athwartship direction) ( 3 ) 7 Echo-sounding device ( 3 ) 8.1 Rudder, propeller, thrust, pitch and operational mode indicators ( 3 ) 8.2 Rate-of-turn indicator ( 3 ) ( 1 ) Excluding those that are included in the lifeboat, liferaft, and rescue boat equipment in order to comply with the LSA code. ( 2 ) Delete as appropriate. ( 3 ) Alternative means of meeting this requirement are permitted under SOLAS V/19. In case of other means, they shall be specified.