Client Questionnaire- ISPS Code
(Information for Preparation of Estimate)
For a quick response, this questionnaire may be faxed or e-mailed directly to:
Fax: 1-281-877-6001
(Americas)
Email: msc-amer@eagle.org
Fax: 30-210-9403610
(Europe)
Email: msc-eur@eagle.org
Fax: 65-6275-0258
(Pacific)
Email: msc-pac@eagle.org
Fax: 86-21-6322-9649
(Greater China)
Email: msc-china@eagle.org
1. General Information
PHYSICAL ADDRESS
.
Company Name
Company IMO Number1
Address
City
State or Country
Contact Person
Title
Phone
Fax
Postal Code
Email
☐
BILLING/INVOICING ADDRESS
SAME AS PHYSICAL
Address
City
State or Country
Contact Person
Title
Phone
Fax
Postal Code
Email
☐
CORRESPONDENCE ADDRESS
SAME AS PHYSICAL
Address
1
City
State or Country
Contact Person
Title
Phone
Fax
Postal Code
Email
Lloyd’s Register Fairplay issues unique Company Identification Numbers. For more information on obtaining this identification number visit
http://imonumbers.lrfairplay.com
MSC Administration
SWZ-122-01-P01
Form B – Rev. 0
Page 1 of 4
Client Questionnaire- ISPS Code
(Information for Preparation of Estimate)
2. Fleet Breakdown by Vessel Type and “Sister Vessels”: Please indicate total number of vessels per vessel
type and the number of vessels that are similar in design. This information will assist ABS in estimating the duration
of plan reviews & assessments, preparing an accurate estimate and identifying any special requirements for your
company’s fleet. A fee reduction may be offered to the second and subsequent sister vessel of each vessel type.
Total
No.
Vessel Type
Type
1.
Type
2.
Sister Vessels (vessels similar in design)
Type Type Type Type Type Type
3.
4.
5.
6.
7.
8.
Type
9.
Type
10.
Passenger Vessels *
Cargo Vessels **
OSV’s / Towing Vessels
Mobile Offshore Drilling Units
*
**
Including Passenger High Speed Craft
Including Oil Tankers, Chemical Tankers, Gas Tankers, Bulk Carriers, Cargo High Speed Craft, Container, General & Other Cargo Vessels
3. Fleet Breakdown by Flag: (please indicate number of vessels by flag). This will assist ABS in preparing an
accurate estimate for your company’s fleet, based upon any additional flag requirements.
Flag of Registry
No. of vessels
4. Fleet Breakdown by Class Society:
Society
ABS
BV
CCS
DNV
GL
KR
LR
NK
RINA
RS
Others
No. of
vessels
5. Planning Information:
Projected Date:
Ship Security Plan Review:
Pre-assessment (optional):
Certification Assessment:
MSC Administration
SWZ-122-01-P01
Form B – Rev. 0
Page 2 of 4
Client Questionnaire- ISPS Code
(Information for Preparation of Estimate)
6. Fleet Vessel Information: The information provided will assist ABS in estimating the fees associated with SSP
reviews and shipboard verifications, as well as identifying any special requirements that may apply. Please
complete table below or attach separate sheet(s).
Vessel Name
MSC Administration
SWZ-122-01-P01
Vessel Type
Form B – Rev. 0
Vessel IMO No.
Class No.
Page 3 of 4
Client Questionnaire- ISPS Code
(Information for Preparation of Estimate)
7. CERTIFICATION TO ABS GUIDE FOR SHIP SECURITY
ABS also offers certification to the ABS Guide for Ship Security in conjunction with ISPS Code certification. The Ship
Security Guide is designed to meet or exceed the requirements of the ISPS Code (Parts A & B). Upon certification,
ABS issues SEC Notation to ABS classed vessel to indicate that the vessel complies with the requirements of Part A
& B, and the ABS Guide for Ship Security:
In addition to mandatory ISPS Code Certification (Part A & relevant sections
of Part B), does your Company want certification to the ABS Guide for Ship
Security?
Yes ☐
No ☐
8. Additional Information or comments (if any):
ABS Use Only
MSC Administration
SWZ-122-01-P01
Received By:
Reviewed By:
Form B – Rev. 0
Page 4 of 4