STATKU TOWAROWEGO CARGO SHIP SAFETY RADIO CERTIFICATE

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1 Dziennik Ustaw Nr Poz. 688 WZÓR Załącznik nr 7 RZECZPOSPOLITA POLSKA REPUBLIC OF POLAND STATKU TOWAROWEGO CARGO SHIP SAFETY RADIO CERTIFICATE This Certificate shall be supplemented by a Record of Equipment of Radio Facilities (Form R) Nr / No.: Issued under the provisions of name of the relevant measure introduced by the Flag State) oraz zgodnie z postanowieniami and under the provisions of THE INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1988 relating thereto RZECZYPOSPOLITEJ POLSKIEJ UNDER THE AUTHORITY OF THE GOVERNMENT OF THE REPUBLIC OF POLAND przez by -. ej instytucji / full official designation of the authorized organisation) DANE STATKU: PARTICULARS OF SHIP: Nazwa statku: Name of ship: Distinctive number or letters: Port macierzysty: Port of registry: Gross tonnage: encji): Sea areas in which ship is certified to operate (regulation IV/2 of the Convention): Numer IMO: 1 IMO Number: 1 Date on which keel was laid or ship was at a similar stage of construction or, where aplicable, date on which work for a conversion or an alteration or modification of a major character was commenced: 1 In accordance with the IMO Ship Identification Number Scheme, adopted by the Organization by Resolution A.600(15) 1/5

2 Dziennik Ustaw Nr Poz. 688 THIS IS TO CERTIFY THAT: the ship has been surveyed in accordance with the requirements of regulation I/9 of the Convention; the survey showed that: the ship complied with the requirements of the Convention as regards radio installations; the functioning of the radio installation used in life-saving appliances complied with the requirements of the Convention; 3. wydany Certyfikat zwolnienia. the Exemption Certificate has / has not * been issued. This Certificate is valid until: 2 pod warunkiem przeprowad subject to the periodical surveys In accordance with regulation I/9 of the Convention Completion date of the survey on which this certificate is based : Issued at: Wydano w: Wpisa Insert the date of expiry specified in accordance with regulation I/14(a) of the Convention. The day and the month of this correspond to the anniversary date as defined in regulation I/2(n) of the Convention, unless amended in accordance with regulation I/14(h). 2/5

Convention as regards radio installations; the functioning of the radio installation used in life-saving appliances complied with the requirements of the Convention; 3. wydany Certyfikat zwolnienia.

3 Dziennik Ustaw Nr Poz. 688 ENDORSEMENT FOR PERIODICAL SURVEYS Konwen THIS IS TO CERTIFY THAT, at a survey required by regulation I/9 of the Convention, the ship was found to comply with the relevant requirements of the Convention. 1 st periodical survey 2 nd periodical survey 3 rd periodical survey 4 th periodical survey 3/5

required by regulation I/9 of the Convention, the ship was found to comply with the

4 Dziennik Ustaw Nr Poz. 688 ) PERIODICAL SURVEY IN ACCORDANCE WITH REGULATION I/14(h)(iii) This is to certify that, at a periodical survey in accordance with regulation I/14 (h) (iii) of the Convention, the ship was found to comply with the relevant requirements of the Convention. ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN 5 YEARS WHERE REGULATION I/14 (c) APPLIES The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14 (c) of the Convention, be accepted as valid until:. PO ENDORSEMENT WHERE THE RENEWAL SURVEY HAS BEEN COMPLETED AND REGULATION I/14 (d) APPLIES niniejszy certyfikat, The ship complies with the relevant requirements of the Convention, and this certificate shall, in accordance with regulation I/14 (d) of the Convention, be accepted as valid until: 4/5

to comply with the relevant requirements of the Convention.

5 Dziennik Ustaw Nr Poz. 688, ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE PORT OF SURVEY OR FOR A PERIOD OF GRACE WHERE REGULATION I/14 (e) OR I/14 (f) APPLIES * Konwencji, y do: This certificate shall in accordance with regulation I/14 (e), I/14(f) * of the Convention, be accepted as valid until: ENDORSEMENT FOR ADVANCEMENT OF ANNIVERSARY DATE WHERE REGULATION I/14 (h) APPLIES In accordance with regulation I/14 (h) of the Convention, the new anniversary date is: In accordance with regulation I/14 (h) of the Convention, the new anniversary date is: * Niepotrzebne skre Delete as appropriate 5/5

APPLIES * Konwencji, y do: This certificate shall in accordance with regulation I/14 (e), I/14(f) * of the Convention, be accepted as valid until: ENDORSEMENT

6 Dziennik Ustaw Nr Poz. 688 WZÓR RZECZPOSPOLITA POLSKA REPUBLIC OF POLAND FORMULARZ R) RECORD OF EQUIPMENT OF RADIO FACILITIES (FORM R), zmodyfikow For compliance with THE INTERNATIONAL CONVENTION FOR THE SAFETY OF LIFE AT SEA, 1974, as modified by the Protocol of 1988 relating thereto owego Statku Towarowego Nr: This Record shall be permanently attached to the Cargo Ship Safety Radio Certificate No.: Nazwa statku: Name of ship: wczy: Distinctive No. or letters: Nr IMO: IMO No.: i Minimum number of persons with required qualifications to operate the radio installations: 1 Dane o ur Details of radio facilites Item Stan faktyczny Actual provision 1 System podstawowy Primary systems 1.1 VHF VHF radio installation Koder DSC DSC encoder DSC watch receiver Radiotelefonia Radiotelephony 1.2 we MF MF radio installation Koder DSC DSC encoder DSC watch receiver Radiotelefonia Radiotelephony 1.3 MF/HF radio installation Koder DSC DSC encoder DSC watch receiver Radiotelefonia Radiotelephony Telegrafia dalekopisowa Direct-printing telegraphy 1/2

SEA, 1974, as modified by the Protocol of 1988 relating thereto owego Statku Towarowego Nr: This Record shall be permanently attached to the Cargo Ship Safety Radio Certificate No.

7 Dziennik Ustaw Nr Poz INMARSATshipearthstation 2 Dodatkowe Secondarymeansofalerting 3 stwa Facilitiesforreceptionofmaritimesafetyinformation 3.1 OdbiornikNAVTEX NAVTEXreceiver 3.2 EGCreceiver 3.3 OdbiornikHFradiotelegrafiidalekopisowej HFdirect-printingradiotelegraphreceiver 4 Satelitarnar awaryjnacospas-sarsat SatelliteEPIRBCOSPAS-SARSAT 5 VHFEPIRB 6 Statkowe niadolokalizacjiwposzukiwaniuiratowaniu 6.1 Transponderradarowy(SART) Radarsearchandrescuetransponders(SART) 6.2 Nadajnikiwposzukiwaniuiratowaniu(AIS-SART) AISsearchandrescuetransmitters(AIS-SART) 2 radiowych nwencji) Methodsusedtoensureavailabilityofradiofacilities(regulationsIV/15.6and15.7oftheConvention) 1 Duplicationofequipment 2 Shore-basedmaintenance 3 ywanianaprawnastatku At-seamaintenancecapability THISISTOCERTIFYthatthisRecordiscorrectinallrespects. Wydanyw: Issuedat: /Place,date /Seal Podpis/Signature 2/2

3 OdbiornikHFradiotelegrafiidalekopisowej HFdirect-printingradiotelegraphreceiver 4 Satelitarnar awaryjnacospas-sarsat SatelliteEPIRBCOSPAS-SARSAT 5 VHFEPIRB 6 Statkowe

ST. VINCENT AND THE GRENADINES

ST. VINCENT AND THE GRENADINES MARITIME ADMINISTRATION CIRCULAR N GEN 015 THE USE OF NATIONAL TONNAGE IN APPLYING INTERNATIONAL CONVENTIONS IMO Resolution A.1073 (28) TO: APPLICABLE TO: EFFECTIVE AS FROM: