제18425호                                                               관                         보                                  2015. 1. 8.(목요일)
11. Health and safety and accident prevention (Regulation 4.3)                                                                                                                     ❑.
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12. On-board medical care (Regulation 4.1)                                                                                                                                         ❑.
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13. On-board complaint procedures (Regulation 5.1.5)                                                                                                                               ❑.
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14. Payment of wages (Regulation 2.2)                                                                                                                                              ❑.
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I hereby certify that the above measures have been drawn up to ensure ongoing compliance,
between inspections, with the requirements listed in Part I.
                                                                                                        Name of shipowner:1 ..................................
                                                                                                        .............................................................................
                                                                                                        Company address: .........................................
                                                                                                        .............................................................................
                                                                                                        Name of the authorized signatory: ........
                                                                                                        .............................................................................
                                                                                                        Title: ...................................................................
                                                                                                        Signature of the authorized signatory:
                                                                                                        .............................................................................
                                                                                                        Date: ...................................................................
                                                                                                        (Stamp or seal of the shipowner1)
The above measures have been reviewed by (insert name of competent authority or duly
recognized organization) and, following inspection of the ship, have been determined as meeting
the purposes set out under Standard A5.1.3, paragraph 10나, regarding measures to ensure initial
and ongoing compliance with the requirements set out in Part I of this Declaration.
                                                                                                        Name: .................................................................
                                                                                                        Title: ...................................................................
                                                                                                        Address: .............................................................
                                                                                                        .............................................................................
                                                                                                        .............................................................................
                                                                                                        Signature: ..........................................................
                                                                                                        Place: ..................................................................
                                                                                                        Date: ...................................................................
                                                                                                        (Seal or stamp of the authority,
                                                                                                        as appropriate)
1 Shipowner means the owner of the ship or another organization or person, such as the
manager, agent or bareboat charterer, who has assumed the responsibility for the operation of the
ship from the owner and who, on assuming such responsibility, has agreed to take over the
duties and responsibilities imposed on shipowners in accordance with this Convention, regardless
of whether any other organizations or persons fulfil certain of the duties or responsibilities on
behalf of the shipowner. See Article II(1)(j) of the Convention.
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