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Declaration of Security for STS operations m/t Atlantic Grace

IMO number : 933 !"" #ort of re$istry: %on$ &on$


Name of other ship Port of Registry: IMO Number: This Declaration of Security is valid from bunkering operations Security level$s% for &'tlantic (race) Security level$s% for ! until completed " for the follo#ing activities !! $list the activities #ith relevant details% under the follo#ing security levels One One

The &'tlantic (race) and & ! !) agree to the follo#ing security measures and responsibilities to ensure compliance #ith the re*uirements of Part ' of the International +ode for the Security of Ships and of Port ,acilities! The affi-ing of the initials of the SSO or P,SO under these columns indicates that the activity #ill be done" in accordance #ith relevant approved plan" by Activity /nsuring the performance of all security duties Monitoring restricted areas to ensure that only authori0ed personnel have access +ontrolling access to the ship Monitoring of the other ship" including areas surrounding the ship 1andling of cargo $bun2er% Delivery of ship3s stores /nsuring that security communication is readily available bet#een the ship and port facility Atlantic Grace ' ' ' ' ' (/A ' $Other ship.s name%

The signatories to this agreement certify that security measures and arrangements for both &'tlantic (race) and & ) during the specified activities meet the provisions of chapter 4I56 and Part ' of +ode that #ill be implemented in accordance #ith the provisions already stipulated in their approved plan or the specific arrangements agreed to and set out in the attached anne-! Dated at Signed for and on behalf of The other ship: ! ! on the

&'tlantic (race7:

$Signature of Security Officer of the other ship% Name and title of person #ho signed Name: Title:

$Signature of Master or Ship Security Officer% Name: S S ISLAM Title: SSO

+ontact Details $to be completed as appropriate% $indicate the telephone numbers or the radio channels or fre*uencies to be used% ,or the other ship: ,or &'tlantic (race) Other ships name: Master: 89:;<<<<6=<< Other ships Security Officer Ship Security Officer: 89:;<<<<6=<< +ompany: 9> 966: <??@ +ompany Security Officer: 9> 966: <??@

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