Document ID: chunk:federal_register_of_legislation:C2024C00459:schedule:1:p10
Version: federal_register_of_legislation:C2024C00459
Segment Type: schedule
Provision Reference: sch 1 (pt 10/10)
Character Range: 63827–65876

force, the text shall be transmitted by the Secretary‑General of the Organization to the Secretariat of the United Nations for registration and publication in accordance with Article 102 of the Charter of the United Nations.

ARTICLE XXI
The present Convention is established in a single copy in the English and French languages, both texts being equally authentic. Official translations in the Russian and Spanish languages shall be prepared and deposited with the signed original.

IN WITNESS WHEREOF the undersigned being duly authorized by their respective Governments for that purpose have signed the present Convention.

DONE at Brussels this twenty‑ninth day of November 1969.
ANNEX
CERTIFICATE OF INSURANCE OR OTHER FINANCIAL SECURITY IN RESPECT OF CIVIL LIABILITY FOR OIL POLLUTION DAMAGE

Issued in accordance with the provisions of Article VII of the International Convention on Civil Liability for Oil Pollution Damage, 1969.

NAME OF SHIP  DISTINCTIVE NUMBER OR LETTERS  PORT OF REGISTRY   NAME AND ADDRESS OF OWNER

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 VII of the International Convention on Civil Liability for Oil Pollution Damage, 1969.

Type of Security

Duration of Security

Name and Address of the Insurer(s) and/or Guarantor(s)
Name
Address

This certificate is valid until
Issued or certified by the Government of

(Full designation of the State)
At On
(Place)(Date)

Signature and Title of issuing or
certifying official.

Explanatory Notes:
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.
2. If the total amount of security has been furnished by more than one source, the amount of each of them should be indicated.
3. If security is furnished in several forms, these should be enumerated.
4. The entry "Duration of the Security" must stipulate the date on which such security takes effect.