TALEP EDİLEN HİZMET ( Requested Service )
GEMİNİN (Ship's Informations)
Gros Ton / Gross Tonnage
:
1969 İnt.Convention of Tonnage konvansiyole göre ölçülmüş ve tonilato belgesindeki en büyük GT yazılacak.
( Measured According to the 1969 towage convention , the biggest GT int the tonnage certificate, will ve writtent)
Çağrı İşareti / Call Sign:
:
Yeni İnşa İçin / Design Gross
:
Geldiği Liman / Departure Port
:
Gittiği Liman / Destination Port
:
Tam Boyu 200 mtr büyük veya Gemi Cinsi Tanker ise Baş/Kıç itici indirim uygulanmaz.
(Bow and stern thruser disrounts are not applied if the LOA is bigger than 200mtr or/and if it is a ship type tanker.)
Kalıp Genişlik / Beam
:
(mtr)
DRAFTLAR (Draughts)
MAKİNE DURUMU (Engine Condition)
Gemi Cinsi / Ships Type
:
Geminin Register Sertifikası(Tasdiknamede) Belirtilen Cinsi Yazılacak.
(The type of the ship specified in the registration certificate shell be written)
Yükün IMDG Kodu / Cargo IMDG Code
:
GasFree Rapor / Gas Free Report
:
GASFREE SERTIFIKASI'nın hizmete başlamadan en fazla 24 saat öncesi idarece yetkili kuruluşlardan alınmış olması gerekmektedir.
(The GASFREE CERTIFICATE must be obtained from to institutions autharized by the adminstration at more 24 hours before the start of the serviceç)
TEHLİKELİ YÜK DURUMU (Dangerous Cargo Details)
KONTEYNER (Container)
KABOTAJ HATTI (Cabotage Line)
ACENTA BİLGİSİ (Agent Detail)
Telefon/Fax - Phone/Fax
:
E-Posta / E-mail
:
Vergi Numarası / Vat No
:
Vergi Dairesi / Tax Department
:
EVRAĞI DOLDURAN KİŞİNİN (The Person Fillling Out The Information)
Adı ve Soyadı / Name and Surname
:
FATURA KESİLECEK FİRMA (Invoice Address)
Telefon/Fax - Phone/Fax
:
E-Posta / E-mail
:
Vergi Numarası / VAT No
:
Vergi Dairesi / Tax Departmant
:
BEYAN (Declaration)
Pilot Mevkii / Pilot Position
Tarih / Date
:
Saat / Hour
:
Yanaşılacak Liman Tesisi / Port Facilities
:
We will make the ship ready in all respects for the performance of these services, the ship's captain/owner, the provisions of your company's service schedule that must be applied within the framework of the current legislation, the ports regulation and other regulations, instructions and the application of the legislation, the UK Standard Towing Services and Other Services of pilotage/tugboat/mooring. We will inform you that it will be provided under the terms of the Services (U.K. Standard Conditions for Towage and Other Services are Revised 1986-Amended 2008), to pay the pilotage, tugboat and mooring services fees invoiced for the services provided by your company, independently of any debt or debt-creating relationship with third parties, and We will not suspend or fulfill our service requests as an agency in case the due invoice debts related to the various services provided are not paid, that we will not change the invoice address after your company has been invoiced for the services mentioned in this request, that we will not act in violation of the obligations imposed by the Law on the Protection of Personal Data No. 6698, and with the information declared above. We irrevocably accept that all the information and documents sent in the attachment of the request are correct, otherwise all responsibilities belong to us, and we undertake that we will not act inconsistently, otherwise we will immediately indemnify all damages and losses of Marin Tug and Pilotage Inc.
ACENTA NOTU (Agent Remark)