LETTER OF UNDERTAKING IN RESPECT OF THE ISSUANCE OF BLUE CARDS The London Steam-Ship Owners’ Mutual Insurance Association Limited 50 Leman Street London E1 8HQ United Kingdom Dear Sirs [Date] Vessel Name(s) Applicable Convention(s)* [insert Vessel name/IMO Number] [A] [B] [C] [insert Vessel name/IMO Number] [A] [B] [C] In consideration of the Association, upon our request and prior to entry in the Association of the above Vessel(s) being concluded, providing Blue Cards for the purposes of satisfying the certification requirements applicable to such Vessel(s) pursuant to any or all of the following Conventions: A B C Article 7 of the International Convention on Civil Liability for Bunker Oil Pollution Damage 2001; Article VII of the International Convention on Civil Liability for Oil Pollution Damage 1969; Article VII of the International Convention on Civil Liability for Oil Pollution Damage 1992; We, [insert name of party giving undertaking], hereby undertake that we will enter the above Vessel(s) in the Association for the Policy Year commencing from noon on 20 February 2012 [or insert another date if appropriate]. In the event that we do not enter the above Vessel(s), or one or more of the said Vessels, with the Association as aforesaid, we hereby undertake that we shall indemnify the Association and hold it harmless in respect of any and all liabilities, losses, damages, risks, costs or expenses whatsoever which it may suffer or incur howsoever and whether directly or indirectly in consequence of the Association issuing Blue Cards in respect of the Vessel(s) which are not so entered with the Association. This Letter of Undertaking shall be governed by and construed in accordance with English law and, without prejudice to the Association’s entitlement to commence proceedings in any other jurisdiction, we hereby submit to the jurisdiction of the High Court of Justice in London for the purposes of any proceedings for the enforcement hereof. We further agree that, when called upon to do so, we will instruct solicitors in London to accept service of proceedings issued on behalf of the Association in connection with this Letter of Undertaking. Yours faithfully (Authorised Signatory) [Please indicate which Blue Cards are needed by specifying A and/or B or C as appropriate after the name of each vessel listed above.] Page 1 of 1