The vessel agent for any vessel loading or unloading cargo shall file a berth application request form with the Operations and Security Manager at least seventy-two (72) hours prior to the arrival of the vessel.
In requesting application for berth, the vessel agent or barge owner assumes responsibility for all charges assessable against the vessel or barge and any additional charges resulting from services from the terminals where the vessel or barge is either working or at lay berth.
In making application for berth, the vessel agent indicates a desire to use port facilities under the jurisdiction of the Port of Pensacola and berth application request shall constitute consent to all the terms and conditions of any and all applicable tariffs to include payment of damages to the ports property caused by the owner, its agent, and employees.
Hazardous material accepted only with prior port management approval, and only if in compliance with applicable governmental regulations.
Chapter 376.071. Florida Statute provides that any vessel operating in state waters with a storage capacity to carry 10,000 gallons or more of pollutants as fuel and cargo shall maintain an adequate written ship-specific Spill Prevention and Control Contingency Plan. Violators are subject to fine as administered by the State of Florida.
| BARGE(s) NAME(s)/NUMBER(s): | _________________________________ |
| TUG NAME: | _________________________________ |
| BARGE LENGTH(s): | _________________________________ |
| MAXIMUM DRAFT: | _________________________________ |
| CARGO TONNAGE (MT): | _________________________________ |
| BERTH # DESIRED: | _________________________________ |
| TYPE OF BARGE: | __ OCEAN GOING __ RIVER __ LASH |
| DATE BARGE(s) WILL DOCK: |
_________________________________ | TIME: | _________________________________ | |
| LAST PORT: | _________________________________ | NEXT PORT: | _________________________________ |
|
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| APPROX TIME: | FROM | (DATE): | ______________ | TO | (DATE): | ______________ | ||||||||||||
| (HOURS): | ______________ |
__
A.M. |
(HOURS): | ______________ | __
A.M. __ P.M. |
|||||||||||||
| STEVEDORE: | __ YES __ NO |
| STEVEDORE NAME: | _________________________________ |
| MAILING ADDRESS: | _________________________________ |
| CITY: | _________________________________ |
| STATE: | ______________ ZIP: ______________ |
In accordance with USCG 33 CFR 105.270 (b) (2) advance notification of vessel stores or bunkers delivery is required.
__ STORES __ BUNKERS __ FRESHWATER __ DUMPSTER __ CREW CHANGE
The undersigned owner or authorized party agrees to furnish to the Port of Pensacola a full and complete statement with respect to cargo handled and such other information as may be required by tariff rules and regulations of the Port of Pensacola within the time prescribed by such rules. The undersigned owner or authorized party agrees to pay the amount of charges accepted thereon, forthwith, upon presentation or bill thereafter and to also pay for all damage to the Port of Pensacola property caused by such owner or authorized party and his or its agents and employees:
* I agree: (required)
__
| *NAME OF COMPANY: | _________________________________ |
| CONTACT PERSON : | _________________________________ |
| *BILLING ADDRESS: | _________________________________ |
| *PHONE #: | _________________________________ |
| * FAX #: | _________________________________ |
| *EMAIL ADDRESS: | _________________________________ |
- - - - - - - - - - - - - - - - Please Leave Blank – Port Will Complete - - - - - - - - - - - - - - - -
BERTH # ASSIGNED:________________________________________________
APPROVED DATE:_________ SIGNATURE OF PORT MEMBER:__________________
REASSINGED DATE:_____________ REASSIGNED BERTH #:_________________
MARSEC LEVEL AT TIME OF FILING:_____________________________________
Port Security Main Gate – Open 24/7
Phone Number: (850) 436-5075
Marine Radio Station – Channel 16