BASTILA SHIP MANAGEMENT PRIVATE LIMITED

ISSUE 0 REV 3 PAGE 1/1

SHIPS FILE M30;C23 OFFICE FILE 153.1; 153.2 FORM NO: 3.10 DATE 05.12.2018
STORES REQUISITION FORM APPLICABLE FOM SECTIONS:4.6, 10.11

Vessel’s Name: Requisition No:

LSA Date:
S. Store Requisitioned IMPA ROB Quantity Purpose Sanction Price Cost
No. Code Required
1 Lifejacket C/W Cert 20
2 Liferaft 10 persons 2
3 Fire fighting radio 4

Please specify, if stores requisitioned are urgent or routine in the purpose column
Grayed columns to be filled by office.
Remarks:

Chief Engineer Master Superintendent Technical Accounts

manager

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