- To:Canadian Vickers Limited,
- Notre Dame Street East, 19
- Montreal, Quebec.
- The Undersigned hereby
- (a)applies for the vessel hereinafter described to be placed in the Dock for the purpose and time stated, on day of 19;
- (b)declares that he is authorized to enter into an agreement binding the owner of the vessel and has read and understood the Canadian Vickers Dry Dock Regulations and particularly, but without restricting the generality of the foregoing, the provisions of section 9 in connection with liability for damage to the said vessel; and
- (c)binds the owner of the vessel to conform to those Regulations and to accept any liability imposed on the owner of the vessel by those Regulations.
Name of Vessel
Length between perpendiculars
Type of vessel (screw or paddle, etc)
Bar keel or flat keel (if bar state depth)
Rise of floor amidships
Probable time Dock required
Purpose Dock required
Special features of vessel as regards length of “cut up” forward or aft; camber of keel, if any, and underwater form etc., etc.
(Please state “usual” or if unusual give particulars.)
- Date modified: