web_preclearance_form.pdf

APPLICATION FOR VESSEL

PRE-CLEARANCE

SEAWAY No.

number will be assigned

PART I - REGISTRATION

1. Registration of Vessel:

Name:

Country of Registry:

Port:

Imo No.

2. Insurance: ( Liability insurance must be equal to or exceed $100 per gross registered ton)

Amount of liability insurance coverage on the vessel (P & I):

Names of underwriters:

Names and addresses of Canadian or U.S. P & I representative:

3. Representative responsible for payment of tolls and charges:

Company Name:

Address:

Telephone No.:

Fax no:

E-mail

4. Certificate of Guarantee: (see bottom of page)

This Certificate shall be good and binding:

A ) until either party ( the Customer or The Corporation ) advises the other of its intention to cancel this contract. This advice must

be submitted in writing either by regular mail, fax or e-mail.

check if applicable

< OR >

B ) for the following

Expected date

voyage:

of arrival:

Dated at

this

day of

year

Signature of authorized officer

NOTE: Approval of this application does not constitute acceptance of the fact that the vessel is in a condition satisfactory for transit

PART II - INFORMATION ON VESSEL

The furnishing of inaccurate information is a violation of seaway regulations

1. Managing Owner or Operator of the Vessel:

Name of Company:

Address:

2. Type of Vessel: (please indicate applicable type )

CARGO

TANKER

PASSENGER ONLY

CARGO / PASSENGER

TANK BARGE NAVAL (military)

UNDER TOW

DREDGE

SCOW

BARGE (non-cargo)

TUG OTHER (specify)

GOVERNMENT

COAST GUARD

PLEASURE CRAFT

SEAWAY VESSELS

CARGO BARGE

3. Type of Service:

Inland

Ocean

(Other)

4. Specifications:

NOTE : It is of the utmost importance to furnish the precise overall length of vessels

in order that Traffic Controllers may arrange lockages accordingly

Gross tons:

Extreme breadth:

Length (overall):

Moulded depth:

RETURN TO:

THE ST. LAWRENCE SEAWAY MANAGEMENT CORPORATION Tel 613 932 5170 ext 3234

202 PITT STREET, CORNWALL, ONTARIO CANADA Fax 613 932 5401

K6J 3P7 ATTENTION: PRE-CLEARANCE DEPT. E-mail tolls@seaway.ca

This form is also available on our Web site at http://www.greatlakes-seaway.com/en/transactions/index.html

Certificate of Guarantee

The signing officer hereby accepts responsibility for the carrying out of the obligations of the representative pursuant to seaway Regulations,

including the accurate completion of Part II hereof, and hereby undertakes to make payment of all monies that may become due by this vessel

for tolls and charges during the full term of this certificate, which undertaking will remain in force not-withstanding the earlier expiration of this

certificate. The signing officer also agrees that security for the payment of tolls, which may be provided by him during the currency of the certificate,

shall be subject to summary forfeiture in the event of non-compliance by him with requirements relating to the payment of tolls and charges.

SLSMC.327

Plik z chomika:

Inne pliki z tego folderu:

Inne foldery tego chomika: