Attachment_A_-Vessel_template.doc

Vessel Contractor Information Template - Attachment A

VESSEL DETAILS

Vessel Name:

Home Port/State:

Vessel:

Permit #:

Hull ID:

USCG Insp. Sticker:

Mo:

Life raft

Yr:

capacity:

EPIRB:

Y N Location:

Construction:

Year:

Shipyard:

Measurements:

Length:

Beam:

Draft:

Tonnage:

Gross:

Net:

Engine:

Make/Model:

Year:

HP:

Owner/Company:

Company Contact:

email:

Address:

Office Phone:

Cell Phone:

Fax Number:

Company Duns No.

CAPTAIN DETAILS

Primary Captain:

Operator #:

Years as Captain

Experience with a comparable sized vessel in estuarine and bay waters:

Secondary Captain

(if applicable)

Operator #:

Yrs. as Captain:

Experience with a comparable sized vessel in estuarine and bay waters: