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At port: __________
3.
5.
Port of Loading:
6. Port of Discharge:
7.
Shipper:
8. Consignee:
9.
Stowage:
10.
Kind of Damage:
11.
Exception at Loading:
12.
Exception at Discharging:
13.
14.
15.
16.
17.
Extent of Damage:
18.
Cause of Damage:
19.
Disposition of Damage:
20.
Note
1.
2.
3.
4.
This Report is requested to send us when Cargo was damaged in the following cases:
a. Damage to Valuable cargo
b. Damage to Refrigerated cargo
c. Pilferage of cargo
d. Damage caused by improper stowage
e. Damage caused while cargo working
f. Large amount of shortland
g. Other important damage to cargo
For items 17, 18, 19, 20:
Please report details of damage using free form paper with Explanation drawing if needed.
Exception means Remarks on Mates Receipt or Bill of Lading
Send one Original and one copy to our cargo superintending team as soon as possible.
DATE:
_________________
PORT: _________________
VOY.NO.: _________________
We certify that the following damage(s) has / have been done to the vessel during
loading / discharging by the stevedores:
DATE: _________________
TIME: _________________
diameter, and extended length of damage is about 2.40 meters including Pilot
Access Door.
_______________
MASTER
________________
STEVEDORES
_____________________
CHARTERERS AGENT /
REPRESENTATIVE
: 15 October 2001
(2). Place
(3). Description
(4). Investigation
(5). Treatment
______________
Master of MV..