2-Formlm-Cd-001-015 Amended1

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SHIP:

MASTER NAME:
PORT:
INSTALLATION:
CHARTERER:
DATE ESP:
TIME ESP:
DATE NORT
TIME NORT:
DATE ALL FAST:
TIME ALL FAST
DATE COMPL. LOAD/DISCH:
C/P DATED:
VOY:
CARGO TYPE 1:
CARGO QUANTITY 1:
CARGO TYPE 2:
CARGO QUANTITY 2:
CARGO TYPE 3:
CARGO QUANTITY 3:
AGENT:
OPERATORS:

FORM LM-CD-016 Rev. 0 22 Mar 05


NOTICE OF READINESS
M.T. 0
VOY NO. 0 DATE: 30-Dec-99

TO: 0

TO WHOM IT MAY CONCERN:

PLEASE BE ADVISED THAT THE ABOVE VESSEL HAS ARRIVED AT THE PORT OF

0 AT 0:00 HOURS

ON 30-Dec-99 IN EVERY RESPECT READY TO COMMENCE

HER CAR 1) 0 0

2) 0 0

3) 0 0

IN ACCORDANCE WITH THE TERMS AND CONDITIONS OF THE CHARTER PARTY GOVERNING

THIS SHIPMENT.

YOURS FAITHFULLY.

Master 0

FOR AND ON BEHALF OF SHIPPERS/RECEIVERS


NOTICE OF READINESS ACCEPTED/RECEIVED

AT HOURS ON THE

BY

FORM LM-CD-001 Rev. 0 22 Mar 05


M.T. 0
PORT OF: 0
VOY NO: 0 TERMINAL: 0
CHARTERERS: 0 C/P DATED: 30 december -99

PORT LOG
STATEMENT OF FACTS
DATE LOCAL TIME

E.S.P. 30-Dec-99 0
N.O.R. Tendered 30-Dec-99 0
Pilot on board
Anchored roads
Reason for anchoring
Anchor aweigh
Anchored
Reason for anchoring
Anchor aweigh
Pilot on board
Tugs alongside
First Line ashore
All made fast
Gangway Secure
N.O.R. Accepted
Commenced hoses connecting
Commenced tank inspection/gauging
Completed tank inspection/gauging
Tanks accepted
Commenced calculation
Completed calculation
Slops hose connected
Commenced discharging slops
Completed discharging slops
Cargo hoses connected Size:
Commenced load/discharge 0

Commenced load/discharge 0

Commenced load/discharge 0
Completed load/discharge 0
Completed load/discharge 0
Completed load/discharge 0
Commenced tank inspection/ullageing
Completed tank inspection/ullageing
Commenced calculation
Completed calculation/ Dry cert issued
Cargo hoses disconnected

FORM LM-CD-002 Rev. 0 22 Mar 05


Documents/Formalities completed/Clearance onboard

FORM LM-CD-002 Rev. 0 22 Mar 05


Continued Page 2
Pilot on board
Commenced unmooring
Last rope off
Tugs alongside
Tugs away
Pilot disembarked
Anchored
Anchor aweigh
Commenced Sea Passage

REMARKS

NUMBER OF TUG BOATS IN: OUT: SHIFTING

Draft S.G. Cargo Ballast Bunker F.W.


FWD (m) AFT (m) m.t. m.t. HFO(mt) DO(mt) m.t.
Arrival
Condition
Departure
Condition

Receivers/Supplier: Agent: Master of 0

FORM LM-CD-002 Rev. 0 22 Mar 05


Ship
Shore

Ship Stop
Shore Stop

FORM LM-CD-002 Rev. 0 22 Mar 05


DEPARTURE REPORT
M.T.

PORT:
DATE TIME IFO ROB MGO ROB
EOSP ###
ANCHOR AWEIGH ###
ALL FAST ###
LAST ROPE OFF
COMMENCED SP ###
CARGO NAME 0
STOWAGE
SHIPS FIGURE SHORE/BL FIGURE
CARGO NAME
STOWAGE
SHIPS FIGURE SHORE/BL FIGURE
CARGO NAME
STOWAGE
SHIPS FIGURE SHORE/BL FIGURE
BUNKERS TAKEN
TOTAL BUNKERS
CONSUMED FOR
VOYAGE
EMPTY TANK CERTIFICATE
M.T. 0

PORT: 0

DATE:

TIME:

This is to certify that after discharge, the following cargo tanks


have been inspected and found dry and drained to satisfaction:

Following tanks inspected:

Surveyor Chief Officer

FORM LM-CD-003 Rev. 0 22 Mar 05


TANK INSPECTION CERTIFICATE
M.T. 0

PORT: 0

TERMINAL: 0

DATE:

TIME:

We, the undersigned, hereby declare that the cargo tanks were jointly inspected
and found well drained after previous cargo, suitable to load the cargo(es) of
0 as follows:

Cargo tanks Nos. for


Cargo tanks Nos. for
Cargo tanks Nos. for
Cargo tanks Nos. for

The ship's pumps, lines, manifolds, deck heaters were inspected


and found empty as far as visible, so acceptable
for loading the above cargo: YES NO

Remarks:

Surveyor: Chief Officer:

Signature Signature

FORM LM-CD-004 Rev. 0 22 MAR 05


Name Name

FORM LM-CD-004 Rev. 0 22 MAR 05


Page: of
M.T. 0 PORT OF: 0 Cargo quantity:

VOY NO: 0 CARGO: 0 Commence operation: hrs

TERMINAL: 0 Completed operation: hrs

LOADING PUMPING RECORD


Date Time MT CBM Manifold E.T.
Barrels MT / hrs CBM / hrs Bbls/hrs Remarks e.g. Stripping etc.
DD/MM LT (Air) (Obs) Pressure Completion

--- --- --- --- ---


30-Dec-99 0000 Commence ops.

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

______________________________ ______________________________ ______________________________


Chief off. Terminal Surveyor....................

FORM LM-CD-005 Rev. 0 22 MAR 0-5


Page: of
M.T. 0 PORT OF: 0 Cargo quantity:

VOY NO: 0 CARGO: 0 Commence operation: hrs

TERMINAL: 0 Completed operation: hrs

LOADING PUMPING RECORD


Date Time MT CBM Manifold E.T.
Barrels MT / hrs CBM / hrs Bbls/hrs Remarks e.g. Stripping etc.
DD/MM LT (Air) (Obs) Pressure Completion

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

______________________________ ______________________________ ______________________________


Chief off. Terminal Surveyor....................

FORM LM-CD-005 Rev. 0 22 MAR 0-5


Page: of
M.T. 0 PORT OF: 0 Cargo quantity:

VOY NO: 0 CARGO: 0 Commence operation: hrs

TERMINAL: 0 Completed operation: hrs

LOADING PUMPING RECORD


Date Time MT CBM Manifold E.T.
Barrels MT / hrs CBM / hrs Bbls/hrs Remarks e.g. Stripping etc.
DD/MM LT (Air) (Obs) Pressure Completion

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

Ave. Rate = #DIV/0! mt/hr

______________________________ ______________________________ ______________________________


Chief off. Terminal Surveyor....................

FORM LM-CD-005 Rev. 0 22 MAR 0-5


DEADFREIGHT
M.T. 0

PORT OF: 0

VOY NO: 0 DATE:

TO: 0
0

DEAR SIRS,

For an on behalf of my owners and/or charterers I hereby


reserve the right to claim deadfreight/excess freight for short/
over shipment of the difference between nominated and loaded
cargo as specified below

Cargo: 0
Quantity nominated to be loaded: 0.0000 mts
Quantity loaded as per B/L mts
Short/over shipped 0.0000 mts

Kindly sign the copy for receipt and return the same to the Master

Yours faithfully

FORM LM-CD-006 Rev. 0 22 MAR 05


Signed: Master

Title:

FORM LM-CD-006 Rev. 0 22 MAR 05


LETTER OF AUTHORIZATION
M.T. 0

From: 0 Master

To: 0 Agent

Date: 30-Dec-99
Place: 0
Vessel: 0

I, the Master of above referenced vessel hereby authorize you to sign the
Bill(s) of Lading for the cargo of: 0
Grade of Cargo

loaded on my vessel at: 0


Port

on the following date: 30-Dec-99


Date

The authorization is limited to signing/releasing the Bill(s) of Lading ONLY when


all details including quantities/quality have been approved in writing by Master
and/or Owners and Operators of the ship, Messrs:
0
Managing Owners/Timecharterers

on Master's behalf agents:


0 0
Agent's name and place

ensure that Bill(s) of Lading will be properly dated, and a non-negotiable


copy will be forwarded to the master and/or Owners and Operators of the
ship for their approval prior to releasing. Agents to ensure that under no
circumstances will any Bill(s) of Lading will be released before a written
confirmation is received from Master and/or Owners and Operators of
the Ship.

Received by: Yours faithfully

FORM LM-CD-007 Ref. 0 22 MAR 05


Agents Master
0

FORM LM-CD-007 Ref. 0 22 MAR 05


LETTER OF PROTEST
M.T. 0

TO: 0 VOY: 0

FROM: 0 DATE: 30-Dec-99

I, the Master of the above named vessel, hereby, on behalf of the Owners and/or
Charterers, protest against the slow discharging rate alongside your terminal
during the discharge of 0

Actual discharge rate: m3/h


Terminal's restricted backpressure: Bar
Terminals restricted discharge rate: Bar
No. of hoses connected by terminal:
Terminal's hose dimension:

Vessel's discharge capacity: m3/h


Vessel's maximum backpressure: Bar
Vessel's number of manifolds:
Vessel's manifold dimension:

The discharge rate was restricted by the above limitations set by the terminal.
For back pressure reference, a thorough pumplog is appended.

I hereby declare, on behalf of the Owners and/or charterers, the right


to revert in this matter at a later date.

Yours faithfully,
Master
0

FORM LM-CD-008 Rev.0 22 MAR 05


Kindly sign the copy for receipt and return the same to the Master

FORM LM-CD-008 Rev.0 22 MAR 05


LETTER OF PROTEST
M.T. 0

TO: 0 VOY: 0

FROM: 0 DATE: 30-Dec-99

I, the Master of the above named vessel, hereby, on behalf of the Owners and/or
Charterers, protest against the slow loading rate alongside your terminal
during the loading of 0

Actual loading rate: m3/h


No. of hoses connected by terminal:
Terminal's hose dimension:

Vessel's requested loading rate: m3/h


Vessel's number of manifolds:
Vessel's manifold dimension:

I hereby declare, on behalf of the Owners and/or charterers, the right


to revert in this matter at a later date.

Yours faithfully,
Master
0

Kindly sign the copy for receipt and return the same to the Master

FORM LM-CD-009 Rev 0 22 MAR 05


PROTEST OF DIFFERENCE
BETWEEN SHIP & BILL OF LADING FIGURES
M.T. 0

TO: 0 VOY: 0

FROM: 0 DATE: 30-Dec-99

Please be advised that there is a discrepancy between ship and Bill of Lading figures

covering 0 loaded at your terminal

30/Dec/99
DATE

Grade B/L fig Ship fig Difference

On behalf of Owners, I hereby protest this difference holding you responsible


for any and/or all claims which may occur due to this difference.

Yours faithfully,

Master 0

Received:
SIGNATURE PRINT NAME

FORM LM-CD-011 Rev. 0 22 MAR 05


LETTER OF PROTEST
M.T. 0

TO: 0 VOY: 0

FROM: 0 DATE: 30-Dec-99

I, the Master, hereby, on behalf of the Owners and/or charterers,


protest against the following

I hereby declare, on behalf of the Owners and/or charterers, the right


to revert in this matter at a later date.

Yours faithfully,
Master 0

Recieved:
SIGNATURE PRINT NAME

FORM LM-CD-012 Rev. 0 22 MAR 05


SLOP & SLUDGE FORM
M.T. 0

Please note the below information regarding recent slop and/or sludge
disposal from the above named ship.

Date:
Port:
Terminal / Location:
Contact Name / Number:
Total Quantity in BBLS:
Total Quantity in MTS:
Price :
What was discharged?
Remarks:

Yours faithfully,
Master
0

FORM LM-CD-013 Rev.0 22 MAR 05


NOTE OF PROTEST FOR
BUNKERING OPERATION
MT: 0
DATE:
To:
Name of Bunker Supplier and/or vessel

Dear Sirs,

The above named vessel received bunkers from you on


at
Place of Delivery

The following discrepancies were noted:

DIFFERENCE IN QUANTITIES:
Quantity delivered as per manifest: M. Tons
Quantity received on board my vessel: M. Tons
Difference (short delivery): M. Tons

DELAY OF VESSEL:
Vessel ready to receive bunkers:
Date/Time
Bunker vessel arrived:
Date/Time
Delay:
Days/Hours/Minutes

APPARENT DIFFERENCE IN QUALITY:


Quality ordered:

Quality received:

I hereby protest against and hold you responsible for the above noted discrepancy and/or delay, and reserve
all rights for Laurin Maritime (America) Inc. and/or Owner to revert on this matter at a later date.

Master/Ch. Engineer Cargo Officer/Bunker Supply Vessel

FORM LM-CD-014 Rev. 0 22 MAR 05


OFF-HIRE STATEMENT
DATE:

VOYAGE

VESSEL:

M/T 0

Reason for off-hire:

LOCATION:

Off-hire:
Date/Time to 0.000 days

Deduction in off-hire period, e.g. bunkering Activity Bunkers cons. in period


Date/Time to IFO MGO
Date/Time to IFO MGO

IFO bunkered: MT MGO/MDO bunkered: MT

Bunker consumption during off-hire period


OFF-HIRE ON-HIRE TOTAL USED PRICE TOTAL COST
M. Ton M. Ton M. Ton M. Ton USD
IFO 0.00 $0.00 $0.00

MDO/MGO 0.00 0.00 0.00 $0.00 $0.00

Total time OFF-HIRE: 0.000 days (time for bunkering deducted)

MASTER (Type name) CHIEF ENGINEER (Type name)

Approved by Technical Dept. (Signature)

DATE:

22 MAR 05
FORM LM-CD-015 Rev. 0

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