Drug and Alcohol Compliance Form
|, the undersigned seafarer hereby confirm that | shall comply with the following
1
Itis strictly prohibited:
- To bring onboard, possess or use any kind of drugs and/or alcohol or beer.
- To bring on board, possess or use any kind of prescribed and/or non-prescribed
medicine without informing the Master.
- To be impaired by drugs and alcohol, during the employment on board the
ship. Impairment shall in this connection be defined as a test showing any
traces of drugs and/or alcohol. (Alcohol contents over 0.00% is considered
impairment)
All crewmembers must participate in a alcohol/drug test required by the Master! the
‘Company, which is done in order to prove to third party, that the above rules aro
beina complied with,
from the ship and the company.
| further confirmed that | have been fully informed and understand that:
~ Drug Trafficking is a heavy crime.
~ The Owners and the Master of this vessel wil fully cooperate with the Public
Authorities in the criminal prosecution of anyone onboard using or possessing drugs
andlor drug equipment.
I shall not be covered by the Owner's P & | insurance should | commit any drug
crimes.
- Lam personally responsible for all consequences (all costs, fines, charges, claims for
damages, etc.) that the owners of the vessel may face or incur as a result of my
committing a drug crime.
~ Should | commit a drug crime, my contract of employment shall be immediately
cancelled and | shall pay and personally shoulder all repatriation costs, fines, ete.
‘The compliance statement is valid on all vessels managed by TB Marine Shipmanagement GmbH & Co. KG.
Thereby confirm understanding and commit full compliance to the Drug and Alcohol Policy
a enforced by the Company,
Seafarers Signature a
Seafarer’s Name & Rank: Teyaey Pet Srd Ena.
Date! Place 13.42.2019 Riga