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CERTIFICATE OF INSURANCE OF
LIABILITY FOR T}IE REMOVAL OF WRECKS
NOT TRANSFERABLE
Certificate Nol
Certificate furnished as evidence of insurance pursuant to article 12 of the Nairobi International
Convention on the Removal of Wrecks,2007
Name of Ship
Grass
Tonnage
IMO Ship
Call Sign
Port of
Registry
Identi{ication
Number
Name and full address of the
principal place of business of
the recistered owner
This is to certify that there is in force in respect of the above named ship while in the above
ownership a policy of insurance satisfying the requirements of article l2 of the Nairobi
International Convention on the Removal of Wrecks, 2007
Condition: To cover,
Liabilities, costs and expenses in respect of the removal or disposal, or the lighting and
marking of:
o
o
The wreck of the Entered Vessel(s).
Cargo, property or goods on board or which were carried on board the Entered Vessel(s)
(other than oil or any othei polluting substance).
o
The wreck of any vessel damaged by the Entered Vessel(s), by collision or otherwise or
cargo on board such a wreck.
Limit of Liability: To meet the requirement of article 6 of the convention on Limitation of
........US$/€
Liability for Maritime Claims' 1976 and up to maximum... .
Period of Insurance:
from.
.........(GMT) to
.
....(GMT)
Signature of Insurer:
Date of Issue:
Name and address of the insurer(s) and/or guarantor(s):
10
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b
dfr*
djL.; arl,i'.}.*,9..- tf al^lfl ts Jb.5t{pl*6
rt"
lr-
4..{
A.qnlf
CERTIFICATE OF INSURANCE OR OTHER FINANCIAL SECURITY IN RESPECT OF
LIABILITY FOR THE REMOVAL OF WRECKS
Issued in occordance with the provisions of arlicle 12 of the Nairobi International Convention on
the Removal of Wrecks,2007
Name of Ship
Grass
Distinctive
IMO Ship
Tonnage
Nurnber of
Letters
Identification
Number
Port of Registry
Name and full address of the
principal place ofbusiness
the registered owner
This is to certify that there is in force, in respect of the above-named ship, a policy of
insurance
or other financial security satisfying the requirements of article 12 of the Nairobi
International Convention on the Removal of Wrecks, 2007.
Typeof Security: POUCY OF INSURAI{CE
Durationof Security: Noon
(GMT)
to Noon
(GMf)
Name and address of the insurer(s) and/or guarantor(s)
Name:
Address:
This certificate is valid until: Noon (GMT)
Issued or certified by the Government of Islamic Republic of IRAN
Date of issue:
Director General of Marine Operation & Maritime Safety
11
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