Bill C-7
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ANNEX
CERTIFICATE OF INSURANCE OR OTHER FINANCIAL SECURITY IN RESPECT OF CIVIL LIABILITY FOR BUNKER OIL POLLUTION DAMAGE
Issued in accordance with the provisions of article 7 of the International Convention on Civil Liability for Bunker Oil Pollution Damage, 2001
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 7 of the International Convention on Civil Liability for Bunker Oil Pollution Damage, 2001.
Type of Security
Duration of Security
Name and address of the insurer(s) and/or guarantor(s)
Name
Address
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This certificate is valid until
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Issued or certified by the Government of
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(Full designation of the State)
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OR
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The following text should be used when a State Party avails itself of article 7(3)
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The present certificate is issued under the authority of the Government of ........ (full designation of the State) by ........ (name of institution or organization)
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At
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On
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(Place)
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(Date)
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......................................
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(Signature and Title of issuing or certifying official)
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Explanatory Notes:
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1. If desired, the designation of the State may include a reference to the competent public authority of the country where the Certificate is issued.
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2. If the total amount of security has been furnished by more than one source, the amount of each of them should be indicated.
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3. If security is furnished in several forms, these should be enumerated.
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4. The entry “Duration of Security” must stipulate the date on which such security takes effect.
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5. The entry “Address” of the insurer(s) and/or guarantor(s) must indicate the principal place of business of the insurer(s) and/or guarantor(s). If appropriate, the place of business where the insurance or other security is established shall be indicated.
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Published under authority of the Speaker of the House of Commons