Statement no: ROT 1611583

Page 1 of 1

Statement
Project: Astilleros Balenciaga SA
YN 407

Client: Heatmaster B.V. Office: Rotterdam

Hendrik ido Ambacht
Netherlands

Client’s Order Number: 15.1725 Date: 28 January 2016

Order Status: Complete

Inspection Dates
First: 19 January 2016 Final: 19 January 2016

This statement is issued to the above Client in order to specify that the undersigned Surveyor to this Society did at their request attend
the Workshop of Heatmaster B.V. in Hendrik Ido Ambacht on the above date in order to examine the under-noted component:

ONE (1) NEW HOT WATER BOILER

Type : Vitoplex 100PV1

Serial no. : 7571152
Capacity : 310 kW

Scope of inspection:

- Visual external examination of boiler,no defects noted.

- Boiler has been sublected to a hydraulic pressure of 7.5 bar,found sound and tight.

Inspection strictly confined to the above.

For identification boiler marked:
ROT 1611583
01 RV 16

R. van de Velde
Rotterdam Office

R. van de Velde
Lloyd's Register EMEA
Surveyor to Lloyd's Register EMEA
LR031.1.2013.12

a member of the Lloyd's Register group.

Lloyd's Register Group Limited, its affiliates and subsidiaries and their respective officers, employees or agents are, individually and collectively, referred to in this clause as
'Lloyd's Register'. Lloyd's Register assumes no responsibility and shall not be liable to any person for any loss, damage or expense caused by reliance on the information or
advice in this document or howsoever provided, unless that person has signed a contract with the relevant Lloyd's Register entity for the provision of this information or
advice and in that case any responsibility or liability is exclusively on the terms and conditions set out in that contract.

Form 1123 (2015.08)