中 国 船 东 互 保 协 会
入 会 申 请 书 A――― 公 司 情 况
APPLICATION FORM A――― DETAILS OF
MEMBER
我公司根据贵会条款、章程，愿将以下船舶加入贵会，申请成为会员。
We hereby apply to enter the ship specified below in the protection & Indemnity class of the Association in accordance with the Rules and the Bye-Law of the Association with which we agree to confirm and we further apply to become a member of the Association and authorise you to enter our name(s) in the register of members of the Association.
|
申请人名址 Name
and address of Member
for registration |
|||
|
邮政编码 Post code |
联系部门及联系人 Attendant
|
电话Telephone |
|
|
传真 Facsimile |
|||
|
公司建立年 Year of foundation |
注册资本 Registered capital |
上级主管部门及公司 Higher responsible authorities |
|
|
公司所有船舶数 Number of vessel |
共计总吨 Total tonnage |
加入CPI总吨 Entered tonnage |
|
|
经营航线 Trading line |
|||
|
经营范围 Scope of business |
|||
|
美元开户行 Bank(USD) |
帐号 Account No. |
||
|
人民币开户行 Bank (RMB) |
帐号 Account No. |
||
―― continued
overleaf ――
中 国 船 东 互 保 协 会
入 会 申 请 书 A――― 公 司 情 况
APPLICATION FORM A――― DETAILS OF MEMBER
(Continued)
|
公司法人代表简历 resume of the legal peram |
||
|
航运经理 Shipping managers |
安技经理 technical manager |
人事经理 personal manager |
|
公司员工情况（人数、学历及等） number, qualification etc.
Of the staff |
||
|
公司经营规模 scale of operating |
||
备注：（Remarks）
1.
请提供公司简介及<<营业执照>>
Please
provide the introduction of the Member and the Business License;
2.
国内会员请将中英文填写清楚。
Please
write both in Chinese and English.
(Only
for Member of China)
公司签字 盖章
中 国 船 东 互 保 协 会
入 会 申 请 书 B
APPLICATION FORM B
我公司根据贵会条款、章程，愿将以下船舶加入贵会，申请成为会员。
We hereby apply to enter the ship specified below in the Protection & Indemnity class of the Association in accordance with the Rules and the Bye-Law of the Association with which we agree to confirm and we further apply to become a member of the Association and authorise you to enter our name(s) in the register of members of the Association.
|
船舶名称 name of ship |
总吨 gross tonnage |
入会吨位entered tonnage |
||
|
船型 type of ship |
建造年 year built |
|||
|
船旗国 flag |
注册港 port of registry |
|||
|
船级社 classification society |
船舶登记号 Lloyd’s/CCS registration No. |
|||
|
申请入会日期 entry to commence from |
航行区域 trading area |
|||
|
船长国籍 nationality of master |
高级船员国籍 nationality of officers |
一般船员国籍 nationality of seamen |
||
|
船壳险保险人 insurer of the hull insurance |
保险条件 insurance conditions |
|||
|
船舶抵押贷款情况 details of mortgage |
||||
|
受抵押人名址 name and address of mortgagee |
||||
中 国 船 东 互 保 协 会
入 会 申 请 书 B
APPLICATION FORM B
（Continued）
|
申请人名址 Name and address of Member for registration |
||
|
邮政编码 Post code |
联系部门及联系人 Attendant |
电话 telephone |
|
传真 facsimile |
||
|
申请人名址（注册船东、所有人、经营人） Interent of member (e.g. owner, operator etc.) |
||
|
注册船东名址 name(s) and address(es) of registered owners |
||
|
合伙人名址 name(s) and address(es) of co-assured members |
||
|
合伙投保人类型（船舶所有人/管理人等） interest of co-assured members (e.g. owners/managers etc.) |
||
备注：
1、请提供船舶各项入级证书、法定证书、年度检验报告及特检报告；
Class certificates are required;
2、请提供船员雇佣合同/劳务合同；
Crew contracts are required;
3、请提供船舶险保险单；
Please provide the Hull Insurance Policy；
4、
请提供其它影响协会承保的资料；
Other documents which are material to the
insurance；
5、请提供ISM文件。
Please provide us with the DOC & SMC certificates。