AGENCY APPOINTMENT AGREEMENT PART I 1. Date of Agreement 2. Agent (full style and address) 3. Principal (full style and address) FONASBA Quality Standard Certification Yes No 4. Vessel 5. Port(s) of call Name: IMO number: 6. Estimated time of arrival 7. Purpose of call 8. Services (tick the to apply) (Clause 3) 9. Agent’s bank details Inward Clearance of Vessel Currency: Outward Clearance of Vessel Bank: Cargo Operations Address: Husbandry Account Number: Other (specify) Account Name: IBAN: BIC/SWIFT code: (See Annex A) 11. Funding (See Annex B) 12. Agent contact details 13. Principal contact details Resolution (Clause 18 BIMCO Dispute Resolution Clause state (a), (b), (c), or (d); if (c) agreed state Singapore or English law; if (d) agreed, governing law and place of arbitration must be stated) 15. Additional Clauses, if any It is mutually agreed that this Agreement be performed subject to the conditions contained herein consisting of Part I, Part II and Annexes A and B. In the event of a conflict of conditions, the provisions of Part I shall prevail over those of Part II and Annexes A and B to the extent of such conflict but no further. Signature and Company Stamp (Agent) Signature and Company Stamp (Principal) Definitions
AGENCY APPOINTMENT AGREEMENT PART I 1. Date of Agreement 2. Agent (full style and address) FONASBA Quality Standard Certification Yes No 3. Principal (full style and address) 4. Vessel Name: IMO number: 5. Port(s) of call 6. Estimated time of arrival 7. Purpose of call 8. Services (tick the to apply) (Clause 3) Inward Clearance of Vessel Outward Clearance of Vessel Cargo Operations Husbandry Other (specify) 9. Agent’s bank details Currency: Bank: Address: Account Number: Account Name: IBAN: BIC/SWIFT code: (See Annex A) 11. Funding (See Annex B) 12. Agent contact details 13. Principal contact details Resolution (Clause 18 BIMCO Dispute Resolution Clause state (a), (b), (c), or (d); if (c) agreed state Singapore or English law; if (d) agreed, governing law and place of arbitration must be stated) 15. Additional Clauses, if any It is mutually agreed that this Agreement be performed subject to the conditions contained herein consisting of Part I, Part II and Annexes A and B. In the event of a conflict of conditions, the provisions of Part I shall prevail over those of Part II and Annexes A and B to the extent of such conflict but no further. Signature and Company Stamp (Agent) Signature and Company Stamp (Principal) Definitions