Republic of the Philippines

PROFESSIONAL REGULATION COMMISION

Manila
BOARD OF MARINE DECK OFFICERS
CERTIFICATE OF SEA SERVICE

(All statements herein are subject to verification)

TO THE BOARD OF MARINE DECK OFFICERS:

THIS CERTIFIES that

RANDOLF GELARIO LENCIOCO

__________________________________________________________________________________________________________________________

actually served under our supervision onboard

M/T

______________________________________________________________________________________________________

Motor

of

(Steam or Motor)

of

7603

741489

(Name of Vessel)

George Town Cayman, Islands

__________________________________________________________________________
__________________________________________________________________________________________

with Registry No.:

vessel

STOLT QUETZAL

(Name of Vessel)

Foreign

__________________________________________________

____________________________________________________________________________

gross tons for a period of

00

(Coastwise/Foreign)
08

10

____________________
________________________________________________________________________________________________________

from

23 June 2009

(No. of years)
01 March 2010

to

_________________________________________________
__________________________________________________

(Months)
as

(Days)
Third Officer

_________________________________________________

(Date of Embarkation)

(Date of Discharge)

(Position

Held)
This certifies further that the above-stated data are all true and that any false statements made
there in shall be a ground for criminal prosecution.
Issued at

Houston

this

________________________________________________

2nd

day of

___________

March

, 20

__________________________________________

10
______

SEAL OF VESSEL

SEAL OF COMPANY

CAPT. RAYMUNDO OCSO SILOT

________________________________________________________________________

MASTER: SIGNITURE ABOVE PRINTED NAME

NATIONALITY:

FILIPINO

KIND OF LICENSE:

MASTER/PHILIPPINES

REGISTRATION NO.

D-1 0004458

DATE OF REGISTRATION:

12/09/1995

EXPIRY DATE:

01/23/2012

MR. HERMINIO F. VILLANUEVA

_________________________________________________________________________________________________

NAME AND SIGNITURE OF PORT CAPTAIN/PERSONEL MANAGER

STOLT NIELSEN TRANSPORTATION GROUP, INC

_________________________________________________________________________________________________

NAME OF LOCAL SHIPOWNER OR MANNING AGENT

ADDRESS:

2ND FLR. DON CHUA LAMKO BLDG.

CORNER DE LA COSTA & ALFARO STREETS

SALCEDO VILLAGE, MAKATI CITY
TEL NO.:

63 2 8159821 TO 24

NOTE: THIS FORM IS GOOD ONLY FOR ONE VESSEL. THIS FORM CAN BE REPRODUCED. ALL ENTRIES MUST BE TYPE WRITTEN.
ANY ERASURE/OBLITERATIONS MAY BE GROUND FOR DENIAL.