1、審圖工作控制號(hào)/Plan Approval No: 檢驗(yàn)單位工作控制號(hào)/Branch Job No:注: 適用 不適用 (Rev.1 20180101- )中 國 船 級(jí) 社CHINA CLASSIFICATION SOCIETY 重 大 改 裝 船 舶 審 圖 / 檢 驗(yàn) 服 務(wù) 協(xié) 議Application for Plan Approval/Survey of Ship during Major Conversion茲申請中國船級(jí)社對下述船舶進(jìn)行We hereby apply China Classification Society to carry out the following

2、services for the vessel mentioned below: FORMCHECKBOX 重大改裝圖紙審批Plan Approval for major convention FORMCHECKBOX 重大改裝檢驗(yàn)Survey during major convention改裝船廠/Shipyard聯(lián)系人/電話/傳真Contact/Tel.No/Fax No設(shè)計(jì)單位/Designer聯(lián)系人/電話/傳真Contact/Tel.No/Fax No船東/船舶營運(yùn)人Ship Owner / Ship Operator聯(lián)系人/電話/傳真Contact/Tel. No/Fax No工程編

3、號(hào)Yard No改裝合同日期/Date of contract for major conversion改裝計(jì)劃Conversion Schedule:開工/Steel cutting交船/Delivery圖紙送審/Dwg. submitting船舶參數(shù)：Ships particular:A現(xiàn)有船舶Existing shipB改裝后船舶The ship after Conversion船名Ships name船旗國FlagIMONO船舶種類Type of ship船藉港 Port of registry船（兩柱間）長Length (B.P.)船（型）寬Breadth (Mid)船（型）深Dep

4、th (Mid)船級(jí) Class航區(qū)Service areas總噸位（69）/（近似）Gross tonnage (69) / (Approx.)載重噸 /（近似）Deadweight / (Approx.)船舶所有人/管理人Ships owner/ Operator申請授予的船級(jí)符號(hào)和附加標(biāo)志Class Characters and Class Notations:船舶的重大改裝方案介紹：Details of Major Conversion:申請中國船級(jí)社簽發(fā)下列船級(jí)證書及代表船旗國政府簽發(fā)下列法定證書及批準(zhǔn)有關(guān)技術(shù)文件。我們接受相關(guān)的中國船級(jí)社規(guī)范、國際公約、船旗國政府及法規(guī)的要求We

5、apply that the following classification certificates are to be issued by China Classification Society, and the following statutory certificates & relevant technical documents are to be issued and/or approved by China Classification Society on behalf of the Government of the State whose flag the ship

6、 is entitled to fly. The application is made on the basis that we accept the relevant CCS rules and international conventions and the requirements of flag government.Part A：下列證書適用于國際航行船舶。The following certificates are applied to the international voyage ships。 FORMCHECKBOX 入級(jí)證書（CLS）Classification ce

7、rtificate噸位證書 Tonnage FORMCHECKBOX 69 國際噸位證書 (CIT)International tonnage certificate (1969) FORMCHECKBOX 巴拿馬運(yùn)河噸位文件(CPCT)Panama Canal PC/UMS documentation FORMCHECKBOX 蘇伊士運(yùn)河噸位證書(CST)Suez Canal tonnageSOLAS相關(guān)證書 SOLAS 1974/1978 and later amendments FORMCHECKBOX 貨船構(gòu)造安全證書(CSC)Cargo ship safety constructio

8、n certificate FORMCHECKBOX 貨船設(shè)備安全證書(CSE)Cargo ship safety equipment cert. FORMCHECKBOX 貨船無線電安全證書(CSR)Cargo ship safety radio certificate FORMCHECKBOX 客船安全證書(CPS) FORMCHECKBOX Passenger ship safety certificate乘員定額證書（CPQ）Passenger quota certificateMARPOL相關(guān)證書和證明文件 MARPOL 73/78 FORMCHECKBOX 國際防止油污證書(COP

9、)International oil pollution prevention cert. FORMCHECKBOX 國際防止散裝運(yùn)輸有毒液體物質(zhì)污染證書(CNL)International pollution prevention cert. For the carriage of noxious liquid substances in bulk FORMCHECKBOX 國際防止生活污水污染證書(CWP) FORMCHECKBOX International sewage pollution prevention cert.國際防止生活污水污染符合證明(CWP-1/CWP-2)Docum

10、ent of compliance for International sewage pollution prevention FORMCHECKBOX 防止船舶垃圾污染檢驗(yàn)證明(CGP)Statement of garbage pollution prevention from ships FORMCHECKBOX 國際防止空氣污染證書(CAP) FORMCHECKBOX FORMCHECKBOX International air pollution prevention cert.國際防止大氣污染符合證明（CAP-1/CAP-2）Document of compliance for in

11、ternational air pollution prevention國際能效證書（CEE） International energy efficiency certificate載重線證書 Load Line FORMCHECKBOX FORMCHECKBOX 國際載重線證書(CLL)International Load line certificate國際船舶載重線免除證書（CEL）International load line exemption certificate高速船證書 High Speed Craft FORMCHECKBOX 高速船安全證書(CHS) High-Speed

12、 craft safety certificate FORMCHECKBOX 高速船營運(yùn)許可證書(CPT) Permit to operate high speed craft其它證書和證明文件 Other Certificates and DeclarationsIBC Code FORMCHECKBOX 國際散裝運(yùn)輸危險(xiǎn)化學(xué)品適裝證書(CIC)International certificate of Fitness for the carriage of dangerous chemicals in bulkIGC Code FORMCHECKBOX 國際散裝運(yùn)輸液化氣體適裝證書(CIG)

13、International certificate of Fitness for the carriage of liquefied gases in bulkIMSBC CodeIMDG Code FORMCHECKBOX 散裝固體貨物證書(CBC) FORMCHECKBOX Certificate of compliance for the carriage of solid bulk cargoes危險(xiǎn)品適裝證書(CFD)Certificate of the Carriage of Dangerous GoodsILO32/152 FORMCHECKBOX 起貨設(shè)備證書(CG)Certi

14、ficate for cargo gearILO92/133 FORMCHECKBOX 船員艙室設(shè)備檢驗(yàn)證書(CCA)MLC2006 FORMCHECKBOX FORMCHECKBOX Certificate of inspection of crew accommodation船員艙室設(shè)備檢驗(yàn)符合聲明CCA(CHN)（適用于中國旗船舶）DOC of inspection of crew accommodation equipment （Apply for China Flag）起居艙室和娛樂設(shè)施檢驗(yàn)證書（CCA-MLC2006）Certificate of inspection of acc

15、ommodation and recreation facilities Anti-Fouling FORMCHECKBOX 防污底系統(tǒng)符合證明 (SAF)Statement of Compliance under the on International Convention on the control of Harmful Anti-fouling Systems on Ship FORMCHECKBOX 防污底系統(tǒng)符合證書 (CAF)Certificate of the International Convention on the control of Harmful Anti-fo

16、uling Systems on ShipNon-Convention Ships FORMCHECKBOX 船舶航行安全證書(CNS)Ship safety navigation certificate FORMCHECKBOX 國際防止油污證書(CMP)(非公約船舶)Oil Pollution prevention certificate (non-convention ship)SPS Code FORMCHECKBOX 特種用途船安全證書(CSP) Ballast Water FORMCHECKBOX 2004 FORMCHECKBOX H.K Internatinal FORMCHE

17、CKBOX Convention FORMCHECKBOX INF CODE FORMCHECKBOX Special purpose ship safety certificate國際壓載水管理證書（CBWM）Certificate of international ballast water managemen國際壓載水管理符合證明（SBWM）DOC of international ballast water managemen國際有害物質(zhì)清單證書(CIHM)International certificate on inventory of hazardous meterials有害物質(zhì)

18、清單符合證明(SIHM)Statement of compliance on inventory of hazardous meterials國際裝運(yùn)INF貨物適裝證書(CFR)Fitness certicate of ships carrying INF goodsOthers FORMCHECKBOX 散裝谷物批準(zhǔn)書(CCG)Approved Stability Declaration of the Safe Carriage of Grain in Bulk FORMCHECKBOX 近海供應(yīng)船符合證書（COS）DOC of offshore supply vessel FORMCHEC

19、KBOX 近海供應(yīng)船散裝運(yùn)輸有限數(shù)量有毒有害液體物質(zhì)適裝證書(CON)Fitness certificate of transporting of limited amounts of hazardous and noxious liquid substances in bulk on offshore Supply Vessels FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 地效翼船安全證書(CWS) Wing in Ground Craft Safety Certificate地效翼船操作許可證書(CPW

20、)Permit to Operate Wing in Ground Craft浮船塢安全證書(CSD)Floating Dock Safety Certificate歐盟有害物質(zhì)清單證書（CIHM(EU)）（適用于歐盟旗船舶）certificate on inventory of hazardous meterials(For EU Flag)歐盟有害物質(zhì)清單符合證明（SIHM(EU)）Statement of compliance on inventory of hazardous meterials FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCH

21、ECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 石油行業(yè)組織對液貨船結(jié)構(gòu)和設(shè)備要求的符合聲明 SOC（OIO）Statement of compliance with the guidelines of oil organizations for structure and equipment of tanker直升機(jī)降落區(qū)域強(qiáng)度證明文件 SOC(SHLS)DOC of strength for helicopter landing areas滿足US 33 CFR 要求的證明文件 SOC（US-3

22、3CFR）DOC to comply with the US 33 CFR美國環(huán)保署VGP要求的塢檢聲明 SOC(US-VGP)Docing inspection statement of EPA VGP蒸汽控制系統(tǒng)符合US 46CFR規(guī)定的證明文件SOC（US-VCS）DOC of Vapor control system complying with the US 46 CFR加拿大北極防污染符合證明 SOC(CAN-APP)Canadas statement of ompliance of Arctic Pollution Prevention 偶爾裝載散貨聲明（MSC.277(85)）

23、Statement for ship occasionally carrying dry cargos in bulk其它聲明文件(如適用）Other Statements（If applicable）Part B：下列證書適用于中國國內(nèi)航行的船舶。The following certificates are applied to the domestic voyage ships in China. 船舶類型 海船 河船 江海聯(lián)運(yùn) FORMCHECKBOX 船舶檢驗(yàn)證書簿 FORMCHECKBOX 防止散裝運(yùn)輸有毒液體物質(zhì)污染證書 FORMCHECKBOX 貨船適航證書/內(nèi)河船舶適航證書*

24、FORMCHECKBOX 散裝運(yùn)輸危險(xiǎn)化學(xué)品適裝證書 FORMCHECKBOX 客船適航證書 FORMCHECKBOX 散裝運(yùn)輸液化氣體適裝證書 FORMCHECKBOX 噸位證書 FORMCHECKBOX 危險(xiǎn)品適裝證書/內(nèi)河船舶裝運(yùn)危險(xiǎn)貨物適裝/推或拖證書* FORMCHECKBOX 載重線證書 FORMCHECKBOX 起重設(shè)備證書 FORMCHECKBOX 乘客定額證書 FORMCHECKBOX 高速船安全證書 FORMCHECKBOX 防止油污證書 FORMCHECKBOX 京杭運(yùn)河型船舶航行證書 FORMCHECKBOX 防止生活污水污染證書 FORMCHECKBOX 川江及三峽庫

25、區(qū)船舶航行證書 FORMCHECKBOX 防止垃圾污染證書 FORMCHECKBOX 游艇適航證書 FORMCHECKBOX 防止空氣污染證書 FORMCHECKBOX 游艇型式檢驗(yàn)證書 FORMCHECKBOX 沿海小船檢驗(yàn)證書 FORMCHECKBOX 內(nèi)河小船檢驗(yàn)證書 FORMCHECKBOX 地效翼船安全證書 FORMCHECKBOX 內(nèi)河氣墊船儲(chǔ)備浮力證書 FORMCHECKBOX 船舶免除證書 FORMCHECKBOX 浮船塢安全證書 FORMCHECKBOX 船員艙室設(shè)備證書 FORMCHECKBOX 海上特種用途船安全證書 FORMCHECKBOX 防污底系統(tǒng)證書 FORMCH

26、ECKBOX FORMCHECKBOX 國內(nèi)航行船舶入級(jí)證書（擬申請 CSAD 船級(jí)符號(hào)的船舶） FORMCHECKBOX FORMCHECKBOX 入級(jí)證書（擬申請 CSA 船級(jí)符號(hào)的船舶） FORMCHECKBOX 完整穩(wěn)性資料 FORMCHECKBOX 破艙穩(wěn)性資料 FORMCHECKBOX 裝載手冊 FORMCHECKBOX 貨物系固手冊 FORMCHECKBOX 干舷計(jì)算書 FORMCHECKBOX 防火控制圖 FORMCHECKBOX FORMCHECKBOX 注：適用者請?jiān)诜娇蛑屑印啊?，?biāo)識(shí)“*”不適用者劃去。需要說明的問題Remarks: (如部分圖紙由供方提供時(shí)，請說明內(nèi)容及

27、聯(lián)系辦法)下面簽名者（申請方）確認(rèn)知悉了本申請書中的重要提示和CCS最新頒布的入級(jí)規(guī)范、入級(jí)規(guī)則中有關(guān)條款，包括但不限于，總則部分的所有條款的內(nèi)容，并同意接受這些條款的約束。The undersigned party (the Applicant) acknowledge all the articles in the Important Notice contained herein and the relevant terms in the latest edition of Rules and Regulations of CCS, including, but not limited

28、to, the General Part of above mentioned rules and regulations have been reviewed, and agree to be governed by those articles and terms. 申請方保證按規(guī)定支付入級(jí)檢驗(yàn)費(fèi)：包括審圖費(fèi)、檢驗(yàn)費(fèi)和驗(yàn)船師為執(zhí)行檢驗(yàn)工作所必需的差旅費(fèi)和其它開支。即使此項(xiàng)審圖、檢驗(yàn)未能由船級(jí)社完成，我們也同意根據(jù)已進(jìn)行的工作按比例向中國船級(jí)社支付相應(yīng)的費(fèi)用。The applicant agree to pay the fee for the specified service and, i

29、n addition, any traveling and other expenses incurred by the surveyor related to the services. In the event of this project not being completed under the Societys services, we also agree to pay on a proportion rata basis for the services provided.申請方承諾為執(zhí)行檢驗(yàn)的驗(yàn)船師提供符合國家和/或檢驗(yàn)現(xiàn)場所在地主管當(dāng)局規(guī)定的安全技術(shù)要求或等效技術(shù)標(biāo)準(zhǔn) 的安

30、全檢驗(yàn)條件，包括永久或臨時(shí)的檢驗(yàn)通道和設(shè)施、艙室環(huán)境、安全防護(hù)。The applicant promise to provide appropriate safety survey conditions for attending surveyors in accordance with the specified safety requirements by the authorities of the country in which the survey was conducted, including permanent or temporary survey access and f

31、acility、environment、safety protection. 申請方Applicant代表簽字Representatives Signature職務(wù) Title電話Tel(申請單位蓋章)Stamp of Applicant傳真Fax郵箱地址E-mail文件寄送地址Full address to post郵政編碼Post code日期date:重要提示：申請方在申請中國船級(jí)社（CCS）進(jìn)行重大改裝船舶審圖和檢驗(yàn)時(shí)，接受該船舶所適用的本社入級(jí)規(guī)范以及其他有關(guān)規(guī)范或規(guī)則中的全部條款約束。When applying to China Classification Society (CC

32、S) for major convention ships plan approval and survey, the applicant accepts to be bound by all the provisions as specified in the classification rules or other relevant rules or regulations of CCS applicable to the ship.在本社與申請人之間沒有其他合同時(shí)，本申請書即為本社與申請方之間的合同。在本社與申請方就被申請船舶的檢驗(yàn)（包括審圖）簽有其他合同的，本申請書各項(xiàng)內(nèi)容是CCS與

33、申請方簽訂的有關(guān)合同的組成部分。本申請書內(nèi)容與有關(guān)合同以及適用的入級(jí)規(guī)范、其他有關(guān)規(guī)范或規(guī)則有不一致的，在本申請書的申請事項(xiàng)范圍內(nèi)，以本申請書內(nèi)容為準(zhǔn)。Where no any other contract is signed between CCS and the applicant, the application constitutes the contract between CCS and the applicant. Where CCS has signed any other contract with the applicant in respect of the survey

34、 of the ship (including plan approval), the contents of the application form an integral part of the relevant contract signed between CCS and the applicant. In the event of any conflict or inconsistency between the contents of the application and the relevant contract, applicable classification rule

35、s, or other relevant rules and regulations, the contents of the application shall prevail, so far as the items specified in the application are concerned.申請方應(yīng)按照本社的要求提供審圖及檢驗(yàn)所需的圖紙、報(bào)告、文件、資料以及其他信息，并對所提供圖紙、報(bào)告、文件、資料以及其他信息的真實(shí)性、及時(shí)性和完整性負(fù)責(zé)。The applicant shall submit to CCS plans, reports, documents, data and

36、other information necessary for plan approval and survey in accordance with the requirements of CCS and shall be responsible for the truthfulness, timeliness and completeness of such plans, reports, documents, data and other information.如申請檢驗(yàn)的船舶是轉(zhuǎn)級(jí)船舶，本社有權(quán)從原船級(jí)社獲得所有有關(guān)的資料文件。If the class of the ship to

37、be surveyed is transferred from another Classification Society, this Society is entitled to gain all relevant documents of this ship from the previous Class Society.申請方應(yīng)根據(jù)上述信息參數(shù)所適用的本社規(guī)范及船旗國政府的要求（公約、法規(guī)等）進(jìn)行設(shè)計(jì)及必要的計(jì)算，并提交審圖。承諾建立適當(dāng)?shù)馁|(zhì)保體系，以保證船舶和產(chǎn)品的設(shè)計(jì)質(zhì)量。The applicant shall carry out design and necessary calc

38、ulations, in accordance with CCS rules and the requirements of the government of the flag State (conventions and regulations etc.) applicable to the above information, and submit them for plan approval. The applicant undertakes to establish an appropriate quality assurance system for the design qual

39、ity of ships and associated marine products.本社入級(jí)規(guī)范、有關(guān)規(guī)范或規(guī)則對本社批準(zhǔn)圖紙有效性做出了規(guī)定，申請方在本申請表中填寫的相關(guān)信息的變更可能導(dǎo)致CCS審批圖紙的失效。The validity of approved plans is stipulated in classification rules of CCS, relevant rules or regulations. The approved plans may be invalidated due to any change of relevant information given by the applicant in the application.本社按照合同提供服務(wù)，在任何情況下本社均不對與本社無直接合同關(guān)系方的任何損失承擔(dān)責(zé)任。This Society provides service(s) based on the contract, in no